HH RCD: Oklahoma Transition to Cycle 5

Published 07/17/2026

As the Review Choice Demonstration (RCD) for home health agencies (HHA) in Oklahoma continues, the time for Cycle 5 is approaching.

If an HHA's full affirmation rate or claim approval rate is 90 percent or greater for the previous six-month period, the provider may choose one of the subsequent review options:

  • Choice 1: Start or continue participating in pre-claim review (PCR) for another cycle
  • Choice 3: Selective post-payment review of a statistically valid random sample (SVRS) of claims every six months for the remainder of the demonstration
  • Choice 4: Spot Check Review of five percent of claims every six months to ensure continued compliance

Note: If an HHA is eligible for a subsequent review option but does not make a selection during the selection period, the HHA will be placed in Choice 3.

If an HHA’s full affirmation rate is less than 90 percent for the previous six-month period, it may choose one of the initial review options:

  • Choice 1: Start or continue participating in PCR for another cycle
  • Choice 2: 100 percent post-payment review

Note: If an HHA is eligible for an initial review option, but does not make a selection during the selection period, the HHA will be placed in Choice 2.

For those options that are evaluated every six months, the claims or PCR requests reviewed during the cycle will determine the provider’s results. Providers will continue in their selected option during the calculation and selection period. The affirmation rate calculation period occurs during the month of June 2026, with result letters being sent to HHAs by the end of June 2026. The selection period for Cycle 5 will take place from July 1, 2026, through July 14, 2026. HHAs that do not make a selection during that time period will default to either Choice 2 or Choice 3 as noted earlier in this article.

Table 1. Transition Timeline.

 

Cycle 1

 Cycle 2

Cycle 3

Cycle 4

Cycle 5

Cycle 6

Cycle 7

Cycle 8

Cycle 9
Cycle Start

12/01/23

08/01/24

04/01/25

12/01/25

08/01/26

04/01/27

12/01/27

08/01/28

04/01/29
Cycle End

05/31/24

01/31/25

09/30/25

05/31/26

01/31/27

09/30/27

05/31/28

01/31/29

05/31/29
Results Posted

06/30/24

02/28/25

10/31/25

06/30/26

02/28/27

10/31/27

06/30/28

02/28/29

 
Selection Start

07/01/24

03/01/25

11/01/25

07/01/26

03/01/27

11/01/27

07/01/28

03/01/29

 
Selection End

07/14/24

03/16/25

11/16/25

07/14/26

03/14/27

11/14/27

07/14/28

03/14/29

 

As providers transition from Cycle 4 to Cycle 5, please be advised of the actions required when changing from one choice to another.

Important Notes:

  • Any claim with a date of service on or after 12/01/2023 is subject to the RCD program in Oklahoma.
  • If your selection changes, remember that the date of submission determines which RCD selection applies to your claims, not the dates of service.
Table 2.
If Your Cycle 4 Choice was: And Your Cycle 5 Choice is: Here are the actions you will need to take:
Choice 1: PCR Choice 1: PCR
  1. Continue PCR process. Data from June and July will be included in the Cycle 5 results.

Choice 1: PCR

Choice 2: Post-Payment Review

  1. Continue to submit PCR requests through 7/31/2026. Data from June and July will be included in the Cycle 5 results.

    1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed).
    2. Respond to ADRs as generated

  2. As of 8/1/2026, submit final claim.

    1. Final bill will adjust, and the ADR will generate
    2. Respond to ADR

Choice 1: PCR

Choice 3: Selective Post-Payment Review

  1. Continue to submit PCR requests through 7/31/2026. Data from June and July will be included in the Cycle 5 results.

    1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed).
    2. Respond to ADRs as generated

  2. As of 8/01/2026, submit final claim for payment.

    1. Final bill will be adjusted, and the ADR will generate
    2. Respond to ADR

Choice 1: PCR

Choice 4: Spot Check

  1. Continue to submit PCR requests through 7/31/2026. Data from June and July will be included in the Cycle 5 results.

    1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed).
    2. Respond to ADRs as generated

  2. As of 8/1/2026, submit final claim.

    1. ADR will generate
    2. Respond to ADR

Choice 2: Post-Payment Review

Choice 1: PCR

  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

  2. Begin submitting PCR requests on 8/1/2026 for any claim that will be submitted on or after 8/1/2026 with a date of service on or after 12/01/2023.

    1. Add UTN to claims with PCR requests.

Choice 2: Post-Payment Review

Choice 2: Post-Payment Review

  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

Choice 2: Post-Payment Review

Choice 3: Selective Post-Payment Review

  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

Choice 2: Post-Payment Review

Choice 4: Spot Check

  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

Choice 4: Spot Check

Choice 1: PCR

  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

  2. Begin submitting PCR requests on 8/1/2026 for any claim that will be submitted on or after 8/1/2026 with a date of service on or after 12/1/2023.

    1. Add UTN to claims for claims with PCR requests

Choice 4: Spot Check

Choice 2: Post-Payment Review
  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

Choice 4: Spot Check

Choice 3: Selective Post-Payment Review
  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

Choice 4: Spot Check

Choice 4: Spot Check
  1. Continue to respond to ADRs. Data from June and July will be included in the Cycle 5 results.

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