Okla. Stat. tit. 56, § 56-1011.9: Establishment of method to reduce payment error rate -

Reporting of errors.

A. 1. The Oklahoma Health Care Authority shall establish a

method to deter abuse and reduce errors in Medicaid billing,

payment, and eligibility through the use of technology and

accountability measures for the Authority, providers, and consumers.

The Authority shall achieve a payment error rate measurement of no

greater than five percent (5%) by fiscal year 2009. The Oklahoma

Health Care Authority shall evaluate and report findings to the

Governor and the Legislature.

2. For the purposes of this section, “error rate” means errors

based on clearly defined objective documentation standards that are

readily available to providers. Training to meet the standards

shall be provided on at least an annual basis by the Oklahoma Health

Care Authority.

B. 1. If errors are suspected to be the result of fraudulent

acts, the errors shall be reported and investigated by the Oklahoma

Attorney General.

2. Recoupment of overpayments due to identified errors

determined not to be fraudulent and shall occur only after the

provider has had the opportunity to exercise the right to an appeal

that shall include a hearing conducted by an administrative law

judge appointed by the Oklahoma Attorney General. The provider

shall have the right to participate in the hearing and to be

represented by legal counsel.

C. The Oklahoma Health Care Authority shall evaluate and report

findings concerning the limited use of the extrapolation method to

the Governor and the Legislature.