Okla. Stat. tit. 56, § 56-1011.9
This is the official text of Okla. Stat. tit. 56, § 56-1011.9, part of Oklahoma’s Stat. tit. 56, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 56,." Browse the sections below, each linked to its official government source.
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Establishment of method to reduce payment error rate -
Official statutory text
Reporting of errors.
A. 1. The Oklahoma Health Care Authority shall establish a
method to deter abuse and reduce errors in Medicaid billing,
payment, and eligibility through the use of technology and
accountability measures for the Authority, providers, and consumers.
The Authority shall achieve a payment error rate measurement of no
greater than five percent (5%) by fiscal year 2009. The Oklahoma
Health Care Authority shall evaluate and report findings to the
Governor and the Legislature.
2. For the purposes of this section, “error rate” means errors
based on clearly defined objective documentation standards that are
readily available to providers. Training to meet the standards
shall be provided on at least an annual basis by the Oklahoma Health
Care Authority.
B. 1. If errors are suspected to be the result of fraudulent
acts, the errors shall be reported and investigated by the Oklahoma
Attorney General.
Oklahoma Statutes - Title 56. Poor Persons Page 236
2. Recoupment of overpayments due to identified errors
determined not to be fraudulent and shall occur only after the
provider has had the opportunity to exercise the right to an appeal
that shall include a hearing conducted by an administrative law
judge appointed by the Oklahoma Attorney General. The provider
shall have the right to participate in the hearing and to be
represented by legal counsel.
C. The Oklahoma Health Care Authority shall evaluate and report
findings concerning the limited use of the extrapolation method to
the Governor and the Legislature.
A. 1. The Oklahoma Health Care Authority shall establish a
method to deter abuse and reduce errors in Medicaid billing,
payment, and eligibility through the use of technology and
accountability measures for the Authority, providers, and consumers.
The Authority shall achieve a payment error rate measurement of no
greater than five percent (5%) by fiscal year 2009. The Oklahoma
Health Care Authority shall evaluate and report findings to the
Governor and the Legislature.
2. For the purposes of this section, “error rate” means errors
based on clearly defined objective documentation standards that are
readily available to providers. Training to meet the standards
shall be provided on at least an annual basis by the Oklahoma Health
Care Authority.
B. 1. If errors are suspected to be the result of fraudulent
acts, the errors shall be reported and investigated by the Oklahoma
Attorney General.
Oklahoma Statutes - Title 56. Poor Persons Page 236
2. Recoupment of overpayments due to identified errors
determined not to be fraudulent and shall occur only after the
provider has had the opportunity to exercise the right to an appeal
that shall include a hearing conducted by an administrative law
judge appointed by the Oklahoma Attorney General. The provider
shall have the right to participate in the hearing and to be
represented by legal counsel.
C. The Oklahoma Health Care Authority shall evaluate and report
findings concerning the limited use of the extrapolation method to
the Governor and the Legislature.
Status: in_force · Read it on the official government site
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