Oklahoma Watch
7:45 am
Tue July 1, 2014

Oklahoma Medicaid Providers Face More Possible Cuts

In its second round of sweeping budget cuts, the Oklahoma Health Care Authority on Tuesday will consider reducing payments to doctors and other Medicaid providers by $159 million, effective immediately.

The authority will meet in special session to vote on provider reimbursement cuts affecting up to 13,932 physicians, 2,097 advanced practice nurses, 1,561 therapists, 1,285 physician assistants, 1,277 pharmacies, 1,255 personal care providers, 1,133 dentists and several thousand other providers.

The cuts are described in the agenda for the board's 1 p.m. meeting.

Several categories of medical services will be exempt from the cuts, including long-term nursing home care, private-duty nursing and medical transportation.

Under the new rate structure, providers will be reimbursed at 89 percent of the comparable rate for Medicare. Before the reduction, Oklahoma's SoonerCare Medicaid program reimbursed at 97 percent of the Medicare rate. Because July 1 is the first day of the 2015 fiscal year, the cut will take effect immediately.

Along with two other, more narrowly targeted reimbursement cuts, the provider rate reductions are expected to generate total annual savings of $159 million, of which $59 million will accrue to the state and $100 million to the federal government.

Last week, the authority approved $93 million in cost savings by restricting eligibility and raising patient copays for SoonerCare services. Both rounds of cuts were precipitated by a formula-based decline in federal matching funds, a drop in earmarked tobacco tax revenue and standstill funding by the Oklahoma Legislature.

"It's certainly something that we didn't want to do," said Health Care Authority spokeswoman Jennie Melendez. "But our hands were tied, and it had to be done... It's kind of a lose-lose situation when we were given the budget that we have. We're trying to make the best of it."