Physician rate increases are approved for state's hospitals

Stillwater- The Oklahoma Health Care Authority (OHCA) Board voted today to increase the Oklahoma Medicaid physician fee schedule to 100 percent of the Medicare rate effective August 1.

Meeting at the Meridian Technology Center in Stillwater, the board heard a recommendation from the Committee on Rates and Standards to increase the rate for services provided to children and adults in the state's Medicaid program.

The OHCA had been directed in a May 19 order from Judge Claire Eagan of the United States District Court for the Northern District of Oklahoma to increase rates in order to insure prompt access to health care for Medicaid children. House Bill 1088 provided $25 million in funding to the agency to increase provider reimbursement for Medicaid services and Medicare co-insurance and deductible payments for state fiscal year 2006. An estimated 8,700 providers will be affected by the rate increase.

In other action, the board voted to remove the marriage penalty from the Medicaid eligibility rules so that some adults in low income two parent households may qualify for Medicaid. Under the current rules, in a household where both parents are present and neither is disabled, neither parent is eligible for Medicaid regardless of their income unless one parent leaves the family. The revised rule will eliminate the marriage penalty and extend health care coverage to the parents of Medicaid eligible children when the total household income is under 35 percent of the Federal Poverty Level. For a family of three, that equates to $471 per month. Officials estimate as many as 27,000 adult Oklahomans could receive coverage under the rule change.

Agency staff estimated an annual total cost of $3.6 million with a state share of approximately $1 million. The rule change will become effective when it is signed by the Governor or Sept. 1, whichever is later.

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