How SB 1380 changes current law

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill amends existing law to enhance verification processes of Medicaid eligibility, including death record checks, and implements measures to prevent coverage and payments for deceased individuals.

• 56 O.S. 2021, Section 246

  the information verified by the Authority shall include, but is not limited to: 8. Death records, which shall be verified through, at a minimum, the Social Security Administration’s Death Master File and the State Department of Health’s system of vital statistics; → 8. Death records, which shall be verified through, at a minimum, the Social Security Administration’s Death Master File and the State Department of Health’s system of vital statistics; prior to approval, excluding those applicants who would be eligible under the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) and excluding those applicants with intellectual disabilities receiving Home and Community Based Medicaid waiver Medicaid home- and community-based services and state-funded services.

  The bill now requires death record verification to be conducted immediately prior to approval of Medicaid assistance.

• 56 O.S. 2021, Section 246

  the Authority shall deny the application and ensure that no Medicaid coverage or payments are authorized on behalf of the deceased individual. → the Authority shall deny the application and ensure that no Medicaid coverage or payments are authorized on behalf of the deceased individual, indicating that no benefits should be provided posthumously.

  It clarifies that applications must be denied if an applicant is confirmed dead prior to approval.

• 56 O.S. 2021, Section 247

  On a quarterly monthly basis → On a monthly basis

  The frequency of reviews of individuals enrolled in Medicaid has been changed to monthly.

• 56 O.S. 2021, Section 247

  The Authority shall conduct monthly death record verification for all individuals enrolled in the state Medicaid program beginning no later than January 1, 2027. → The Authority shall conduct monthly death record verification for all individuals enrolled in the state Medicaid program beginning no later than January 1, 2027.

  Regular monthly death record verifications for Medicaid enrollees are mandated, starting on the specified date.

• 56 O.S. 2021, Section 247

  the Authority shall ensure that no Medicaid payments are made on behalf of a deceased enrollee for services rendered after the date of death. → the Authority shall ensure that no Medicaid payments are made on behalf of a deceased enrollee for services rendered after the date of death.

  It mandates that no payments can be made for Medicaid services provided after an enrollee's death.

• 56 O.S. 2021, Section 247

  The Authority shall recoup any funds expended on behalf of a deceased enrollee for capitated payments or services occurring after the date of death, to the extent permitted under state and federal law. → The Authority shall recoup any funds expended on behalf of a deceased enrollee for capitated payments or services occurring after the date of death, to the extent permitted under state and federal law.

  This provision requires the recoupment of funds for payments made after a member's death, subject to legal limitations.

• 56 O.S. 2021, Section 247

  the Authority shall explore joining any multistate cooperative to identify individuals who are also enrolled in public assistance programs outside of this state, including the National Accuracy Clearinghouse. → the Authority shall explore joining any multistate cooperative to identify individuals who are also enrolled in public assistance programs outside of this state, including the National Accuracy Clearinghouse, and provide further eligibility verification.

  The Authority is now tasked with investigating collaborative efforts to improve eligibility verification across state lines.

• 56 O.S. 2021, Section 247

  the Authority shall conduct periodic reviews of the Oklahoma Health Care Authority to ensure compliance with the requirements of this section. → The State Auditor and Inspector shall conduct periodic reviews of the Oklahoma Health Care Authority to ensure compliance with the requirements of this section.

  Shifts the responsibility for periodic reviews of Medicaid eligibility compliance to the State Auditor and Inspector.