Authority delays cuts to Soonercare rates
The Oklahoma Health Care Authority now will wait until Jan. 1 to cut Soonercare provider reimbursement rates.
The authority also will consider less of a cut than originally planned when it meets Dec. 1 to approve the new rates.
Its decision came after Gov. Mary Fallin vetoed most of the Legislature’s budget bill but left some of the funding intact, including $22.8 million earmarked for the OHCA. Before receiving the money, the authority was scheduled on Dec. 1 to reduce reimbursement rates by 9 percent across the board and 4 percent for nursing facilities.
The new rate cut would be 6 percent, with exceptions, plus 1 percent for nursing facilities. Like the original plan, the authority plans for cuts on Jan. 1 to eliminate Medicare crossover coinsurance and deductible payments for nursing facilities.
Nico Gomez, president and CEO of the Oklahoma Association of Health Care Providers and a nursing home advocate, doesn’t see much of a silver lining.
“It proves the governor’s veto is creating a lot of chaos and uncertainty in our health care sector with the Health Care Authority’s actions. Any cut to the nursing home rate is going to have a negative impact on the residents we serve,” Gomez said. “At least we would have been funded potentially through the end of June at least to give us time to come up with a long-term solution. Now we have a shorter amount of time to come up with a long-term solution.”
OHCA said it works diligently to prevent reductions in the amount of money paid to doctors and other medical providers who take Soonercare patients.
“However, while these funds have provided an immediate relief, even with the Jan. 1 rate reductions, we are still approximately $9.5 million short of a balanced budget,” CEO Becky PasternikIkard said. “We will continue to work with leadership to try to find funding solutions that will fully fund the agency and possibly allow us to reverse these reductions.”
OHCA, the Department of Human Services and Department of Mental Health and Substance Abuse Services were hit with the bulk of a $215 million revenue shortfall in August when the state’s high court struck down a proposed cigarette fee.
Lawmakers tried to remedy the situation during the special session, but they only managed to adopt a so-called “cash and cuts” plan that spread out the shortfall to 49 agencies and used leftover cash to cover the rest. Fallin vetoed the budget, but she left funding to those three agencies intact.
She will announce next week when she will call lawmakers back to another special session.
After learning in August that the authority would abruptly lose $70 million from this year’s budget, it implemented program and budget changes that shaved nearly $20 million from its spending needs.
Fallin’s line-item veto that spared health care funding also meant planned cuts at the DHS won’t take effect. The agency said this week that it will not have to reduce or eliminate service programs for seniors and people with disabilities as originally planned.