Sallisaw and Sallisaw’s hospital have been informed that the plan to help finance the hospital and keep it financially afloat is being denied by the federal Centers for Medicare and Medicaid Services (CMS).
Tywanda M. Cox, chief of federal and state policy for the Oklahoma Health Care Authority (OHCA), said the CMS “has recommended disapproval of the plan because of an amendment by the state.” She did not explain what the amendment required.
Cox informed the City of Sallisaw that, “Based on this information, OHCA (Oklahoma Health Care Authority) is suspending the review of applications for participation in the program based on lack of federal authority to implement the program.”
Cox told KXMX this week that the CMS has 90 days to explain why the UPL program is to be disapproved, and the 90 days are up Aug. 14. She hopes to have more information available at that time.
“We have a lot of interest in this so we’ll get the information out as soon as we know something,” Cox said.
It is possible that the amended plan can be amended again to seek CMS approval Cox said, but that will take some time.
Hospitals and nursing homes around the state are seeking to get into the Upper Payment Limit program which provides additional federal money to both if hospitals oversee the nursing homes. In Sallisaw, the hospital, now Northeastern Health System, hoped to partner with nursing home facilities within 150 miles, a plan that would generate an expected $1 million and keep the hospital open.
It was explained at several city meetings that the program is designed to improve the level of healthcare provided by nursing homes to their patients, and is funded through Medicaid. It requires the city to become the owner of the license of participating nursing home facilities, while the current owners of the nursing homes become the managing partners.
The UPL required that the City of Sallisaw participate in the plan as the Non State Governmental Organization.
Sally Maxwell, Senior News Director
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