Okla. Admin. Code § 317:30-5-359.2

Current through Vol. 42, No. 4, November 1, 2024

Section 317:30-5-359.2 - Reimbursement

(a)Provider-based clinics. Payments for provider-based clinics will be made for RHC "core" services based on an all-inclusive visit fee established by one of the following:

(1) An interim rate established by calculating a statewide average rate for RHCs in the state; and

(2) The statewide average rate will be updated annually by the increase in the Medicare Economic Index (MEI); or

(3) An Alternative Payment Methodology (APM) established by the RHC periodic rate notification from the Medicare Fiscal Intermediary. In order to receive this rate, the RHC must submit a copy of the periodic rate notification letter for its most recent full cost reporting year received from the fiscal intermediary to the state. The APM rate cannot be lower than mentioned above in (a)(1) or (a)(2).

(b)Independent clinics. Payments for independent clinics will be made for RHC "core" services based on an all-inclusive visit fee established by one of the following:

(1) An interim rate established by calculating a statewide average rate for RHCs in the state; and

(2) The statewide average rate will be updated annually by the increase in the MEI; or

(3) An APM established by the RHCs periodic rate notification from the Medicare Fiscal Intermediary. In order to receive this rate, the RHC must submit a copy of the periodic rate notification letter for its most recent full cost reporting year received from the fiscal intermediary to the state. The APM rate cannot be lower than mentioned above in (b)(1) or (b)(2).

Okla. Admin. Code § 317:30-5-359.2

Added at 13 Ok Reg 397, eff 11-14-95 (emergency); Added at 13 Ok Reg 1645, eff 5-27-96 ; Amended at 15 Ok Reg 1895, eff 3-17-98 (emergency); Amended at 16 Ok Reg 1429, eff 5-27-99 ; Amended at 30 Ok Reg 1164, eff 7-1-13

Amended by Oklahoma Register, Volume 37, Issue 24, September 1, 2020, eff. 9/14/2020