SECTION 317:35-17-12. Certification for ADvantage program services

(a)   Application date. When the applicant is determined eligible for ADvantage, his/her certification is effective the date that medical and financial eligibility was determined. When eligibility or ineligibility for ADvantage program services is established, the worker updates the authorization and the computer-generated notice is mailed to the member and ADvantage Administration (AA).

(b)   Financial certification period The financial certification period is twelve (12) months.

(c)   Medical Certification period. The medical certification period is twelve (12) months. Redetermination of medical eligibility by an Oklahoma Department of Human Services (DHS) nurse is:

(1)   completed annually in coordination with the annual reauthorization of the member's patient-centered service plan.

(2)   completed when documentation is received that supports a reasonable expectation the member may not continue to meet medical eligibility criteria.

[Source: Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff 6-26-00; Amended at 21 Ok Reg 2252, eff 6-25-04; Amended at 25 Ok Reg 2710, eff 7-25-08; Amended at 26 Ok Reg 758, eff 4-1-09 (emergency); Amended at 27 Ok Reg 1507, eff 6-11-10; Amended at 29 Ok Reg 1172, eff 6-25-12; Amended at 35 Ok Reg 27, eff 11-1-17 (emergency); Amended at 35 Ok Reg 1479, eff 9-14-18]