Native American Consultation Page

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The Oklahoma Health Care Authority (OHCA) seeks advice from Indian Health Services,tribal organizations and urban lndian clinics (I/T/U) in developing new or amended state plans, waiver amendments,or policy changes.

The Native American page is designed to notify Indian Health Services,tribal organizations and urban lndian clinics of any state plan, waiver, or proposed rule changes by providing an online tribal consultation forum.

This forum will provide I/T/U's an opportunity to review and make comments.

Please use the feedback forms below in the applicable  proposed change box to give feedback on the proposed policy change.

 

 

nacp 

Use the links below to make suggestions on rules not currently being considered for change.

 

        Proposed Policy 

 

 Circulated
Date
 

 Proposed Change Work Folder 

 Description of Change 

 Comment
Due Date
 

 OHCA Public Hearing/MAC/Board
Dates & Agendas
 
12/16/2014  APA WF # 14-02 

 Feedback Form 

 FQHC & RHC Encounter Limitation— Rules are revised to limit encounters within Federal Qualified Health Centers (FQHC) and Rural Health Clinic Services (RHC) to one encounter per member per day as well as limit encounters to a total of four visits per member per month for adults. These emergency revisions are necessary to reduce the Agency's operations budget in order to meet the balanced budget requirements as mandated by State law. Without the recommended revisions, the Agency is at risk of exhausting its State appropriated dollars required to maintain the State's Medicaid Program. 

01/15/2015  Public Hearing: 01/15/2015 

 MAC: 01/15/2015

 Board: 02/12/2015

 
12/16/2014  APA WF # 14-08 

  Feedback Form  

 Provider Policy for Payment of Glasses — Rules are amended to limit the number of payment for glasses to two per year. Any additional glasses beyond this limit must be prior authorized and determined to be medically necessary. These changes are needed in order to reduce the overall costs of the Medicaid program. 

01/15/2015

 Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014  APA WF # 14-09 

  Feedback Form  

 SoonerCare Choice Enrollment Ineligibility — SoonerCare Choice enrollment ineligibility rules are amended to include making individuals with other forms of creditable health insurance coverage ineligible for SoonerCare Choice; individuals in the former foster care eligibility group are also ineligible for SoonerCare Choice. Additionally, members who are currently enrolled in SoonerCare Choice who have or gain other forms of creditable insurance will be disenrolled from the program. Children who are known to be in OKDHS custody are now eligible to participate in SoonerCare Choice.  

01/15/2015

 Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014  APA WF # 14-12 

  Feedback Form  

 Elimination of Hospital Leave — Rules are revoked to eliminate payment for hospital leave to nursing facilities and ICF/IIDs. Hospital leave is planned or unplanned leave when the patient is admitted to a licensed hospital. These emergency revisions are necessary to reduce the Agency's operations budget in order to meet the balanced budget requirements as mandated by State law. Without the recommended revisions, the Agency is at risk of exhausting its State appropriated dollars required to maintain the State's Medicaid Program. 

01/15/2015

 Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015 

12/16/2014

 APA WF # 14-18  

  Feedback Form  

 State Plan Personal Care Services — Rules for the State Plan Personal Care services are amended to match current processes and procedures that are currently in place at OKDHS. Changes include policy clean up to remove unneccessary or redundant language regarding service settings and the criteria for persons eligible to serve as Personal Care Assistants. 

01/15/2015

 Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-24  

  Feedback Form   

 340B Drug Discount Program — Policy is added to outline special provisions and contracting requirements for providers participating in the 340B Drug Discount Program per federal regulation. 

01/15/2015  Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-26  

  Feedback Form  

 Nurse Aide Training The Agency's nurse aide training program rules are revised to specify that payment for training will be directly reimbursed to qualified nurse aides on a quarterly basis for every quarter the individual is employed in a nursing facility. Rules are also revised to establish a maximum rate for reimbursement for nurse aides who have paid for training and competency examination fees. 

01/15/2015  Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-27  

  Feedback Form  

 Private Duty Nursing services Private Duty Nursing (PDN) rules are revised to reflect an OHCA physician will be responsible for utilizing the acuity grid to help make a determination for medical necessity. The Care Management nurses' responsibility will be to gather, summarize, and present the individual cases to the physician. 

01/15/2015  Public Hearing: 01/15/2015 

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-29A   

  Feedback Form  

 Lock-in policy clean up — Policy is revised to clean up language regarding the pharmacy lock-in program. Current policy locks members in to one primary physician and/or on pharmacy. Policy is revised to allow members to be locked in to an approved prescriber rather than primary care physician and pharmacy.  

01/15/2015  Public Hearing: 01/15/2015 

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-29B  

  Feedback Form  

 Lock-in policy clean up — Policy is revised to clean up language regarding the pharmacy lock-in program. Current policy locks members in to one primary physician and/or on pharmacy. Policy is revised to allow members to be locked in to an approved prescriber rather than primary care physician and pharmacy. 

01/15/2015  Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-35  

  Feedback Form  

 DMEPOS Free Choice — Rules regarding SoonerCare member's freedom of choice to select their provider of durable medical equipment, prostethics, orthotics, and supplies (DMEPOS) are amended to state that providers must inform members of this right when filling or ordering DMEPOS. 

01/15/2015  Public Hearing: 01/15/2015 

 MAC: 01/15/2015

 Board: 02/12/2015

12/16/2014

 APA WF # 14-41  

  Feedback Form  

 Referrals for Specialty ServicesPolicy is revised to convey that electronic referrals will eliminate the need of paper referral documentation within members' medical records. 

01/15/2015  Public Hearing: 01/15/2015

 MAC: 01/15/2015

 Board: 02/12/2015

 

 

     Home and Community-Based Services (HCBS) Waivers 

 

Circulated
Date
  

Proposed
Changes
  

Description of
Change
  

OHCA Comment
Due Date
  

Proposed Submittal Date  

  

SoonerCare Choice (SC) Waivers  

 

Circulated
Date
 

Waiver Application/Amendment 

 Waiver Program 

OHCA Comment
Due Date
 

Proposed Submittal Date 

 

 State Plan Amendment (SPA) 

 

Circulated
Date
 

Proposed
Change
 

Description of Change 

OHCA Comment
Due Date
 

Proposed Submittal Date 

Disclaimer: Oklahoma Health Care Authority (OHCA) policy comment section will be reviewed and considered under the current change. Personal information should not be shared/or submitted in the comment section. This comment section is reserved for proposed rule changes.