OHCA Increasing Provider Reimbursement Rates
Friday, August 31, 2018
Posted by: Tyler Lenz
For immediate release August 29, 2018
OHCA to increase provider reimbursement rates for first time since 2009
Program and administrative savings, record drug rebate collections fund rate increases
OKLAHOMA CITY – In collaboration with state and legislative leadership, the Oklahoma Health Care Authority (OHCA) will give the first across-the-board reimbursement rate increases since 2009 to long-term care and other SoonerCare (Oklahoma Medicaid) providers.
No new state dollars, carryover or other one-time funds will be used for the increases, which are planned to go into effect on Oct. 1.
Consistent with the legislative direction of Senate Bill 1605 that was signed into law in May 2018, OHCA will propose using program and administrative savings and record drug rebate collections to increase the provider rates by four percent for long-term care facilities and three percent for other certain contracted provider types or groups.
As also directed in the legislation, these rate increases will be in compliance with federal and state law and regulations, as well as state cost reimbursement methodologies.
“Increasing provider reimbursement rates has long been a priority to the Legislature and me,” said Governor Mary Fallin. “I commend the Oklahoma Health Care Authority for overcoming historical budgetary constraints and achieving this goal by efficiently managing precious agency resources. Restoring rates is a positive measure to foster continued partnership with providers, which benefits not only members, but our state as a whole.”
“As we strive to improve the health of our state, increasing reimbursement rates is a critical part of attaining that goal,” said Senator Kim David, chair of the Oklahoma Senate Appropriations Committee. “It’s also important to the economies of the towns and cities where these healthcare facilities are located. As we move forward, I think it is vital to target additional rate increases that are tied to better health outcomes.”
“My entire time in the State Senate, I have been concerned about health care, but especially rural health care,” said Sen. Roger Thompson, chair of the Oklahoma Senate Appropriations Subcommittee on Finance. “Rural health care has been challenged for the last few years. The increase in provider rates is a positive step forward, providing quality health care statewide. I commend the Health Care Authority for their diligent work in making this happen.”
“Increasing Oklahoma provider rates is a priority for the legislature and the Oklahoma Health Care Authority,” said Rep. Kevin Wallace, chair of the Oklahoma House Appropriations and Budget Committee. “I’m pleased that the legislature has been able to provide the funding along with the increased Federal Medical Assistance Percentages for this rate increase. As we continue to work together, I am confident we will build a better, healthier Oklahoma.”
“The OHCA shares a common intent with state and legislative leadership to increase provider rates. We recognize the importance of rates to sustaining our provider network and ensuring access for our members,” said OHCA CEO Becky Pasternik-Ikard. “State fiscal year 2018 reflects a multitude of efforts and hard work by leadership and the Health Care Authority. We appreciate being in the position to increase rates and are thankful our providers stayed with us through difficult budget years.”
A three percent rate increase will put SoonerCare physician rates at about 89.17 percent of the Medicare physician fee schedule. In addition to physician rates, the three percent increase will affect most provider types including hospitals and pharmacies.
The agency is moving forward with the required public notification process and will present the proposed increases for action at upcoming public meetings including the Sept. 10 State Plan Amendment Rate Committee and the Sept. 13 OHCA Board meeting.
The meetings will be held at the OHCA in the Charles (Ed) McFall Boardroom, 4345 N. Lincoln Blvd., Oklahoma City. Anyone interested in the SoonerCare program is encouraged to attend.
Additional information about these meetings, including agendas, will be posted at www.okhca.org/calendar as the information becomes available.
The Oklahoma Health Care Authority (OHCA) administers two health programs for the state. The first is SoonerCare, Oklahoma’s Medicaid program. SoonerCare works to improve the health of qualified Oklahomans by ensuring that medically necessary benefits and services are available. Qualifying Oklahomans include certain low-income children, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. The second program OHCA operates is Insure Oklahoma, which assists qualifying adults and small business employees in obtaining health care coverage for themselves and their families. Currently, there are 815,069 Oklahomans enrolled in OHCA’s programs. The agency contracts with a network of 47,073 providers. For more information, visit www.okhca.org or www.insureoklahoma.org.
Katelynn Burns, Sr. Public Information Representative
Office: (405) 522-7266 or cell: (405) 397-6757
Jo Stainsby, Director, Office of Public Information and Government Relations
Office: (405) 522-7474 or cell: (405) 365-6454