Okla. Admin. Code § 317:30-5-355.1

Current through Vol. 41, No. 19, June 17, 2024

Section 317:30-5-355.1 - RHC professional staff

(a) RHCs must either directly employ or contract the services of professional staff who is licensed or certified and in good standing in the state in which services are provided. Services must be within the scope of the professional's license or certification for which claims are submitted to OHCA or its designated agent.

(b) Professional staff contracted or employed by the RHC recognized by the OHCA for direct reimbursement are required to individually enroll with the OHCA and will be affiliated with the organization which contracts or employs them. Participating RHCs are required to submit a list of names upon request of all practitioners working within the RHC and a list of all individual OHCA provider numbers. Reimbursement for services rendered at or on behalf of the RHC is made to the organization. Practitioners eligible for direct reimbursement for providing services to a clinic patient outside of the clinic may bill with their individual assigned number if they are not compensated under agreement by the RHC.

(c) Other providers who are not eligible for direct reimbursement may be recognized by the OHCA for the provision and payment of RHC services to an RHC as long as they are licensed or certified in good standing and meet OHCA enrollment requirements.

Okla. Admin. Code § 317:30-5-355.1

Added at 13 Ok Reg 397, eff 11-14-95 (emergency) ; Added at 13 Ok Reg 1645, eff 5-27-96 ; Amended at 14 Ok Reg 3077, eff 7-1-97 (emergency) ; Amended at 15 Ok Reg 1528, eff 5-11-98 ; Amended at 16 Ok Reg 141, eff 10-14-98 (emergency) ; Amended at 16 Ok Reg 1429, eff 5-27-99 ; Amended at 24 Ok Reg 895, eff 5-11-07 ; Amended at 30 Ok Reg 1164, eff 7-1-13

Amended by Oklahoma Register, Volume 32, Issue 23, August 17, 2015, eff. 8/27/2015

Amended by Oklahoma Register, Volume 34, Issue 23, August 15, 2017, eff. 9/1/2017

Amended by Oklahoma Register, Volume 37, Issue 24, September 1, 2020, eff. 9/14/2020

Amended by Oklahoma Register, Volume 38, Issue 23, August 16, 2021, eff. 9/1/2021