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1 STATE OF OKLAHOMA
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2 2nd Session of the 60th Legislature (2026)
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3 SENATE BILL 1807 By: Coleman
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6 AS INTRODUCED
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7 An Act relating to the state Medicaid program;
7 amending 56 O.S. 2021, Section 2002, as amended by
8 Section 1, Chapter 214, O.S.L. 2025 (56 O.S. Supp.
8 2025, Section 2002), which relates to the Nursing
9 Facilities Quality of Care Fee; conforming language;
9 clarifying certain definition; eliminating certain
10 reduced assessment rate; requiring certain uniform
10 assessment rate; updating statutory language; and
11 providing an effective date.
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14 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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15 SECTION 1. AMENDATORY 56 O.S. 2021, Section 2002, as
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16 amended by Section 1, Chapter 214, O.S.L. 2025 (56 O.S. Supp. 2025,
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17 Section 2002), is amended to read as follows:
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18 Section 2002. A. For the purpose of providing quality care
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19 enhancements, the Oklahoma Health Care Authority is authorized to
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20 and shall assess a Nursing Facilities Quality of Care Fee pursuant
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21 to this section upon each nursing facility licensed in this state.
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22 Facilities operated by the Oklahoma Department of Veterans Affairs
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23 shall be exempt from this fee. Quality of care enhancements
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1 include, but are not limited to, the purposes specified in this
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2 section.
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3 B. As a basis for determining the Nursing Facilities Quality of
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4 Care Fee assessed upon each licensed nursing facility, the Authority
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5 shall calculate a uniform per-patient day rate. The rate shall be
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6 calculated by dividing six percent (6%) of the total annual patient
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7 gross receipts of all licensed nursing facilities in this state by
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8 the total number of patient days for all licensed nursing facilities
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9 in this state. The result shall be the per-patient day rate.
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10 Beginning July 15, 2004, the Nursing Facilities Quality of Care Fee
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11 shall not be increased unless specifically authorized by the
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12 Legislature.
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13 C. Pursuant to any approved Medicaid waiver and pursuant to
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14 subsection N of this section, the Nursing Facilities Quality of Care
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15 Fee shall not exceed the amount or rate allowed by federal law for
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16 nursing home licensed bed days.
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17 D. The Nursing Facilities Quality of Care Fee owed by a
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18 licensed nursing facility shall be calculated by the Authority by
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19 adding the daily patient census of a licensed nursing facility, as
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20 reported by the facility for each day of the month, and by
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21 multiplying the ensuing figure by the per-patient day rate
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22 determined pursuant to the provisions of subsection B of this
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23 section.
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1 E. Each licensed nursing facility which is assessed the Nursing
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2 Facilities Quality of Care Fee shall be required to file a report on
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3 a monthly basis with the Authority detailing the daily patient
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4 census and patient gross receipts at such time and in such manner as
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5 required by the Authority.
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6 F. 1. The Nursing Facilities Quality of Care Fee for a
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7 licensed nursing facility for the period beginning October 1, 2000,
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8 shall be determined using the daily patient census and annual
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9 patient gross receipts figures reported to the Authority for the
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10 calendar year 1999 upon forms supplied by the Authority.
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11 2. Annually the Nursing Facilities Quality of Care Fee shall be
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12 determined by:
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13 a. using the daily patient census and patient gross
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14 receipts reports received by the Authority for the
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15 most recent available twelve (12) months, and
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16 b. annualizing those figures.
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17 Each year thereafter, the annualization of the Nursing
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18 Facilities Quality of Care Fee specified in this paragraph shall be
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19 subject to the limitation in subsection B of this section unless the
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20 provision of subsection C of this section is met.
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21 G. The payment of the Nursing Facilities Quality of Care Fee by
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22 licensed nursing facilities shall be an allowable cost for Medicaid
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23 reimbursement purposes.
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1 H. 1. There is hereby created in the State Treasury a
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2 revolving fund to be designated the "Nursing Facility Quality of
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3 Care Fund".
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4 2. The fund shall be a continuing fund, not subject to fiscal
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5 year limitations, and shall consist of:
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6 a. all monies received by the Authority pursuant to this
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7 section and otherwise specified or authorized by law,
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8 b. monies received by the Authority due to federal
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9 financial participation pursuant to Title XIX of the
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10 Social Security Act, and
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11 c. interest attributable to investment of money in the
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12 fund.
