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