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STATE OF OKLAHOMA
1st Session of the 60th Legislature (2025)
HOUSE BILL 1820 By: Newton
AS INTRODUCED
An Act relating to poor persons; amending 56 O.S.
2021, Sections 246 and 247, which relate to the Act
to Restore Hope, Opportunity, and Prosperity for
Everyone; removing language related to verifying
eligibility information; and providing an effective
date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 56 O.S. 2021, Section 246, is
amended to read as follows:
Section 246. A. This act shall be known and may be cited as
the "Act to Restore Hope, Opportunity and Prosperity for Everyone"
or the "HOPE Act".
B. Prior to awarding assistance under Medicaid, the Oklahoma
Health Care Authority shall verify eligibility information of each
applicant, excluding those applicants who would be eligible under
the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) and
excluding those applicants with intellectual disabilities receiving
Home and Community Based Medicaid waiver and state-funded services.
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C. The information verified by the Authority shall include, but
is not limited to:
1. Earned and unearned income;
2. Employment status and changes in employment;
3. Immigration status;
4. Residency status, including a nationwide best-address source
to verify individuals are residents of the state;
5. Enrollment status in other state-administered public
assistance programs;
6. Financial resources;
7. Incarceration status;
8. Death records;
9. Enrollment status in public assistance programs outside of
this state; and
10. Potential identity fraud or identity theft.
D. The Authority shall sign a memorandum of understanding with
any department, agency or division for information detailed in
subsection C of this section.
E. The Authority shall contract with one or more independent
vendors to provide information detailed in subsection C of this
section. Any contract entered under this subsection shall establish
annualized savings that exceed the contract's total annual cost to
the state.
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F. Nothing in this section shall preclude the Authority from
receiving, reviewing or verifying additional information related to
eligibility not detailed in this section or from contracting with
one or more independent vendors to provide additional information
not detailed in this section.
SECTION 2. AMENDATORY 56 O.S. 2021, Section 247, is
amended to read as follows:
Section 247. A. On a quarterly basis, the Oklahoma Health
Care Authority shall receive and review information concerning
individuals enrolled in Medicaid that indicates a change in
circumstances that may affect eligibility, excluding those
individuals who would be eligible under the Tax Equity and Fiscal
Responsibility Act of 1982 (TEFRA) and excluding those individuals
with intellectual disabilities receiving Home and Community Based
Medicaid waiver and state-funded services.
B. The information provided to the Authority shall include, but
is not limited to:
1. Earned and unearned income;
2. Employment status and changes in employment;
3. Residency status;
4. Enrollment status in other state-administered public
assistance programs;
5. Financial resources;
6. Incarceration status;
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7. Death records;
8. Lottery winnings; and
9. Enrollment status in public assistance programs outside of
this state.
C. The Authority shall sign a memorandum of understanding with
any department, agency or division for information detailed in
subsection B of this section.
D. The Authority shall contract with one or more independent
vendors to provide information detailed in subsection B of this
section. Any contract entered under this subsection shall establish
annualized savings that exceed the contract's total annual cost to
the state.
E. The Authority shall explore joining any multistate
cooperative to identify individuals who are also enrolled in public
assistance programs outside of this state, including the National
Accuracy Clearinghouse.
F. Nothing in this section shall preclude the Authority from
receiving or reviewing additional information related to eligibility
not detailed in this section or from contracting with one or more
independent vendors to provide additional information not detailed
in this section.
G. If the Authority receives information concerning an
individual enrolled in Medicaid that indicates a change in
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circumstances that may affect eligibility, the Authority shall
review the individual's case using the following procedures:
1. If the information does not result in the Authority finding
a discrepancy or change in an individual's circumstances that may
affect eligibility, the Authority shall take no further action;
2. If the information results in the Authority finding a
discrepancy or change in an individual's circumstances that may
affect eligibility, the Authority shall promptly redetermine
eligibility after receiving such information;
3. If the information results in the Authority finding a
discrepancy or change in an individual's circumstances that may
affect eligibility, the individual shall be given an opportunity to
explain the discrepancy; provided, however, that self-declarations
by applicants or recipients shall not be accepted as verification;
4. The Authority shall provide notice to the individual which
shall describe in sufficient detail the circumstances of the
discrepancy or change, the manner in which the applicant or
recipient may respond, and the consequences of failing to take
action. The applicant or recipient shall have ten (10) business
days to respond in an attempt to resolve the discrepancy or change.
The explanation provided by the recipient or applicant shall be
given in writing. After receiving the explanation, the Authority
may request additional documentation if it determines that there is
risk of fraud, misrepresentation or inadequate documentation;
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5. If the individual does not respond to the notice, the
Authority shall discontinue assistance for failure to cooperate, in
which case the Authority shall provide notice of intent to
discontinue assistance. Eligibility for assistance shall not be
established or reestablished until the discrepancy or change has
been resolved;
6. If an individual responds to the notice and disagrees with
the findings, the Authority shall reinvestigate the matter. If the
Authority finds that there has been an error, the Authority shall
take immediate action to correct it and no further action shall be
taken. If, after an investigation, the Authority determines that
there is no error, the Authority shall determine the effect on the
individual's case and take appropriate action. Written notice of
the Authority action shall be given to the individual; and
7. If the individual agrees with the findings, the Authority
shall determine the effect on the individual's case and take
appropriate action. Written notice of the Authority action shall be
given to the individual. In no case shall the Authority discontinue
assistance upon finding a discrepancy or change in circumstances
until the individual has been given notice of the discrepancy and
the opportunity to respond as required under the HOPE Act.
SECTION 3. This act shall become effective November 1, 2025.
60-1-11387 CMA 12/19/24