Okla. Admin. Code § 340:65-5-3

Current through Vol. 41, No. 19, June 17, 2024

Section 340:65-5-3 - Benefit suspension and resolution

(a) State Supplemental Payment (SSP) and SoonerCare (Medicaid) benefits may be suspended when the Social Security Administration (SSA) suspends the recipient's Supplemental Security Income (SSI) until the SSI benefit is reinstated or closed.

(b) Sooner Care (Medicaid) may be suspended when:

(1) SSA suspends the recipient's SSI until the SSI benefit is reinstated or closed;

(2) the recipient is incarcerated, for the duration of the incarceration period, per Oklahoma Administrative Code (OAC) 317:35-6-45; or

(3) the Oklahoma Health Care Authority initiates an administrative sanction until the sanction is removed, per OAC 317:35-13-7; or

(4) Form 08TA018E, Continued Medical Benefit Reply Form, is not received timely for households who are eligible for a continued medical benefit (CMB) following a Temporary Assistance for Needy Families benefit closure due to earnings. When the worker does not reinstate CMB by the suspension month's advance notice deadline, per OKDHS Appendix B-2, Deadlines for Case Actions, CMB automatically closes effective the next month, per OAC 340:10-3-75.

(c) Following suspension, when the recipient is determined:

(1) eligible, the worker reinstates the benefit effective the month the benefit was suspended;

(2) eligible for the month following the suspension month, the worker recertifies the benefit effective the next month; or

(3) ineligible for the benefit, the worker closes the benefit effective the next month.

Okla. Admin. Code § 340:65-5-3

Amended at 10 Ok Reg 4465, eff 8-5-93 (emergency); Amended at 11 Ok Reg 1687, eff 5-12-94; Amended at 18 Ok Reg 2096, eff 7-1-01; Amended at 26 Ok Reg 1272, eff 6-1-09; Amended at 28 Ok Reg 880, eff 6-1-11

Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/15/2022