|
Spring 2017, Vol. 2
The 2017 legislative session ended Friday, May 26, with an approved budget. The Legislature first unveiled the FY 2018 budget the evening of May 23. Thanks to the advocacy of our providers and members as well as the diligence of lawmakers, the Oklahoma Health Care Authority (OHCA) was prioritized as a core function of state government.
State leadership appropriated just more than $1 billion for the agency’s state fiscal year (SFY) 2018 budget. Appropriations bills were sent to be signed by Gov. Fallin on May 26.
"We are grateful to legislative leadership for prioritizing SoonerCare in the state fiscal year 2018 budget,” said OHCA Chief Executive Officer Becky Pasternik-Ikard. “SoonerCare is vital to the hundreds of thousands of vulnerable Oklahomans who rely on the program for their health coverage needs.”
Even with the appropriated funding, the OHCA projects a nearly $34 million budget shortfall for SFY2018 due to rising costs and declining federal funds.
“Throughout this year's budget process, the Oklahoma Health Care Authority heard about the importance of maintaining the program's current service levels from members, providers and health care leaders,” Pasternik-Ikard said. “The OHCA will continue to monitor its financial obligations and work diligently to reduce any future impact of this situation on SoonerCare members and providers. We intend to protect the program's benefits and rates by drawing on all other financial resources to meet the budget gap. Reductions to benefits and provider rates will only be considered as a last resort."
OHCA SFY 2018 Budget
Back to top
Marshall settles in as new Government Relations director
Austin Marshall has joined the Oklahoma Health Care Authority (OHCA) as director of Government Relations.
As director of Government Relations, Marshall is responsible for interfacing with the Oklahoma State Legislature, governor’s office, congressional delegation, and the 39 federally-recognized tribes on behalf of the agency. He also monitors state and federal legislation affecting the agency and oversees the tribal consultation process on matters related to Medicaid. Read more here.
Austin replaces Emily Shipley who has accepted a position with the State Chamber of Oklahoma.
Back to top
|
2017 legislative session
OHCA request bills
OHCA had four request bills approved by the governor this session:
SB 773 directs the OHCA to issue a request for information (RFI) for care coordination models to serve children in state custody. The legislation directs the agency to collaborate with the Department of Human Services and the Department of Mental Health and Substance Abuse Services and submit findings to the Legislature and governor by January 1, 2018.
SB 819 modifies the agency’s homestead lien process. Currently, the agency may only file a lien for the amount of uncompensated care provided after a person has been in a long-term care facility for longer than one year. This bill allows OHCA to include the first year of uncompensated care in the lien amount and assign the liens to interested third parties.
SB 828 creates the Nursing Facility Supplemental Payment Program Revolving Fund. This fund will be used to increase Medicaid payments to the upper payment limit (UPL) for participating providers; the state portion will be funded by the intergovernmental transfer. In addition, a portion of the supplemental payment will be redistributed to the Oklahoma nursing home base rates for all Oklahoma nursing homes.
HB1579 permits OHCA to exchange state identification data (i.e., driver’s licensing verification) with the Department of Public Safety for the purposes of verifying SoonerCare eligibility.
OHCA impact bills
The following bills have a direct impact on the OHCA:
HB 1270 requires OHCA to overhaul its eligibility determination process and verify certain information prior to awarding assistance through SoonerCare. However, this measure duplicates several efforts currently performed by the agency and requires written notice to ineligible persons, a process currently achieved through electronic means. Preliminary estimates indicate this would cost $1.2 million in one-time expenses and ongoing monthly expenses of $50,000 to $75,000.
-
Status: Dormant until 2018 session
HB 2311 creates the Agency Performance and Accountability Commission to conduct performance audits of the state’s largest 15 agencies at least once every four years. The Commission would identify inefficiencies and recommend changes to address its concerns. If submitted, the OHCA would have one year to implement recommendations made by the Commission.
