08/31/2024
Here is the OHCA Global Update that went out today regarding the incentive payments for SoonerCare/Managed Care clients - including Childrens Specialty Program.
(Update titled: 08/30/2024 SoonerSelect health and CSP supplemental payments)
https://oklahoma.gov/ohca/providers/updates/global-messages/global-messages.html
Here is the link as well to the provider types page to confirm if you are/arent eligible:
https://oklahoma.gov/content/dam/ok/en/okhca/docs/providers/types/Provider%20Types%20and%20Specialties%20List.pdf
Summary of the update:
Provider Type: 08, 09, 10, 11, 14, 31, 53, and 60
Beginning in September, eligible providers will begin receiving supplemental payments for services rendered to SoonerSelect health and SoonerSelect Children’s Specialty Plan members. These supplemental payments will be lump-sum enhancements to base fees paid by the SoonerSelect contracted entities.
Providers must meet the following criteria to be eligible for payment under this arrangement:
• In network with a contracted entity. Only in-network paid claims will be evaluated for enhancement. If you are not yet in-network but execute a contract in the contract year (prior to June 30, 2025), you will become eligible for the incentive program.
• The rendering provider must be an advanced practice nurse, mid-level practitioner, mental health provider or licensed behavioral health practitioner, podiatrist, physician, or anesthesiologist assistant.
• The billing provider cannot be: Eligible for a separate State Directed Payment program, including academic medical center-affiliated physicians and Community Mental Health Centers (CMHCs).
Clinics, including but not limited to public health clinics, FQHCs, RHCs, ITU clinics, and dental clinics.
A therapy (OT/PT/ST/RT) group.
The initial supplemental payment will be for SoonerSelect paid claims with dates of services between April and June 2024. You may only receive payment from one contracted entity, but all qualifying SoonerSelect paid claims will be enhanced. Subsequent supplemental payments will be made after the end of each quarter. The contracted entities, as directed by OHCA, will distribute these payments.
For additional information, please view the Provider Incentive Directed Payment Program guide.
