Provider update: December 4, 2020
To: Home Care Providers, Hospice Providers, Adult Day Health Providers, Assisted Living Providers, and Nursing Facility Respite Providers
Subject: Rate Adjustment for Direct Care Service Providers
Date: December 4, 2020
Earlier today, Oklahoma Human Services posted a News Release regarding a rate adjustment for Medicaid Waiver provider agencies that provide direct personal care services. The full content of that release is included below and may also be found at http://www.okdhs.org/sites/searchcenter/Pages/okdhsnewsreleaseresults.aspx.
In summary, OK Human Services will be providing a one-time, retroactive rate adjustment of 20% for direct care services that were provided from April 1, 2020 through September 30, 2020. To apply the rate adjustment, claims for this time period will be recycled by the Oklahoma Health Care Authority in February 2021. In order to receive maximum benefit of the rate adjustment, all claims for the provider types listed below, having dates of service during this six-month timeframe, should be successfully submitted prior to January 1, 2021.
Following are the services eligible for the one-time rate adjustment:
- Home Care Services
- G0299 Registered Nurse Skilled Nursing – Home Health Setting
- G0299 TF Registered Nurse Skilled Nursing – Extended State Plan
- G0300 Licensed Practical Nursing – Home Health Setting
- G0300 TF Licensed Practical Nursing – Extended State Plan
- T1019 Personal Care Services
- T1019 TF Advanced Supportive/Restorative
- T1005 In-home Respite (less than 8 hours)
- S9125 In-home Extended Respite (8+ hours)
- Adult Day Health Services
- S5100 U1 Adult Day Health
- S5105 Personal Care in Adult Day Health
- · Assisted Living Services
- T2031 Assisted Living Standard Tier
- T2031 TF Assisted Living Intermediate Tier
- T2031 TG Assisted Living High Tier
- S9126 Hospice Services
- 120 Nursing Facility Respite Services
Please see below for the full content of the News Release.
OKDHS announces retroactive rate adjustment for Medicaid Waiver providers
Oklahoma Human Services (OKDHS) is excited to announce a retroactive rate adjustment for Medicaid Waiver providers serving Oklahomans with developmental disabilities and low-income seniors. This one-time payment will aid providers with increased costs related to personal protective equipment (PPE) and unprecedented overtime directly related to serving during COVID-19.
“We value the sincere dedication of these provider communities,” said Justin Brown, OKDHS Director and Secretary of Human Services and Early Childhood Initiatives. “There is no greater measure of character and compassion than caring for people when they can’t care for themselves, including when the people being served are sick or recovering from COVID-19.”
“COVID-19 has reinforced the commitment of providers who serve people with developmental disabilities to be the 24/7 community system ensuring health and safety needs are met,” said Pat Ownbey, Executive Director of Oklahoma Community-Based Providers. “We are abundantly appreciative to the leadership of OKDHS for valuing services for our people, and providing relief and support so we may continue to stand and serve as this pandemic intensifies.”
Payments will be a one-time 20% retroactive rate adjustment for services rendered April 1, 2020 through Sep. 30, 2020, and will be issued in Feb. 2021 after all of the approval processes and public comment periods have been satisfied.
“We want to make this commitment today to our providers who serve as the community side of the long-term care industry, because they need assurance of our support as they prepare for the coming months,” said Samantha Galloway, OKDHS Chief of Staff and Operations.
Providers will not need to do anything to receive this payment other than have all of their billing complete and up-to-date for the applicable timeframe by Jan. 1, 2021. OKDHS’ partner agency, the Oklahoma Health Care Authority, will recycle claims and will make the lump sum payment on the agency’s behalf by the end of Feb. 2021.
“These are challenging times and knowing we have a true partnership in serving Oklahoma’s vulnerable seniors alongside OKDHS has been unprecedented,” said Lola Edwards, Home and Community-Based Services Council President.
Thank you for your service to ADvantage Members.