Payment is made for targeted case management service as set forth in this Section.

1. (1) Adults. Payment is made for services to persons with an intellectual disability and/or related conditions as follows:

   1. (A) The target group for Developmental Disabilities Services Division Targeted Case Management (DDSDTCM) services are Medicaid eligible individuals:

      1. (i) served by the Home and Community Based Waivers operated by the Department of Human Services/Developmental Disabilities Services Division (DHS/DDSD); or

      2. (ii) residing in institutions who:

         1. (I) have requested Home and Community Based Waiver services operated by DHS/DDSD, and
         2. (II) receive targeted case management services during a transition period not to exceed 180 consecutive days immediately prior to entering the Waiver; or
      3. (iii) who are being assessed for admission to the Home and Community Based Waiver operated by DHS/DDSD.
   2. (B) Targeted case management services may be provided when the client, the client's family as appropriate, the client's legal representative and case manager have worked together to achieve a plan.
2. (2) Children. Services for children are the same as for adults.
3. (3) Individuals eligible for Part B of Medicare. Case Management Services provided to Medicare eligible recipients are filed directly with the fiscal agent.

Added at 14 Ok Reg 3704, eff 8-1-97 (emergency)

Added at 15 Ok Reg 1528, eff 5-11-98

Amended at 18 Ok Reg 968, eff 3-21-01 (emergency)

Amended at 19 Ok Reg 1067, eff 5-13-02

Amended at 29 Ok Reg 1076, eff 6-25-12