(Published in The Norman Transcript March 19, 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 its methods and standards for setting payment rates for services. Changes are necessary to reduce the specified Agency's operations to balance the state budget in accordance with Article 10, Section 23, of the Oklahoma Constitution and to ensure that rules conform with practice. The changes will be presented in two public hearings. These are the State Plan Amendment Rate Committee (SPARC) on March 22, 2016, at 10:00 a.m. and the OHCA Board meeting on March 24, 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. Hospital Potentially Preventable Readmission Rate Decrease The OHCA will set a target rate for Potentially Preventable Hospital Readmissions as follows: • The target rate will be set to 102% for CY 2015 data and decreasing 1% per year until the target is 100% (101% for CY 2016 data, 100% for CY 2017 data and beyond). A target of 102% means OHCA would allow a hospital to have 102% of the potentially-preventable admissions that would be expected (100%) based on statewide data (for all hospitals) before assessing a penalty. The penalties assessed for the Hospital PPR program are expected to result in a state fiscal year 2016 budget savings of approximately $1,571,145 total dollars, $612,904 state share. Diagnosis-Related Group (DRG) Transfer Outlier Payments Method Change The OHCA will change transfer methodology policy to reflect current practice as follows: Transfers pay the lesser of transfer fee or Diagnosis-Related Group (DRG). In the case of a transfer, the Transfer Allowable Fee for the Transferring Facility shall be calculated as follows: Transfer Allowable Fee = (MS-DRG Allowable Fee/Mean Length of Stay) X (Length of Stay + 1 day). The total Transfer Allowable Fee paid to the transferring facility shall be capped at the amount of the MS-DRG Allowable Fee for a non-transfer case. Outlier payments will be paid to the transferring hospital, if applicable. Payment to the receiving facility, if it is also the discharging facility, will be at the DRG allowable plus outlier if applicable. No budget impact will result from this change in methodology as the action simply aligns the policy with the current practice. Eyeglass Materials Method Change The OHCA will set a flat rate for eyeglass materials as follows: • V2020 = Eyeglass frame = $10.00 per frame • V2100-V2114 and V2200-V2214 lens = $13.98 per lens The proposed budget impact for this change for SFY2017 is an annual total cost savings of $3,945,960, with a state share of $1,539,318. 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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