Senate Bill No. 904 seeks to amend the reimbursement rate plan for nursing facilities under the Oklahoma Medicaid program, with a focus on improving resident outcomes and quality of life. The bill introduces a new incentive reimbursement rate plan that allocates $5.00 per patient day for quality assurance, which nursing facilities can earn based on their long-stay quality measures ratings. This funding will be derived from a $2.00 deduction from each facility's per diem rate, supplemented by $3.00 from the Oklahoma Health Care Authority. The bill establishes a tiered payment structure that rewards facilities with higher quality ratings and includes a staff retention initiative allowing facilities to earn up to $3.00 per Medicaid patient day for retaining nursing staff for at least twelve months.

Additionally, the bill mandates the Oklahoma Health Care Authority to audit the program for transparency and requires the electronic submission of an annual performance report on the incentive reimbursement plan. It deletes previous language regarding specific performance metrics and the establishment of an advisory group for quality measures, while inserting new criteria for payment qualifications based on long-stay quality measures ratings. The bill also amends staffing requirements for intermediate care facilities for individuals with intellectual disabilities, establishing a tiered staffing requirement based on Medicaid reimbursement rates and creating the Oklahoma Nursing Facility Funding Advisory Committee to develop a new methodology for calculating Medicaid reimbursements. The act is set to take effect on July 1, 2025, with an emergency clause for immediate implementation upon passage.