Medicaid providers see first rate hike in 9 years

BY DALE DENWALT Capitol Bureau ddenwalt@oklahoman.com

For the first time in almost 10 years, Oklahoma medical professionals will get more money for treating Medicaid patients.

The 3 percent rate hike comes after years of cuts and unease over budget shortfalls. Doctors and other professionals saw their Medicaid reimbursement rates fall by 3.25 percent in 2010, by 7.75 percent in 2014 and another 3 percent two years later.

The last time the Oklahoma Health Care Authority voted to increase the rate was in 2009.

As part of the boost in funding, nursing home providers will see an effective rate hike of 3.2 percent in reimbursements from the state for treating patients on SoonerCare, Oklahoma’s Medicaid program. Lawmakers approved a 2 percent, across-theboard rate increase, but the Oklahoma Health Care Authority planned to use savings from program and administrative changes, along with drug rebate collections, to boost the rate hike another percentage point.

Provider advocacy groups have hailed the changes as a positive step forward. As the state slashed provider rates in the past, there were concerns that doctors would stop seeing or limit new Medicaid patients because of the pay cuts.

Nursing home owners said they might have to close, and some who did blamed the state’s fiscal health.

For nursing homes, the state’s contribution will increase from $146.06 to $150.74 per day, which is still about $15 short of what it costs on average to take care of a long-term patient, according to nursing home advocates. Facilities plan to make up the difference with rates paid by residents who aren’t on state aid. Nico Gomez, CEO of the

Oklahoma Association of Health Care Providers, told The Oklahoman that the increased reimbursement would make that balancing act easier.

“We’re grateful,” he said when the new rates were announced. “We just have a little further to go.”

Other medical association leaders expressed similar sentiments.

During its meeting Thursday, Health Care Authority staff reported on the status of a legislative mandate that could require some unemployed Medicaid recipients to get a job or volunteer.

So far, the agency has received about 1,000 comments from the public about the rules, which must be approved by federal regulators before they go into effect.

The proposal requires SoonerCare recipients to prove they meet guidelines on work status, skills training or education. Many recipients would be exempt, including Oklahomans younger than 19 or older than 50, pregnant women, people unable to work and parents of children younger than 6.

The Health Care Authority also will consider exempting Native Americans, foster care parents, adults formerly in foster care, people enrolled in a program for breast and cervical cancer, enrollees with the state’s family planning program and people who are recently released from incarceration.

Agency officials will continue to accept public comments until the end of September, and then submit their proposal to the federal government in October. After another 60 days of review and comments, negotiations between state and federal officials begin.