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13 3. All monies accruing to the credit of the fund are hereby
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14 appropriated and shall be budgeted and expended by the Authority
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15 for:
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16 a. reimbursement of the additional costs paid to
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17 Medicaid-certified nursing facilities for purposes
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18 specified by Sections 1-1925.2 and 5022.2 of Title 63
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19 of the Oklahoma Statutes,
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20 b. reimbursement of the Medicaid rate increases for
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21 intermediate care facilities for individuals with
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22 intellectual disabilities (ICFs/IID),
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23 c. nonemergency transportation services for Medicaid-
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24 eligible nursing home clients,
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1 d. eyeglass and denture services for Medicaid-eligible
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2 nursing home clients,
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3 e. fifteen ombudsmen employed by the Office of the
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4 Attorney General,
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5 f. ten additional nursing facility inspectors employed by
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6 the State Department of Health,
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7 g. pharmacy and other Medicaid services to qualified
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8 Medicare beneficiaries whose incomes are at or below
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9 one hundred percent (100%) of the federal poverty
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10 level; provided however, pharmacy benefits authorized
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11 for such qualified Medicare beneficiaries shall be
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12 suspended if the federal government subsequently
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13 extends pharmacy benefits to this population,
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14 h. costs incurred by the Authority in the administration
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15 of the provisions of this section and any programs
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16 created pursuant to this section,
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17 i. durable medical equipment and supplies services for
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18 Medicaid-eligible elderly adults, and
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19 j. personal needs allowance increases for residents of
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20 nursing homes and Intermediate Care Facilities for
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21 Individuals with Intellectual Disabilities
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22 intermediate care facilities for individuals with
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23 intellectual disabilities (ICFs/IID) from Thirty
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1 Dollars ($30.00) to Fifty Dollars ($50.00) per month
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2 per resident.
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3 4. Expenditures from the fund shall be made upon warrants
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4 issued by the State Treasurer against claims filed as prescribed by
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5 law with the Director of the Office of Management and Enterprise
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6 Services for approval and payment.
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7 5. The fund and the programs specified in this section funded
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8 by revenues collected from the Nursing Facilities Quality of Care
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9 Fee pursuant to this section are exempt from budgetary cuts,
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10 reductions, or eliminations.
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11 6. The Medicaid rate increases for intermediate care facilities
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12 for individuals with intellectual disabilities (ICFs/IID) shall not
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13 exceed the net Medicaid rate increase for nursing facilities
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14 including, but not limited to, the Medicaid rate increase for which
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15 Medicaid-certified nursing facilities are eligible due to the
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16 Nursing Facilities Quality of Care Fee less the portion of that
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17 increase attributable to treating the Nursing Facilities Quality of
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18 Care Fee as an allowable cost.
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19 7. The reimbursement rate for nursing facilities shall be made
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20 in accordance with Oklahoma's Medicaid reimbursement rate
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21 methodology and the provisions of this section.
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22 8. No nursing facility shall be guaranteed, expressly or
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23 otherwise, that any additional costs reimbursed to the facility will
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1 equal or exceed the amount of the Nursing Facilities Quality of Care
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2 Fee paid by the nursing facility.
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3 I. 1. In the event that federal financial participation
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4 pursuant to Title XIX of the Social Security Act is not available to
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5 the Oklahoma state Medicaid program, for purposes of matching
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6 expenditures from the Nursing Facility Quality of Care Fund at the
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7 approved federal medical assistance percentage for the applicable
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8 fiscal year, the Nursing Facilities Quality of Care Fee shall be
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9 null and void as of the date of the nonavailability of such federal
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10 funding, through and during any period of nonavailability.
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11 2. In the event of an invalidation of this section by any court
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12 of last resort under circumstances not covered in subsection J of
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13 this section, the Nursing Facilities Quality of Care Fee shall be
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14 null and void as of the effective date of that invalidation.
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15 3. In the event that the Nursing Facilities Quality of Care Fee
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16 is determined to be null and void for any of the reasons enumerated
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17 in this subsection, any Nursing Facilities Quality of Care Fee
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18 assessed and collected for any periods after such invalidation shall
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19 be returned in full within sixty (60) days by the Authority to the
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20 nursing facility from which it was collected.
