Current through Vol. 42, No. 1, September 16, 2024
Services are provided statewide by case management
providers established for the purpose of providing early intervention case
management services. Services must be made available to all eligible recipients
on a statewide basis, in a manner that ensures continuity of services, without
duplication and in compliance with federal and state mandates and regulations
related to servicing the targeted population in a uniform and consistent
manner.
(1)
Department of
Education criteria. OHCA will reimburse case managers who meet program
criteria set by the Oklahoma State Department of Education (OSDE), the
certification agency. Case manager qualifications are:
(A) Knowledge or community-based, facility
and institutional resources available to the target group and the experience to
link to said resources;
(B)
Experience in working in education, health or human service field;
(C) Administrative experience to meet state
and federal requirements as well as requirements set out by the certifying
agency;
(D) Ability to maintain
programmatic and financial records required by the certifying agency including
the capacity to document case records consistent with program standards and
state and federal requirements;
(E)
Graduation from an accredited college or university with a bachelor's degree in
education, social work, health-related field and one year of experience in one
of more of these fields;
(F)
Receipt of approved State Department of Education Training; and
(2)
Provider
agreement.
(A) A memorandum of
agreement between the Oklahoma Health Care Authority (OHCA) and the Oklahoma
State Department of Education (OSDE) for Medicaid reimbursement of early
intervention case management services must be in effect before reimbursement
can be made for compensable services. The agreement outlines the contractual
requirements for reimbursement.
(B)
Provision of case management services will not restrict an individual's free
choice of medical providers. Eligible case management providers must be
certified by the OSDE in keeping with certification standards referenced in
State Law Title 7O, Section 3- 104, Part 9 to ensure that the case managers for
the targeted group of recipients are capable of assisting the recipients in
receiving the full range of services they need. Recipients will have free
choice of providers of other medical care under the plan.
Added at 12 Ok Reg
751, eff 1-5-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3131, eff
7-27-95; Amended at 16 Ok Reg 1927, eff 6-11-99
