Senate and House Pass Managed Care "Guardrails" Bill
On Wednesday, the Oklahoma State Senate voted 38-9 to approve SB 131, a bill that imposes restrictions on managed care plans in Oklahoma's Medicaid program. On Thursday, the House followed suit, passing the bill 74-20. Governor Stitt has five days to act on the measure, which received veto-proof majorities in both houses.
The updated version of SB 131 does not prohibit the Oklahoma Health Care Authority (OHCA) from contracting with private managed care organizations (MCOs) as the earlier version did. Instead, the bill codifies many of the provisions in contracts between OHCA and managed care companies, providing additional legislative and judicial oversight. The bill would also require OHCA to acquire legislative approval before adding the Aged, Blind, and Disabled (ABD) population or other additional populations to managed care contracts.
Additionally, the bill requires MCOs to "contract to the extent possible and practicable with all essential community providers" including community health centers and encourages value-based contracting while establishing current fee schedules as payment floors.
Legislature Sends Budget to Governor Stitt
After a budget agreement was reached last week, the Legislature passed and sent a general appropriations bill and several instructional bills to Governor Stitt this week for his signature. HB 2900 was passed 38-9 in the Senate before being sent to the governor, who has until next Friday to act on the bill and the rest of the appropriations bills.
Health Information Exchange Bill Sent to Governor
SB 547, a bill regarding the Oklahoma State Health Information Network and Exchange (OKSHINE), was passed by the Senate this week 47-1 and is now on the Governor’s desk awaiting his signature. The bill also clarifies that providers participating in MyHealth will not be required to rebuild their infrastructure to connect through another entity. The Governor has until next Wednesday to sign SB 574.
340B Violation Letters Sent to Pharmaceutical Manufacturers
On May 17, 2021, HRSA's Acting Administrator sent letters to six
pharmaceutical manufacturers acknowledging their actions are a direct violation of the 340B statute. HRSA demands manufacturers comply with their 340B statutory obligations by shipping 340B covered drugs to covered entities through their contract pharmacy arrangements, crediting or refunding all covered entities for overcharges, and contacting all impacted covered entities and establishing mutually agreed upon refund arrangements. Manufacturers must also update HRSA on any plans to restart selling, without restriction, covered outpatient drugs at the 340B price to covered entities that dispense medications through contract pharmacies by June 1, 2021. If the manufacturers do not comply with HRSA's requests, they will be subject to the 340B Program Ceiling Price and Civil Monetary Penalties statute. They can receive a fine of up to $5,000 per instance of overcharging.