Feds Push Back On State’s 5-Year Residency Requirement For Medicaid Waivers
OKLAHOMA CITY — A federal official says Oklahoma is “not permitted” to carry out a new law that requires individuals with intellectual or developmental disabilities to live in the state for five years before they can apply for certain state-funded services through Medicaid.
In a letter sent last week, a Centers for Medicare and Medicaid Services official said the law is unconstitutional based on previous U.S. Supreme Court decisions that determined the 14th Amendment to the Constitution requires states to treat new residents the same as longtime residents.
Federal regulations also prohibit state Medicaid agencies from denying eligibility if a person has not lived in the state for a specified period of time, wrote Daniel Tsai, deputy CMS director and administrator.
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“Thus, imposition of a 5-year residency requirement for the receipt of HCBS (home and community-based services) waiver services is not permitted,” he wrote in a letter to the legal director of the National Health Law Program, which fights for health care access for low-income and underserved people.
The letter, provided to The Oklahoman by the Oklahoma Disability Law Center, addressed House Bill 2899 that passed the Oklahoma Legislature in May and took effect July 1.
The law sought to impose a five-year residency requirement to get on the state’s waiting list for in-home and community-based services provided to adults and children with disabilities.
“OKDHS received the letter from CMS to the National Health Law Program just this afternoon,” agency spokeswoman Casey White said in a statement last week. “We remain on course to find solutions to end the waiting list in Oklahoma. We encourage others to join us in that mission.”
White did not respond to a question about whether the state will drop the residency requirement.
Republican proponents of HB 2899 said the legislation was necessary because state leaders plan to make a concerted effort to eliminate Oklahoma’s 13-year waiting list for disability aid. Lawmakers expressed concerns that once the list was eliminated, people waiting years for services in other states would flock to Oklahoma for help.
The legislation caused an uproar among the state’s disability community this spring when disability advocates said HB 2899 was likely unconstitutional.
On June 1, the National Health Law Program, Oklahoma Disability Law Center, Legal Aid Services of Oklahoma, Oklahoma Policy Institute, The Arc of Oklahoma and The Arc of the United States requested CMS prohibit Oklahoma’s Medicaid agency from enforcing the residency requirement. Last week’s letter was in response to their request.
The state Department of Human Services has contracted with an Oklahoma company to conduct a review of the state’s developmental disabilities waiting list.
Earlier this month, Liberty of Oklahoma Corp. began case-by-case assessments of all the nearly 6,000 families on the waiting list. The company was hired to get a better picture of individual needs and determine what it would cost the state to eliminate the list entirely.
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