- The governor signed this measure on May 24.
HB 2316 permits the governor, speaker of the House and president pro tempore of the Senate to remove any of their appointees for any reason.
- Status: Dormant until 2018 session
Back to top
OHCA Chief Dental Officer Leon Bragg, D.D.S., will retire on July 13, 2017. Dr. Bragg became the OHCA’s first full-time dentist on Feb. 23, 2004.
In his position at OHCA, Dr. Bragg has helped develop program policy for dental care for SoonerCare members, established benefits standards for quality, and assisted with utilization review for the program. He has also served as a liaison between OHCA and its dental providers.
In addition to his role at OHCA, Dr. Bragg has been active in several local, state and national dental organizations. Most recently, Delta Dental of Oklahoma recognized Dr. Bragg for his service and leadership as president of the national Medicaid Medicare CHIP (Children's Health Insurance Program) Services Dental Association (MSDA). In June 2006, he was invited to fellowship in the American College of Dentists, a non-profit professional organization comprised of dentists who have demonstrated exceptional leadership and contributions to the profession and their community. Dr. Bragg has also served as president of the Board of Directors for Community Health Centers, Inc.
To learn more about the SoonerCare Dental program, click here.
Connect your patients to Soonercare Dental info: www.okhca.org/dental.
Back to top
|
 |
The Oklahoma Health Care Authority’s Focus Forward Oklahoma Program is partnering with the University of Oklahoma Health Sciences Center (OUHSC) to offer long-acting reversible contraceptive (LARC) trainings to providers who offer family planning services to females under the age of 19.
These workshops will cover:
- Patient-centered counseling techniques
- Billing and coding basics
- Hands-on intrauterine device (IUD) clinical instruction using state of the art simulators
- Manufacturer-provided implant training
LARC trainings will be held on select Fridays and Saturdays July - August 2017. There is no cost to attend. Continuing education applications are in progress, so there may be opportunities for trainees to receive continuing education credits.
For more information, please contact Mary Gowin at (405) 522-7391 or email focusforwardok@okhca.org.
Back to top
Contract renewals are underway for the following provider types:
- Outpatient Behavioral Health Angency
- Outpatient Behavioral Health Day Treatment
- Outpatient Behavioral Health Partial Hospitalization
- Paraprofessional
- Psychologist
- School-based Paraprofessional
- Schools - EPSDT
Contracts for these providers expire June 30, 2017. We encourage you to start the re-enrollment process as soon as possible through the secure OHCA Provider Portal.
Tell Us What You Want!
The OHCA would like to know what kind of training, if any, you need in regard to onsite enrollment and provider contracts.
If you have an interest or suggestions, please contact the Provider Enrollment department at ProviderEnrollment@okhca.org.
Back to top
Did you know?
Not sure if a child you’re caring for has had his or her blood lead screening test? Providers can check this and a patient’s additional treatment history on the secure OHCA Provider Portal.
Once logged in to the Portal, providers can find Treatment History under the Eligibility tab. Simply fill in the Member ID, date of service, and procedure type/code to search a patient’s treatment history.
*Note: Treatment history search results are claims paid to SoonerCare-contracted providers only.
Back to top
SoonerCare Choice Behavioral Health Screening and SBIRT Update
In 2014, the OHCA established a requirement and incentive for providing behavioral health screenings during physician visits. These actions were to support the integration of behavioral health into the physical health delivery system and to encourage early screening for behavioral health issues.
Upon implementation, OHCA provided onsite training to all contracted providers in the SoonerCare Choice (medical home) Program. This training included a review of the OHCA Behavioral Health Screening Toolkit, other available screening tools, and Screening Brief Intervention and Referral to Treatment (SBIRT) training opportunities. It also provided billing guidance and assistance in locating contracted behavioral health providers.
Today, phone and email support continue to be available, as well as additional SBIRT training through OHCA’s partnership with the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS).
