Okla. Admin. Code § 317:30-5-96.4

Current through Vol. 41, No. 19, June 17, 2024
Section 317:30-5-96.4 - Outlier intensity adjustment

Subject to approval by the Centers for Medicare and Medicaid Services (CMS), an outlier payment may be made to instate hospitals and PRTFs on a case by case basis, to promote access for those members who require expensive care. The intent of the outlier adjustment is to reflect the increased staffing requirements, co-morbidities and longer lengths of stay, for children with developmental disabilities or eating disorders. This adjustment is limited to 60 days annually.

Okla. Admin. Code § 317:30-5-96.4

Added at 23 Ok Reg 2508, eff 6-25-06; Amended at 27 Ok Reg 2737, eff 7-20-10 (emergency); Amended at 28 Ok Reg 1452, eff 6-25-11