OHCA Board Approves Rate Increase for Private Duty Nurses and Dental Providers

Oklahoma City, OK – The Oklahoma Health Care Authority (OHCA) board voted to approve a twenty-five percent rate increase for private duty nurses (PDN), a five percent aggregate rate increase for pediatric dental providers, and a fourteen percent aggregate rate increase for adult dental providers during their September 21 board meeting.

OHCA’s mission statement expresses the importance of optimizing accessibility and quality of health care and improving health outcomes for Oklahomans.  However, OHCA has noted significant access challenges since implementing the adult dental benefit.

“We have heard from SoonerCare dental providers who suggest this issue is due to the SoonerCare reimbursement rate,” said Kevin Corbett, OHCA CEO and Secretary of Health and Mental Health. “We are revising the rates to attract more dentists to serve both adults and children. A strong network ultimately benefits SoonerCare members by improving their access to care.”

Currently, more than 1,000 general dentists are contracted with OHCA. Only 100 pediatric dentists are contracted.

“The most recent Oral Health Report Card evaluated Oklahoma’s oral health at a D-,” said Corbett. “Less than 50% of children ages 1-20, enrolled in Medicaid, received any preventive oral care, while 66% of third graders experienced tooth decay. A robust provider network is essential to improving oral health outcomes.”

OHCA contracts with five private duty nursing companies throughout Oklahoma while more than 450 children receive PDN services. Without this additional support, staffing shortages could result in adverse health and safety outcomes for the individuals served.

“Private Duty Nursing agencies have indicated to us they are experiencing challenges hiring nurses due to the rising market value of nurses,” explains Corbett.  “A rate increase for PDNs will have a positive impact on access to care as providers are able to meet increased labor costs.”

The rate increases are contingent upon approval by the Centers for Medicare and Medicaid Services (CMS).