Nursing facility UPL program to be resubmitted

Posted on: 1/10/18


The Oklahoma Health Care Authority (OHCA) will again ask the federal government to approve a Medicaid supplemental payment program for governmentally-owned nursing homes. CMS denied a similar, but less detailed, proposal by OHCA about six months ago.

Like Oklahoma hospitals’ SHOPP, this is an upper payment limit (UPL) program to improve Medicaid reimbursement. Oklahoma nursing facilities already have a provider assessment program, known as the Quality of Care Assessment, which increases SoonerCare nursing home payments. Unlike SHOPP, the proposed program is funded by the intergovernmental transfer (IGT) of public funds from a participating unit of local government to the state, for matching by CMS.

OHCA intends to satisfy all of the concerns that led CMS to deny the 2017 proposal. Initially, 20 nursing facilities operated by the cities of Pauls Valley, Hugo, Frederick and Vici will participate in the program. Other facilities operated by cities or counties may apply for future participation. CMS has ruled that Oklahoma public trust authorities do not qualify for inclusion.

Interested parties may review and comment on the proposed rule revisions by Jan. 17 on the OHCA website(Rick Snyder)

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