§56-1001. Short title.
This act shall be known and may be cited as the “Oklahoma Medicaid Program Integrity Act”. Added by Laws 1989, c. 220, § 1, operative July 1, 1989.
§56-1002. Definitions.
As used in the Oklahoma Medicaid Program Integrity Act: 1. “Authority” means the Oklahoma Health Care Authority; 2. “Attorney General” means the Attorney General of this state, his employees or his authorized representatives; 3. “Claim” means a communication, including written, electronic, or magnetic, which is utilized to identify a good, item, or service as reimbursable […]
§56-1003. Medicaid fraud control unit – Creation – Status – Power and authority – Attorney General’s Medicaid Fraud Revolving Fund.
A. There is hereby created within the Office of the Attorney General, a Medicaid fraud control unit. B. The Medicaid fraud control unit shall be the state entity to which all cases of suspected Medicaid fraud shall be referred by the Oklahoma Health Care Authority or its fiscal agents for the purposes of investigation, civil […]
§56-1004. Potential recipient’s authorization to examine records – Provider’s signed statement as to accuracy of reports, etc. – Maintenance of records – Access to records – Confidentiality of records and information – Disclosure – Liability.
A. No potential Medicaid recipient shall be eligible for medical assistance unless such recipient has, in writing, authorized the Oklahoma Health Care Authority and the Attorney General to examine all records maintained as required by the Oklahoma Medicaid Program by the recipient, or of those receiving or having received Medicaid benefits through the recipient, whether […]
§56-1005. Unlawful acts.
A. It shall be unlawful for any person to willfully and knowingly: 1. Make or cause to be made a claim, knowing the claim to be false, in whole or in part, by commission or omission; 2. Make or cause to be made a statement or representation for use in obtaining or seeking to obtain […]
§56-1005.1. Definitions – Fraudulent receipt of assistance.
A. As used in this section: 1. “Administrative sanction” means the court may enter an order making an individual who violates a provision of this section ineligible for assistance for a specified period of time. Such order shall be communicated to the Oklahoma Health Care Authority Legal Division; and 2. “Insure Oklahoma” means the program […]
§56-1005.2. Short title – Defunding Fetal-Body-Parts Trafficking Act.
This act shall be known and may be cited as the “Defunding Fetal-Body-Parts Trafficking Act”. Added by Laws 2018, c. 202, § 1, eff. Nov. 1, 2018.
§56-1005.3. Definitions.
For purposes of this act: 1. “Provider” means a provider of services for compensation; 2. “Affiliate” means an entity which licenses the use of a trademark or other recognized name to the provider, and which exercises control over the use of part or all of the provider’s name, or any entity so licensed or controlled; […]
§56-1005.4. Violations – Penalties – Investigation.
A. No provider shall be eligible for reimbursement through Medicaid or any other federal or state program or any other funding from any political subdivision of this state including but not limited to cities, towns, municipalities or counties, directly or by subcontract with any other party, if that provider, or any affiliate of that provider, […]
§56-1006. Medicaid fraud – Penalties.
A. Any person found to have committed any violation of paragraphs 1 through 6 of subsection A of Section 1005 of this title shall be deemed guilty of Medicaid fraud. B. 1. Any person committing Medicaid fraud where the aggregate amount of payments illegally claimed or received is Two Thousand Five Hundred Dollars ($2,500.00) or […]
§56-1007. Additional penalties.
A. Any person who receives payment for furnishing goods or services under the Oklahoma Medicaid Program, which the person is not entitled to receive by reason of offenses under paragraphs 1 through 6 of subsection A of Section 1005 of this title, shall, in addition to any other penalties provided by law, be liable for: […]
§56-1007.1. Short title – Defunding Statutory Rape Cover-up Act.
This act shall be known and may be cited as the “Defunding Statutory Rape Cover-up Act”. Added by Laws 2019, c. 239, § 1, eff. Nov. 1, 2019.
§56-1007.2. Definitions.
As used in the Defunding Statutory Rape Cover-up Act: 1. “Provider” shall mean a provider of services for compensation; and 2. “Affiliate” shall mean an entity which licenses the use of a trademark or other recognized name to the provider, and which exercises control over the use of part or all of the provider’s name, […]
§56-1007.3. Eligibility for Medicaid reimbursement – Failure to report statutory rape.
A. No provider shall be eligible for reimbursement through Medicaid or any other federal or state program, directly or by subcontract with any other party, if: 1. That provider, or any affiliate of that provider, has been found by a court of law, either civilly or criminally, to have failed to report statutory rape as […]
§56-1007.4. Promulgation of rules to investigate complaints.
The Oklahoma Health Care Authority shall promulgate rules to investigate complaints pursuant to the Defunding Statutory Rape Cover-up Act. Nothing in the Defunding Statutory Rape Cover-up Act shall preclude the Oklahoma Attorney General or any district attorney with jurisdiction from prosecuting violations of the Defunding Statutory Rape Cover-up Act. Added by Laws 2019, c. 239, […]
§56-1008. Annual report on Medicaid fraud.
The Attorney General shall submit an annual report, due by July 1 of each year, to the Speaker of the House of Representatives, the President Pro Tempore of the Senate, the Governor and the Secretary of State detailing the number of Medicaid fraud cases investigated and litigated and the amount of monies collected in the […]
§56-1009.1. Short title – Legislative findings.
A. Sections 1 and 2 of this act shall be known and may be cited as the “All Kids Act”. B. The Legislature finds that, for the economic and social benefit of all residents of the State of Oklahoma, it is important to enable all children of this state to access affordable health insurance that […]
§56-1009.2. Medical coverage for children 18 and under – Eligibility – Privately sponsored insurance – Partial coverage – Cost-sharing – Rules – Waivers – Funding.
A. On or before January 1, 2011, the Oklahoma Health Care Authority shall establish and maintain a program with a voucher and/or other subsidy to provide medical coverage assistance to children, eighteen (18) years of age or younger, whose family incomes are between one hundred eighty-five percent (185%) and three hundred percent (300%) of the […]
§56-1010.1. Oklahoma Medicaid Program Reform Act of 2003 – Coverage of certain children – Application for waivers – Revolving fund.
A. Section 1010.1 et seq. of this title shall be known and may be cited as the “Oklahoma Medicaid Program Reform Act of 2003”. B. Recognizing that many Oklahomans do not have health care benefits or health care coverage, that many small businesses cannot afford to provide health care benefits to their employees, and that, […]
§56-1010.12. Prescriptions for non-sedating antihistamines – Exemption from prior authorization procedures.
Subject to the provisions of subsection B of Section 204 of Title 56 of the Oklahoma Statutes, effective September 1, 1998, children age eighteen (18) or younger may be prescribed non-sedating antihistamines under the state Medicaid plan without prior authorization by the Medicaid Drug Utilization Review Board. Adults age nineteen (19) or older shall continue […]