OK SPA 22-0007 Ambulance Service Provider Access Payment Program (ASPAPP)

The proposed Title XIX state plan amendment (SPA) will establish federal authority to create and enforce an Ambulance Service Provider Access Payment Program to promote access to quality emergency transports for Medicaid members in accordance with House Bill 2950 (HB 2950) mandates that OHCA. The program will assess a fee to privately owned ambulance service providers licensed in Oklahoma to supplement appropriations and support ambulance service provider reimbursement. The SPA will establish the program’s provider qualifications and exemptions the methodology used to determine the access payment by multiplying the paid Medicaid claims for each eligible provider by the Medicare equivalent of the average commercial rate (total amount of the average commercial payments for the claims divided by the total Medicare payments for the claims) minus the base payment. The annual assessment is calculated on an annual basis and paid out quarterly are within the applicable fee-for-service upper payment limits as defined in 42 CFR 447.272.

Please view the draft SPA pages here: OK SPA 22-0007 and submit feedback via the comment box below.

Tribal Consultation: 11/02/2021

60-day Tribal Consultation Period: 10/19/2021 – 12/18/2021

Circulation Date: 12/15/2021

Comment Due Date: 01/14/2022