Medicaid; requiring certain death record verifications; requiring certain denial or disenrollment of deceased individuals; prohibiting certain coverage or payments. Effective date.
Summary
SB 1380 amends Oklahoma Medicaid eligibility verification statutes to require more frequent and more detailed checks of applicant and enrollee information, with a particular focus on death record verification. The bill directs the Oklahoma Health Care Authority to verify eligibility information before approving coverage, including checking death records immediately prior to approval against the Social Security Administration’s Death Master File and the State Department of Health’s vital statistics system. It also requires monthly death-record verification for all Medicaid enrollees beginning no later than January 1, 2027, and requires prompt disenrollment when death is confirmed.
The bill further prohibits Medicaid coverage or payments on behalf of deceased individuals for services rendered after death and requires the Authority to recoup funds paid after death, to the extent allowed by law. It also updates the Authority’s ongoing eligibility review process by requiring monthly review of changes in circumstances, including income, residency, incarceration, lottery winnings, and participation in other public assistance programs. The bill authorizes the use of memoranda of understanding and independent vendors to obtain verification data, and requires vendor contracts to produce annual savings greater than their cost.
Impact
SB 1380 would amend 56 O.S. 2021, Sections 246 and 247, expanding the Oklahoma Health Care Authority’s duties for Medicaid eligibility screening and post-enrollment monitoring. It adds statutory requirements for death-record checks, disenrollment of deceased enrollees, denial of applications when death is confirmed, and recoupment of improper payments made after death. It also changes the review cadence from quarterly to monthly for certain eligibility-change reviews and adds a compliance review role for the State Auditor and Inspector. The bill affects Medicaid applicants, current enrollees, the Authority’s verification procedures, and any vendors or agencies used to supply eligibility data.
Sentiment
The bill appears to have broad support in the Legislature, passing the Senate 41-5 and advancing through House committees unanimously or near-unanimously. Committee votes in the Senate Health & Human Services Committee and the House Public Health and House Health and Human Services Oversight committees were strongly favorable, suggesting general agreement with the goal of improving Medicaid integrity and preventing improper payments. The overall tone reflected in the voting history is positive and procedural rather than contentious.
Contention
The main points of potential contention are the increased administrative burden and the expanded use of automated and third-party verification tools. The bill requires monthly death checks, additional data-sharing agreements, and independent vendor contracts, which could raise concerns about cost, implementation, and privacy. Another possible issue is the strict treatment of discrepancies: self-declarations are not accepted as verification, and failure to respond to notice can lead to discontinuance of assistance. While the votes suggest limited opposition, these provisions could be the focus of concern from advocates for beneficiaries and from administrators concerned about workload and due process.
Occupation certification; allowing for certain certifications; requiring certain registration; permitting certain participation; authorizing certain termination; prohibiting certain action. Effective date.