State pushes forward with Medicaid outsourcing

·3 min read

Jun. 24—Editor's note: This article has been updated to properly attribute statements from the Oklahoma Hospital Association.

After a contentious battle in the state Legislature last year, Oklahoma is moving forward with its plans to outsource its Medicaid program despite concerns from some who fear it will harm rural health outcomes.

Senate Bill 1337 allows Oklahoma to outsource services from SoonerSelect — the state's new managed care plan — to private medical insurers. Senate Bill 1396 brings federal dollars to the state to pay for the privatized plan, according to Norman Regional Health System.

Lawmakers set aside $164.1 million for Medicaid expansion this year. Oklahoma Gov. Kevin Stitt, who visited Norman Regional's Porter campus Thursday to tout the new legislation, claimed the shift will positively impact about 1 million people enrolled in the state's Medicaid program.

"For far too long, our leaders, we've been a little too complacent with mediocrity, and enough is enough," Stitt said. "When Medicaid expansion was put into our Constitution in the summer of 2020, I knew we needed to reassess how we deliver healthcare in our state. That's why I called for this new system — to make sure Oklahoma was getting the dollars from the federal government that we needed to provide the best care for the people of Oklahoma."

The measures both received bipartisan legislative support a year after lawmakers and the state's Supreme Court blocked Stitt's prior attempt to switch to a managed care system. The state Supreme Court ultimately ruled last year that Stitt couldn't move forward without legislative approval.

Those opposed to the managed care plan approved by legislators this year fear it could delay health care for rural residents.

Sen. Rob Standridge, R-Norman, was one of the 10 senators who voted against SB 1337.

He said Oklahoma's rural access will be "decimated" because it pushes the state "into a failing experiment."

Standridge, a pharmacist, runs two pharmacies that received a combined $3.4 million from 2017 to 2020, a Transcript investigation found.

"Like the actor that goes to the plastic surgeon hoping to come out like Tom Cruise, the Medicaid system in Oklahoma will look like Mickey Rourke when these companies are done," Standridge said in a statement Thursday. "As other states try to roll back some of these huge giveaways to insurance companies as it costs their states billions, insurance companies defraud their states by the billion."

Kevin Corbett, state secretary of health and mental health, said roughly 40 states, including all that have expanded Medicaid, have adopted similar managed care models.

When asked about concerns that costly procedures will be denied, Corbett said the Healthcare Authority "will remain accountable" by looking at authorizations, timeliness and denial rates.

"Those are all under our control. We are not ceding control to any of our partners, we are just using the opportunity to use the expertise for an opportunity that we currently do not have," he said.

He also said rural hospitals gave input to the state before Oklahoma rolled out the plan this year.

Oklahoma Hospital Association president Patti Davis said last year's proposed plan would have reduced care by 40% while promising to deliver better health outcomes.

"That math simply did not add up," she said in response to Transcript questions. "This year's plan includes no cuts to care and injects hundreds of millions of dollars into both urban and rural Oklahoma."

In a statement Thursday, the Hospital Association said the model will build on "the quality care Oklahomans are already delivering to Oklahomans, as well as provides a transformational opportunity to invest in health care, both rural and urban."