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OHCA Policies and Rules

OHCA Policies and Rules Main Page

317:30-5-390. Home and Community-Based Services waivers for adults with an intellectual disability or certain adults with related conditions

[Revised 09-14-2020]

(a) Introduction to waiver services.  Each Home and Community-Based Services (HCBS) waiver that includes services for adults with an intellectual disability or certain adults with related conditions allows payment for home health care services as defined in the waiver approved by the Centers for Medicare and Medicaid Services.

(1) Home health care services are skilled nursing services provided to a member by a registered nurse (RN) or a licensed practical nurse (LPN) that include:

(A) Direct nursing care;

(B) Assessment and documentation of health changes;

(C) Documentation of significant observations;

(D) Maintenance of nursing plans of care;

(E) Medication administration;

(F) Training of the member's health care needs;

(G) Preventive and health care procedures; and

(H) Preparing, analyzing, and presenting nursing assessment information regarding the member.

(2) The first thirty-six (36) visits provided by the home health care agency are covered by the Oklahoma Medicaid State Plan.

(b) Eligible providers.  Skilled nursing services providers must enter into contractual agreements with the Oklahoma Health Care Authority (OHCA) to provide HCBS for adults with an intellectual disability or certain adults with related conditions.

(1) Individual providers must be currently licensed and in good standing in the state in which services are provided as a:

(A) RN; or

(B) LPN.

(2) Agency providers must:

(A) Have a current Medicaid HCBS home health care agency contract; or

(B) Be certified by the Oklahoma State Department of Health (OSDH) as a home health care agency.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.

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Oklahoma Health Care Authority

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Oklahoma City, OK 73105

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The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.