Provider update: June 18, 2020

To: All ADvantage Case Management and DME Providers

Subject: DME Update

Date: June 18, 2020

The Oklahoma Health Care Authority will delay the DME to Home Health project that was to be effective July 1, 2020. DME reimbursement will stay at the current rates. The agency is awaiting CMS review and approval for proposed changes and cannot move forward until the approval process is completed. OHCA continues to evaluate the proposed rates and any additional rate changes will be posted in accordance with the public notification process. The agency anticipates CMS approval by Sept. 30, 2020 and providers will be notified as soon as the new effective date is set.

Please see http://www.okhca.org/globals/ for the official notice from OHCA.

For now, case managers will continue to request DME as they always have.   ADvantage DME requests beginning 7/1/2020 or after that were previously not authorized by ADvantage have now been reviewed and authorized as appropriate.  If you find that a Member's DME service request was missed, please submit a Member-specific PQ in Harmony and the request will be processed. 

More information regarding process changes will be provided closer to the implementation date.  If you have other questions or concerns, please submit a PQ through Harmony. 

Thank you.

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