How to start a hospice in Oklahoma

Oklahoma requires a Hospice license — first-year license, then permanent (annual) license from Oklahoma State Department of Health, Medical Facilities Service to operate a hospice. Fee: $2,000.

License required

Yes

License

Hospice license — first-year license, then permanent (annual) license

Issuing agency

Oklahoma State Department of Health, Medical Facilities Service

Fee

$2,000

Fee details

First-year license: $500 non-refundable application fee + $1,500 first-year license fee. Permanent license after the first year: $2,000. Change of ownership: new first-year application ($500 + $1,500) plus $2,000, plus $500 per alternate administrative office.

Renewal

Every year · $2,000 annual renewal of a permanent license; $50 late fee if filed within 30 days after expiration.

Survey and inspection

Initial inspection before services and follow-up inspection after 6 months; a compliant follow-up survey may be required before a permanent license.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

Oklahoma Hospice Licensing Act, 63 O.S. § 1-860.1 et seq.; OAC 310:661

1. File the Application for License to Operate a Hospice (ODH Form 924) at least 30 days before starting operations, with the $500 application fee and $1,500 first-year license fee
2. Pass the initial inspection before providing services
3. Pass a follow-up inspection after at least 6 months of services
4. Apply for a permanent license ($2,000) — a first-year license cannot be held more than 24 months
5. Renew the permanent license annually

Program

SoonerCare (Oklahoma Health Care Authority, OHCA), including SoonerSelect managed care

Enrollment portal

OHCA Provider Portal (ohcaprovider.com) — online provider contracting

Application fee

OAC 317:30-3-19.4 sets the fee at the CMS amount, adjusted for inflation, for provider types listed in OHCA's appendix. Individual physicians and non-physician practitioners are exempt, as are providers who already paid the fee to Medicare or another state's Medicaid/CHIP program. The fee is not refunded if screening leads to denial. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.

Fingerprinting

Under OAC 317:30-3-19.4, high-risk screening adds a fingerprint-based criminal background check of the provider and of anyone owning 5% or more. OHCA's enrollment sheet lists DME and home health as high-risk provider types and says providers enrolled with Medicare may be exempt. Limited- or moderate-risk providers move to high risk after a fraud-based payment suspension, an overpayment, or an exclusion.

Site visit

Moderate-risk screening includes pre- and post-enrollment site visits by OHCA Provider Enrollment staff. OHCA lists these moderate-risk types: ambulance services, behavioral health agencies and groups, individual behavioral health providers, hospice, independent diagnostic testing facilities, laboratories, and physical therapy groups and physical therapists. High-risk types also get site visits.

Revalidation

OHCA screens and enrolls providers and revalidates them periodically, as federal rules require. Existing providers handle this through 'renewal contracts' in the OHCA provider portal. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full Oklahoma Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (Long-term Care CON Act; Psychiatric and Chemical Dependency Facility CON Act)

Agency

Oklahoma State Department of Health, Health Facility Systems

Services covered

• long-term care facilities as defined in 63 O.S. §1-851.1 (licensed nursing facility beds)
• ICF/IID beds
• psychiatric or chemical dependency facilities, services or units in hospitals or related institutions
• acquisitions of covered health care facilities

Oklahoma certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

309 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

135 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

992,735 (as of Jun 1, 2026)

All Oklahoma Hospice Medicaid rates, ranked →