State Medicaid Agency Board Approves Medicaid Privatization
On Tuesday, a divided Oklahoma Health Care Authority (OHCA) board voted 5-4 to move forward on the agency's plan to contract with managed care organization (MCOs) to manage the state's Medicaid program for children and adults. Several provider groups spoke out against the move toward manged care during the public comment period, arguing that increased administrative costs for MCOs would lead to cuts in covered services and provider reimbursement rates. The contract awards are expected to be announced Friday afternoon and implementation is scheduled for October 1.
On Monday, OHCA CEO Kevin Corbett presented the agency's fiscal year 2022 appropriations request to the Senate Appropriations Subcommittee on Health and Human Services. On Tuesday, OHCA presented their appropriations request to the Oklahoma House Appropriations and Budget Committee. OHCA's $210 million increase is largely earmarked for Medicaid expansion, which was approved by voters last year.
Funding for the managed care transition has not yet been approved by the Legislature. Last May, Governor Stitt vetoed a funding mechanism that was intended to allow OHCA to expand its internal capacity for patient-centered care management to manage the Medicaid population. After his veto, Governor Stitt directed OHCA to pursue MCO contracts.
At the House A&B hearing, Chairman Marcus McEntire told Corbett, "I found this process, especially the RFP, to be very opaque, the most opaque transparent government I've ever seen. We've been told what you were going to do, you've presented the RFP to me and Speaker McCall,l and I so much appreciate that, but we had no input into the design of the program, and it's going to be really hard for you to get buy-in from this body without that."
Executive Order on Marketplace Enrollment
President Biden issued an executive order on Thursday to create special enrollment period for plans sold in the federal Healthcare.gov market from February 15 to May 15. The enrollment period will allow individuals in the 38 states including Oklahoma that use the federally facilitated marketplace to enroll in health care coverage. Read more.
MyHealth HIE Protest Bid Denied
The Oklahoma Purchasing Director denied a protest from MyHealth Access Network this week, stating that the Oklahoma State Health Information Exchange will move forward with its chosed HIE vendor, Orion. MyHealth filed a protest bid this month after OHCA announced last month that its lower-cost bid had been rejected in favor of Orion's. Read more.
Over 3,000 Bills Filed For Oklahoma's 2021 Legislative Session
The First Session of Oklahoma's 58th Legislature begins next week on February 1. Over 3,000 bills await legislators, setting a modern state record for pre-filed bills and joint resolutions. OKPCA has secured bills removing language referring to health center board members as public bodies for the purpose of the Open Meeting Act (SB 0105 and HB 1690) as well as bills removing barriers to health centers' provision of Medication Assisted Treatment (MAT) services (HB1071 and SB168).
Senate President Pro Tempore Greg Treat filed legislation this week (SB 1031) to extend Open Meeting Act exemptions that expired last November and says he wants to fast track the bill's passage.
Rep. Carol Bush has filed a harm reduction bill similar to the needle exchange bill that easily passed the House last year.
Legislators will grapple with COVID-19, redistricting, funding Medicaid expansion, the budget and more before adjourning by May 28.
Deadline to Submit Comments to OHCA on Managed Care is February 3
The Oklahoma Health Care Authority (OHCA) is seeking approval from the Centers for Medicare and Medicaid Services (CMS) for an 1115 waiver to transition the state's Medicaid program to managed care. The waiver also seeks to waive retroactive eligibility for most enrolled adults, with the exception of pregnant women and individuals enrolled in the Aged, Blind and Disabled (ABD) eligibility group. View the notice of public comment for more information.
HRSA Delays Implementation of 340B Insulin and EpiPen Pricing Rule
Yesterday afternoon, the Health Resources and Services Administration (HRSA) published a notice in the Federal Register officially delaying the effective date on the 340B pricing rule for community health centers. The effective date was originally January 22, but it has been delayed by 60 days—the maximum time allowed under the White House order "to give Department officials the opportunity for further review and consideration of new regulations.” The rule is viewed as likely to be rescinded within the next 60 days, but if it is not, it can be pushed back further again. Thank you to everyone who submitted comments on this rule and advocated for health centers!
CMS Rule Change Lets Physicians Prescribe Buprenorphine Without Waiver
New federal guidance announced on January 15 will allow most physicians to prescribe buprenorphine for opioid use disorder without a waiver. The move by the U.S. Department of Health and Human Services (HHS) eliminates the eight-hour “X-waiver” course physicians were required to complete by the Drug Enforcement Agency before prescribing buprenorphine treatment. Physician assistants, nurse practitioners and other approved advanced practice nurses will still need to obtain an X waiver before prescribing buprenorphine for the treatment of opioid use disorder. View more information.