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1 STATE OF OKLAHOMA
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2 2nd Session of the 60th Legislature (2026)
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3 SENATE BILL 1380 By: Stewart
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6 AS INTRODUCED
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7 An Act relating to the state Medicaid program;
7 amending 56 O.S. 2021, Sections 246 and 247, which
8 relate to verification of Medicaid eligibility;
8 updating statutory language; requiring certain death
9 record verifications; requiring certain denial or
9 disenrollment of deceased individuals; prohibiting
10 certain coverage or payments on behalf of deceased
10 individuals; directing certain recoupment of funds;
11 requiring certain periodic reviews by the State
11 Auditor and Inspector; and providing an effective
12 date.
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15 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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16 SECTION 1. AMENDATORY 56 O.S. 2021, Section 246, is
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17 amended to read as follows:
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18 Section 246. A. This act shall be known and may be cited as
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19 the "Act to Restore Hope, Opportunity and Prosperity for Everyone"
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20 or the "HOPE Act".
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21 B. Prior to awarding assistance approving coverage under the
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22 state Medicaid program, the Oklahoma Health Care Authority shall
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23 verify eligibility information of each applicant, including death
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24 record verification conducted immediately prior to approval,
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Req. No. 3477 Page 1
1 excluding those applicants who would be eligible under the Tax
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2 Equity and Fiscal Responsibility Act of 1982 (TEFRA) and excluding
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3 those applicants with intellectual disabilities receiving Home and
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4 Community Based Medicaid waiver Medicaid home- and community-based
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5 services and state-funded services.
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6 C. The information verified by the Authority shall include, but
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7 is not limited to:
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8 1. Earned and unearned income;
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9 2. Employment status and changes in employment;
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10 3. Immigration status;
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11 4. Residency status, including a nationwide best-address source
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12 to verify individuals are residents of the state;
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13 5. Enrollment status in other state-administered public
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14 assistance programs;
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15 6. Financial resources;
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16 7. Incarceration status;
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17 8. Death records, which shall be verified through, at a
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18 minimum, the Social Security Administration's Death Master File and
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19 the State Department of Health's system of vital statistics;
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20 9. Enrollment status in public assistance programs outside of
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21 this state; and
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22 10. Potential identity fraud or identity theft.
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23 D. If the death of an applicant is confirmed prior to approval,
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24 the Authority shall deny the application and ensure that no Medicaid
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1 coverage or payments are authorized on behalf of the deceased
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2 individual.
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3 E. The Authority shall sign a memorandum of understanding with
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4 any department, agency or division for information detailed in
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5 subsection C of this section.
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6 E. F. The Authority shall contract with one or more independent
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7 vendors to provide information detailed in subsection C of this
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8 section. Any contract entered under this subsection shall establish
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9 annualized savings that exceed the contract's total annual cost to
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10 the state.
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11 F. G. Nothing in this section shall preclude the Authority from
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12 receiving, reviewing or verifying additional information related to
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13 eligibility not detailed in this section or from contracting with
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14 one or more independent vendors to provide additional information
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15 not detailed in this section.
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16 SECTION 2. AMENDATORY 56 O.S. 2021, Section 247, is
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17 amended to read as follows:
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18 Section 247. A. On a quarterly monthly basis, the Oklahoma
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19 Health Care Authority shall receive and review information
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20 concerning individuals enrolled in the state Medicaid program that
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21 indicates a change in circumstances that may affect eligibility,
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22 excluding those individuals who would be eligible under the Tax
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23 Equity and Fiscal Responsibility Act of 1982 (TEFRA) and excluding
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24 those individuals with intellectual disabilities receiving Home and
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1 Community Based Medicaid waiver Medicaid home- and community-based
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2 services and state-funded services.
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3 B. The information provided to the Authority shall include, but
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4 is not limited to:
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5 1. Earned and unearned income;
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6 2. Employment status and changes in employment;
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7 3. Residency status;
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8 4. Enrollment status in other state-administered public
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9 assistance programs;
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10 5. Financial resources;
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11 6. Incarceration status;
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12 7. Death records;
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13 8. Lottery winnings; and
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14 9. Enrollment status in public assistance programs outside of
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15 this state.
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16 C. 1. The Authority shall conduct monthly death record
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17 verification for all individuals enrolled in the state Medicaid
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18 program beginning no later than January 1, 2027. Such verification
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19 shall include, at a minimum, comparison against the Social Security
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20 Administration's Death Master File and the State Department of
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21 Health's system of vital statistics.
