OK HB2797

Oklahoma Health Care Authority is prohibited from using extrapolation or statistical sampling methods to audit Medicaid home and community-based services claims submitted between January 27, 2020 and November 1, 2027, where such methods would require providers to repay amounts exceeding the actual audited claims

All prior audits using extrapolation methodology conducted under Oklahoma Administrative Code 317:30-3-2.1 for the period January 27, 2020 through November 1, 2025 are declared invalid, and any related payment demands or penalties are null and void

Oklahoma Health Care Authority and Department of Human Services must jointly develop a refined audit methodology for Home and Community Based Waiver claims, along with provider training materials on audit standards and claims submission guidelines, to be completed by November 1, 2027

Department of Human Services is designated as responsible for annual performance audits of community-based services through Home and Community-Based Medicaid Waivers, while OHCA retains responsibility for auditing claims to confirm service delivery per CMS requirements

Declared an emergency measure, taking effect immediately upon passage and approval