Medicaid

Starting this weekend, an estimated 446,000 low-to-middle-income Oklahomans can sign up for government-subsidized health insurance for 2015 through the online marketplace established by the Affordable Care Act.

The 2015 open enrollment period begins Saturday, Nov. 15, and ends Sunday, Feb. 15. Federal officials and ACA advocates are encouraging people to complete their applications by Dec. 15 to avoid ensure their coverage begins on Jan. 1.

A recent national survey by the Henry J. Kaiser Family Foundation in Washington, D.C., showed that 89 percent of uninsured people were not aware that open enrollment begins this month.

“It’s an unfortunate continuation of a trend that’s been going on for quite a while now,” Kaiser Foundation Senior Fellow Karen Politz said in a briefing with reporters. “People really aren’t that familiar with what’s in the ACA, whether it will help them, and what the rules are.”

The operator of some Oklahoma dental clinics has agreed to pay more than $5 million to settle allegations that it submitted false Medicaid claims.

Federal and state prosecutors said Friday they had alleged that Ocean Dental, which operates clinics throughout the state, submitted false Medicaid claims for work that was either never performed or billed at higher rates than allowed.

Healthcare advocates asked lawmakers Tuesday to find solutions to reduce Oklahoma’s uninsured population -- whether it be accepting Medicaid expansion under the Affordable Care Act or via its own state funded alternative.

The comments were made in the Appropriations and Budget Subcommittee on Public Health during a combination of interim studies related to healthcare funding, access and the uninsured.

The studies were requested by Reps. David Perryman, D-Chickasha; Emily Virgin, D-Norman; Joe Dorman, D-Rush Springs; Chuck Hoskin, D-Vinita.

The Oklahoma Health Care Authority Board approved a request to the legislature to increase funding by $275 million for next fiscal year. Of that increase, nearly 60% would fund the agency’s priority items and maintain their existing program in fiscal year 2016.

The increase would add to the base funding of around $953 million in state funds.

Oklahoma nursing homes are rated 49th and Oklahoma’s health care system for the elderly is ranked 47th in two new studies. A three-year $11.5 million dollar grant from the Donald W. Reynolds Foundation to the Oklahoma Healthy Aging Initiative will help deal with some of the shortcomings. Increased state funding is still needed to improve the health of Oklahoma seniors.

Some hospital officials say they're frustrated over losing out on reimbursements because Medicaid wasn't expanded in Oklahoma.

The Tulsa World reports a report by the Urban Institute finds Oklahoma hospitals are projected to lose more than $4 billion in reimbursements between 2013 and 2022. Some Tulsa hospitals say they've let go of workers to offset the lost revenue.

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 Oklahoma Health Care Authority will consider $252 million in Medicaid cutbacks at its board meeting on Thursday, including new limits on patient services, higher copays and smaller reimbursements to doctors and other medical providers.

The cutbacks, described in a draft agenda for the board’s 1 p.m. meeting (see below), were devised by leaders of the Health Care Authority and the Oklahoma Department of Mental Health and Substance Abuse Services in response to standstill state funding and reduced federal support.

The number of Oklahomans enrolled at one time in the state’s Medicaid program reached an all-time high in March, and officials are examining whether many people who signed up were spurred to do so by the Affordable Care Act.

By the end of March, there were 830,850 Oklahomans enrolled in SoonerCare, the state’s Medicaid program; that was the highest single-month total of enrollees since the program began, according to data from the Oklahoma Health Care Authority.