SoonerCare providers get smaller rate cuts

SoonerCare providers won’t lose as much as they had expected to, but neither they nor the state board that pays them were satisfied with going halfway.

The Oklahoma Health Care Authority lost $70 million when the state Supreme Court struck down the $1.50-per-pack cigarette tax. A budget bill at the end of the special session in November restored $22.8 million for the authority, which oversees Oklahoma’s Medicaid program, called SoonerCare. Gov. Mary Fallin vetoed parts of the budget bill, though she left the health care funding intact, and has said she will call lawmakers back for a second special session.

The authority board voted Friday to revise its rate cuts because of the new budget. The total cut to all providers will fall from $68.4 million to $38 million.

Most providers had been told to expect a 9 percent rate cut but will take a 6 percent cut instead. Nursing facilities will take a 1 percent cut instead of a 4 percent cut.

The board left another cut in place, however. SoonerCare previously paid some out-of-pocket costs not covered by Medicare for patients who have both types of insurance. Now, SoonerCare no longer will pay those costs, but nursing facilities can’t pass them on to patients.

Nico Gomez, president of the Oklahoma Association of Health Care Providers, said nursing homes will lose about $5 million from the rate change and the decision to stop paying Medicare out-of-pocket costs. He asked the board to delay the cuts until the fourth quarter, in hope that lawmakers would come up with a solution before April. If they didn’t, cuts would have been substantially deeper because OHCA couldn’t spread them over time.

“I think it’s a risk most health care providers would want to take because we’re so close to the edge” financially, he said.

Rural nursing homes and those that treat substantial numbers of patients covered by Medicare would be hurt most by cuts and are vulnerable to closing, Gomez said.

“Any loss of service in rural Oklahoma will likely be lost forever,” he said.

Craig Jones, president of the Oklahoma Hospital Association, also asked the board for a delay, saying hospitals would need to make cuts quickly. He estimated Medicaid cuts since 2010 have totaled $150 million.

“Once these cutbacks are made, they are difficult to restore,” he said.

Wes Glinsman, executive director of the Oklahoma State Medical Association, also said he would like agencies to “give the Legislature the opportunity to do the right thing” and to create a more stable environment for physicians, but he’s not optimistic they’ll reach a solution to fully fund health care.

“They’ve been arguing over the same points for months now,” he said. “That’s what’s really disheartening.”

Tony Armstrong, the board’s vice chair, said he sympathizes with providers’ struggles, but the board’s constitutional duty to balance the budget made delaying cuts impossible. Armstrong presided over the meeting because Chairman Ed McFall wasn’t reappointed to the board after his term expired.

Armstrong said the board would vote to reinstate cuts if the Legislature makes that financially possible but sarcastically noted that lawmakers and the public hadn’t shown up for the meeting.

“We have deaf ears in this state,” he said. “They may be hearing, but they're not listening.”