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22 2. Upon confirmation of death, the Authority shall disenroll
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23 the deceased enrollee from the state Medicaid program promptly.
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1 3. The Authority shall ensure that no Medicaid payments are
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2 made on behalf of a deceased enrollee for services rendered after
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3 the date of death.
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4 4. The Authority shall recoup any funds expended on behalf of a
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5 deceased enrollee for capitated payments or services occurring after
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6 the date of death, to the extent permitted under state and federal
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7 law.
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8 D. The Authority shall sign a memorandum of understanding with
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9 any department, agency or division for information detailed in
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10 subsection B of this section.
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11 D. E. The Authority shall contract with one or more independent
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12 vendors to provide information detailed in subsection B of this
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13 section. Any contract entered under this subsection shall establish
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14 annualized savings that exceed the contract's total annual cost to
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15 the state.
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16 E. F. The Authority shall explore joining any multistate
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17 cooperative to identify individuals who are also enrolled in public
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18 assistance programs outside of this state, including the National
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19 Accuracy Clearinghouse.
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20 F. G. Nothing in this section shall preclude the Authority from
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21 receiving or reviewing additional information related to eligibility
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22 not detailed in this section or from contracting with one or more
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23 independent vendors to provide additional information not detailed
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24 in this section.
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1 G. H. If the Authority receives information concerning an
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2 individual enrolled in the state Medicaid program that indicates a
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3 change in circumstances that may affect eligibility, the Authority
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4 shall review the individual's case using the following procedures:
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5 1. If the information does not result in the Authority finding
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6 a discrepancy or change in an individual's circumstances that may
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7 affect eligibility, the Authority shall take no further action;
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8 2. If the information results in the Authority finding a
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9 discrepancy or change in an individual's circumstances that may
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10 affect eligibility, the Authority shall promptly redetermine
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11 eligibility after receiving such information;
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12 3. If the information results in the Authority finding a
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13 discrepancy or change in an individual's circumstances that may
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14 affect eligibility, the individual shall be given an opportunity to
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15 explain the discrepancy; provided, however, that self-declarations
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16 by applicants or recipients shall not be accepted as verification;
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17 4. The Authority shall provide notice to the individual which
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18 shall describe in sufficient detail the circumstances of the
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19 discrepancy or change, the manner in which the applicant or
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20 recipient may respond, and the consequences of failing to take
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21 action. The applicant or recipient shall have ten (10) business
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22 days to respond in an attempt to resolve the discrepancy or change.
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23 The explanation provided by the recipient or applicant shall be
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24 given in writing. After receiving the explanation, the Authority
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1 may request additional documentation if it determines that there is
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2 risk of fraud, misrepresentation or inadequate documentation;
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3 5. If the individual does not respond to the notice, the
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4 Authority shall discontinue assistance for failure to cooperate, in
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5 which case the Authority shall provide notice of intent to
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6 discontinue assistance. Eligibility for assistance shall not be
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7 established or reestablished until the discrepancy or change has
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8 been resolved;
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9 6. If an individual responds to the notice and disagrees with
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10 the findings, the Authority shall reinvestigate the matter. If the
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11 Authority finds that there has been an error, the Authority shall
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12 take immediate action to correct it and no further action shall be
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13 taken. If, after an investigation, the Authority determines that
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14 there is no error, the Authority shall determine the effect on the
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15 individual's case and take appropriate action. Written notice of
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16 the Authority action shall be given to the individual; and
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17 7. If the individual agrees with the findings, the Authority
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18 shall determine the effect on the individual's case and take
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19 appropriate action. Written notice of the Authority action shall be
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20 given to the individual. In no case shall the Authority discontinue
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21 assistance upon finding a discrepancy or change in circumstances
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22 until the individual has been given notice of the discrepancy and
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23 the opportunity to respond as required under the HOPE Act.
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1 I. The State Auditor and Inspector shall conduct periodic
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2 reviews of the Oklahoma Health Care Authority to ensure compliance
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3 with the requirements of this section.
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4 SECTION 3. This act shall become effective November 1, 2026.
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6 60-2-3477 DC 12/30/2025 5:49:13 PM
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Req. No. 3477 Page 8Every fact on this page links to its source, starting with the official bill record.