SoonerCare cuts avoided, but future still uncertain

Health care providers who had braced for a planned rate cut on Monday got a lastminute reprieve Friday afternoon when the state Medicaid agency voted not to implement the cutbacks, at least for now.

The board of the Oklahoma Health Care Authority oversees SoonerCare, the state Medicaid program, and cuts would have hit most of the 46,477 health care providers who see patients covered by the program.

As of November, 807,810 Oklahomans were enrolled in SoonerCare.

Gov. Mary Fallin signed a bill Dec. 22 that provides $17.7 million to fund the authority until May 1, meaning cuts are still possible in the last two months of the budget year. Fallin has said she will call lawmakers back in January to come up with a final funding deal.

The cuts, which the board had voted on in early December, would have reduced nursing facilities’ rates by 1 percent, and cut another form of reimbursement for care to patients covered by both Medicaid and Medicare. Most other medical providers

would have absorbed a 6 percent cut.

The combined cuts would have saved the state just short of $18 million, while costing another $25.4 million in federal funds. Some professional groups had raised alarms that nursing facilities would close and doctors could stop seeing Medicaid patients.

Providers may not be able to rest quite yet, though. The authority still faces a roughly $9.5 million budget gap, and will have to make cuts in May if the Legislature doesn’t act.

If the Legislature can find funding for the authority in January, it would bring an end to a long period of uncertainty about what the state would pay for health services. The authority’s budget was thrown into chaos this summer when the Oklahoma Supreme Court struck down a $1.50-per-pack cigarette fee, eliminating about $70 million of its funding.

The authority partially balanced its budget by delaying some payments to providers until the new fiscal year starts in July, using more than $16 million in leftover funds, removing ineligible members from

the program faster, limiting tooth extractions to emergencies and reducing the number of people who qualify for cystic fibrosis screening.

When that wasn’t enough, the board voted in November to cut rates to nursing facilities by 4 percent and to most other providers by 9 percent. The board members made it clear they didn’t want to vote for cuts, but said they had no choice because of their obligation to produce a balanced budget.

The cuts were scheduled to take effect Dec. 1, though the board reduced and delayed them in early December after lawmakers passed a budget at the end of the first special session. Fallin vetoed portions of the budget and called lawmakers back for a second special session, where they passed additional funding for the authority.

“We are thankful to state leadership for continuing to work toward a solution to protect our providers and the Medicaid program. The OHCA has long held a commitment to our providers to pay rates that ensure access to care for our SoonerCare members. The additional appropriation we received allows us to continue that mission,” authority CEO Becky Pasternik-Ikard said in a news release.