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21 J. 1. If any provision of this section or the application
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22 thereof shall be adjudged to be invalid by any court of last resort,
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23 such judgment shall not affect, impair, or invalidate the provisions
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24 of the section, but shall be confined in its operation to the
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Req. No. 2454 Page 7
1 provision thereof directly involved in the controversy in which such
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2 judgment was rendered. The applicability of such provision to other
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3 persons or circumstances shall not be affected thereby.
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4 2. This subsection shall not apply to any judgment that affects
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5 the rate of the Nursing Facilities Quality of Care Fee, its
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6 applicability to all licensed nursing homes in the state, the usage
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7 of the fee for the purposes prescribed in this section, or the
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8 ability of the Authority to obtain full federal participation to
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9 match its expenditures of the proceeds of the fee.
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10 K. The Authority shall promulgate rules for the implementation
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11 and enforcement of the Nursing Facilities Quality of Care Fee
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12 established by this section.
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13 L. The Authority shall provide for administrative penalties in
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14 the event nursing facilities fail to:
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15 1. Submit the Nursing Facilities Quality of Care Fee;
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16 2. Submit the fee in a timely manner;
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17 3. Submit reports as required by this section; or
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18 4. Submit reports timely.
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19 M. As used in this section:
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20 1. "Nursing facility" means any home, establishment or
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21 institution, or any portion thereof, licensed by the State
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22 Department of Health as defined in Section 1-1902 of Title 63 of the
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23 Oklahoma Statutes and includes the nursing care component of a
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1 continuum of care facility as defined in Section 1-890.2 of Title 63
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2 of the Oklahoma Statutes;
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3 2. "Medicaid" means the medical assistance program established
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4 in Title XIX of the federal Social Security Act and administered in
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5 this state by the Authority;
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6 3. "Patient gross revenues" receipts" means gross revenues
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7 received in compensation for services provided to residents of
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8 nursing facilities including, but not limited to, client
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9 participation. The term "patient patient gross revenues" receipts
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10 shall not include amounts received by nursing facilities as
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11 charitable contributions; and
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12 4. "Additional costs paid to Medicaid-certified nursing
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13 facilities under Oklahoma's Medicaid reimbursement methodology"
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14 means both state and federal Medicaid expenditures including, but
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15 not limited to, funds in excess of the aggregate amounts that would
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16 otherwise have been paid to Medicaid-certified nursing facilities
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17 under the Medicaid reimbursement methodology which have been updated
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18 for inflationary, economic, and regulatory trends and which are in
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19 effect immediately prior to the inception of the Nursing Facilities
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20 Quality of Care Fee.
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21 N. 1. As per any approved federal Medicaid waiver Until the
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22 effective date of this act, the assessment rate subject to the
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23 provision of subsection C of this section is to remain the same as
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Req. No. 2454 Page 9
1 those rates that were in effect prior to January 1, 2012, for all
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2 state-licensed continuum of care facilities.
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3 2. Any facilities that made application to the State Department
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4 of Health to become a licensed continuum of care facility no later
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5 than January 1, 2012, shall be assessed at the same rate as those
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6 facilities assessed pursuant to paragraph 1 of this subsection;
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7 provided, that any facility making the application shall receive the
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8 license on or before September 1, 2012. Any facility that fails to
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9 receive such license from the State Department of Health by
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10 September 1, 2012, shall be assessed at the rate established by
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11 subsection C of this section subsequent to September 1, 2012 that
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12 were licensed by this state on or before September 1, 2012. Upon
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13 the effective date of this act, the assessment rate for those
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14 continuum of care facilities shall be increased to equal the
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15 assessment rate for all other facilities and thereafter the
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16 assessment rate for all facilities shall be uniform.
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17 O. If any provision of this section, or the application
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18 thereof, is determined by any controlling federal agency, or any
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19 court of last resort to prevent the state from obtaining federal
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20 financial participation in the state's state Medicaid program, such
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21 provision shall be deemed null and void as of the date of the
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22 nonavailability of such federal funding and through and during any
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23 period of nonavailability. All other provisions of the bill shall
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24 remain valid and enforceable.
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1 SECTION 2. This act shall become effective November 1, 2026.
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3 60-2-2454 DC 1/14/2026 9:26:10 PM
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Req. No. 2454 Page 11Every fact on this page links to its source, starting with the official bill record.