(Published in The Norman Transcript April 17, 2016, 1t) PUBLIC NOTICE Pursuant to C.F.R. § 447.205, the Oklahoma Health Care Authority (OHCA) is required to give public notice of any significant proposed change in methods and standards for setting payment rates for services in the SoonerCare program. Changes are requested as necessary to reduce the spending of the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) to balance the state budget in accordance with Article 10, Section 23, of the Oklahoma Constitution, which prohibits a state agency from spending more money than is allocated. The changes will be presented in two public hearings. These are the State Plan Amendment Rate Committee (SPARC) on April 25, 2016, at 10:00 a.m. and the OHCA Special Board meeting on April 28, 2016, at 1:00 p.m. Both meetings will be held at the OHCA offices located at 4345 N. Lincoln Blvd., OKC, OK 73105 in the OHCA Board Room. The proposed changes will be effective May 1, 2016. Freestanding Psychiatric Hospitals Rate Decrease The rates for inpatient hospital services provided in freestanding psychiatric hospitals and reimbursed using a prospective per diem methodology will be decreased by 3 percent from the rates that were in effect as of April 30, 2016. Estimated savings to ODMHSAS for SFY2016 is $57,249 Total; $22,333 State share. Estimated savings to ODMHSAS for SFY2017 is $343,501 Total; $134,000 State share. Additionally, the State provides clarification that the inpatient hospital provider rate cut of 7.75 percent promulgated in 2014 with an effective date of July 1, 2014, was applicable to inpatient DRG and freestanding rehabilitation hospitals only; the 2014 inpatient hospital provider rate cut of 7.75 percent did not affect freestanding psychiatric hospitals. Licensed Behavioral Health Professionals in Independent Practice Method Change New methodology will establish the basis for reimbursement of licensed behavioral health professionals in independent practice at an equivalent of no less than 70 percent of the rates for services rendered by these practitioners in an outpatient behavioral health clinic setting. This will be the equivalent of up to and including a 30 percent rate cut from the present payment structure. Estimated savings to ODMHSAS for SFY2016 is $889,005 Total; $346,801 State share. Estimated savings to ODMHSAS for SFY2017 is $5,334,045 Total; $2,080,811 State share. Independent Psychologists Rate Change The rates for services rendered by independent psychologists will be reduced to 86 percent of the CY 2013 Medicare Physician Fee Schedule which is equivalent of a 10 percent rate cut from the present structure. This will be the equivalent of a 10 percent rate cut from the present payment structure. Estimated savings to ODMHSAS for SFY2016 is $125,608 Total dollars; $49,000 State share. Estimated savings to ODMHSAS for SFY2017 is $751,089; $293,000 State share. Licensure Candidates Rate Decrease The rates for services rendered by Behavioral Health Licensure candidates in outpatient behavioral health clinics will be reduced by 10 percent. Estimated savings to ODMHSAS for SFY2016 is $1,377,641 Total; $537,418 State share. Estimated savings to ODMHSAS for SFY2017 is $8,265,862 Total; $3,224,513 State share. Psychiatric Residential Treatment Facilities Rate Decrease The rates for services will be reduced by 15 percent for affected facilities. Base rates for private in-state facilities with 17 beds or more will be Special Populations, $340.04; Standard, $286.08; and Extended, $271.61. The base rate for private, in-state facilities with 16 beds or less is a prospective per diem payment of $187.42. The base per diem rates for Private Psychiatric Hospitals and General Hospitals with Psychiatric Units based on a facility peer group will be Standard, $293.29; Specialty 1 Sexual Offender, $293.29; and Specialty 2 Eating Disorder, Traumatic Brain Injury, $367.42. Estimated savings to ODMHSAS for SFY2016 is $2,243,014 Total; $875,000 State share. The estimated savings to ODMHSAS for SFY2017 is $13,329,915 Total; $5,200,000 State share. Copies of the proposed changes are available for public review at the Oklahoma Health Care Authority by contacting Melinda Thomason at the Oklahoma Health Care Authority, 4345 N. Lincoln Blvd., Oklahoma City, Oklahoma, 73105, Telephone 405-522-7125. She will link callers with local agencies in each county where copies of the proposed changes are available for public review. Written and oral comments will be accepted during regular business hours by contacting Ms. Thomason as indicated. Comments so submitted will be available for review by the public Monday Friday, 9:00 a.m. to 4:30 p.m., at OHCA at the above address.
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