In 2016, OHCA notified SoonerCare Choice providers of coding and billing changes to the Behavioral Health Screening. The agency made these changes to align with anticipated new codes and guideline revisions by the American Medical Association (AMA) for 2017.
Providers were advised to bill 96160 (Administration and interpretation of patient-focused health risk assessment) in place of 99420 (Administration and interpretation of health risk assessment) for providing the annual behavioral health screening. This was in addition to any other code billed for the visit.
As of March 2017, OHCA made 111,330 incentive payments for the behavioral health screening initiative and 1,423 payments for SBIRT interventions.
For more information about the SoonerCare Choice Behavioral Health Screening and/or SBIRT, please contact Crystal Hooper at crystal.hooper@okhca.org or Mary Dimery at mary.dimery@okhca.org.
Back to top
|
Behavioral Health Screening Tools
Part of the responsibilities of our SoonerCare Choice medical homes is to conduct annual behavioral health screenings for members age 5 and older, for all tiers.
OHCA has put together a Behavioral Health Screening Toolkit of available resources to help our providers accomplish this task, and it has been recently updated. Visit us online here to download your copy.
Two of the items included in the Toolkit are our very own pediatric and adult screeners for mental health and substance abuse. These screening forms are also available for download independent of the Toolkit.
Back to top
|
Each year, the Asthma and Allergy Foundation of America (AAFA) declares May to be "National Asthma and Allergy Awareness Month." It's a peak season for asthma and allergy sufferers, and a perfect time to educate your patients, family, friends, coworkers and others about these diseases.1 The Centers for Disease Control and Prevention (CDC) estimates nearly 10 percent of Oklahomans have a current diagnosis of asthma.2 Furthermore, the same study showed 52 Oklahomans died due to asthma-related mortality in 2015.2
In 2012, the National Asthma Education and Prevention Program Expert Panel updated their summary guidelines for the diagnosis and management of asthma. Click here for a quick reference summary. The complete systematic review and report are here.
In addition to the review and summary, AAFA has developed materials for health care professionals to teach patients ways to manage their asthma and allergies better. These resources are available in both English and Spanish on the AAFA's Programs webpage. Wee BreathersTM is their active learning educational program specifically designed to teach parents of young children about managing asthma.
A recent study by the Agency for Healthcare Research and Quality (AHRQ) noted that patient education interventions should be focused on self-monitoring and self-management. Interventions should include patients, parents and caregivers. They should also incorporate multiple strategies such as role-playing, videos and handouts.3 The CDC and the Environmental Protection Agency (EPA) have developed the following resources to assist providers and patients as they implement these strategies:
EHR Incentive attestations for program year 2017 are being accepted through March 31, 2018.
Program year 2017 is a 90-day reporting period. Only returning eligible professionals (EPs) and eligible hospitals (EHs) may participate.
For Modified Stage 2: EPs report on 10 objectives and measures; EHs report on nine objectives and measures.
For Stage 3 (optional): Both EPs and EHs report on eight objectives and measures.
If you have any questions or concerns regarding this program, please contact the EHR Incentive Team at EHRIncentive@okhca.org or by phone at 405-522-7347. You may also visit us online here.
Back to top
Now accepting larger nonprofits
There's good news for Oklahoma nonprofit organizations that previously may not have qualified for Insure Oklahoma. The program is now accepting nonprofits with 500 or fewer employees.
To qualify, the organizations must meet all other Insure Oklahoma criteria, such as offering a qualified health plan and being registered with the state of Oklahoma. Nonprofits that wish to apply may do so at www.insureoklahoma.org.
Back to top
|
Hop to it!
Help parents of young SoonerCare members properly prepare their kids for summer and/or back-to-school sports. Download our new sports physicals flyer.
We've made some changes!
Make sure you're current on our SoonerCare's tobacco cessation counseling requirements. Download our new 5As counseling form.
Back to top
OHCA Provider Helpline: 800-522-0114
|
