MM Curator summary
OK lawmakers have moved forward with efforts to make to violations of MCO contracts a violation of state law.
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The Oklahoma Senate on Wednesday overwhelmingly approved a bill to add legislative oversight and legal guardrails to Gov. Kevin Stitt’s plan to outsource care for most Medicaid recipients.
The passage of an updated version of Senate Bill 131 gives opponents of third-party managed care a victory, but perhaps not the victory they wanted.
The latest version of the bill did not include House-approved language that sought to undo Stitt’s plan entirely by requiring the Oklahoma Health Care Authority to better manage Medicaid care in-house, as opposed to relying on four health insurance giants.
Senate Pro Tem Greg Treat, R-Oklahoma City, called the latest version of SB 131, crafted by Sen. Greg McCortney, R-Ada, a good compromise that left people on both sides of the managed care debate dissatisfied.
Treat, who voted in favor of SB 131, characterized the decision as a choice between letting the governor’s plan for privatized managed care move forward as is or putting into law some checks on the program, including the possibility for legislative involvement at a later point.
House version would have created ‘massive bureaucracy,’ senate leader says
The version passed by the House that would have required the Health Care Authority to do in-house managed care, at a cost of $263 million annually, was a nonstarter, he said.
“When Senate Bill 131 came across the rotunda, it was going to eviscerate the current model that the governor and the Health Care Authority put into place and create a massive bureaucracy at the Health Care Authority,” Treat said.
The most recent version of SB 131 puts into state law much of what the four health insurance companies agreed to through contracts with the Health Care Authority, which oversees the state’s Medicaid program.
The bill would also require the agency to seek legislative approval before expanding the contracts to include more Medicaid recipients. Initially, care for the aged, blind and disabled Medicaid population will remain with the Health Care Authority due to the high costs of care for that group of Medicaid recipients.
A framework is better than nothing, said Rep. Marcus McEntire, who sought to derail the governor’s Medicaid plan, dubbed SoonerSelect.
Now under SB 131, if a managed care company breaks its contractual obligation to the state, the company will be breaking state law as well, said McEntire, R-Duncan.
“It’s very disappointing, but it is what it is,” he said. “Sometimes, the chess board is set up before you even get to play.
“We worked too hard this year not to at least get some type of regulatory framework around (third-party managed care).”
Some opposition from supporters of governor’s plan
Senate Majority Floor Kim David, R-Porter, opposed SB 131. A longtime supporter of privatized managed care, David stood beside the governor as he announced his SoonerSelect plan earlier this year.
On the Senate floor Wednesday, David argued private companies can provide better care management than the government.
Calling McCortney’s version of SB 131 “the best of the worst” managed care proposals she’d seen, David insinuated opponents of privatized Medicaid were more concerned about making sure health care providers get paid than improving care for patients.
“I’ve always believed it’s our job to protect the people that we serve, not protect the people who are paid to put the programs out there on the government dollar,” she said.
McCortney said he’s optimistic some Medicaid recipients, namely pregnant mothers and children, will see better care coordination and improved health outcomes under privatized managed care.
But SB 131 allows the legislature to keep a close watch on the program and expand SoonerSelect if outcomes improve or slow down changes if Medicaid deteriorates, he said.
“Managed care is not this horrible, evil, awful, thing, but it is this really big thing that, in many instances, has been done poorly,” McCortney said.
With a veto-proof margin, the Senate passed SB 131 on a vote of 39-8. The bill now returns to the House.
Clipped from: https://www.oklahoman.com/story/news/2021/05/20/oklahoma-senate-want-framework-stitts-medicaid-managed-care/5162921001/
Stitt’s office did not respond to a request for comment on the bill.