Oklahoma Code § 56-4002.12b

Title 56. Poor Persons: Oklahoma Health Care Authority to ensure
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sustainability.
A.  The Oklahoma Health Care Authority shall ensure the
sustainability of the transformed Medicaid delivery system.
B.  The Authority shall ensure that existing revenue sources
designated for the state share of Medicaid expenses are designed to
maximize federal matching funds for the benefit of providers and the
state.

C.  The Authority shall develop a plan, utilizing waivers or
Medicaid state plan amendments as necessary, to preserve or increase
supplemental payments available to providers with existing revenue
sources as provided in the Oklahoma Statutes including, but not
limited to:
1.  Hospitals that participate in the supplemental hospital
offset payment program as provided by Section 3241.3 of Title 63 of
the Oklahoma Statutes;
2.  Hospitals in this state that have Level I trauma centers, as
defined by the American College of Surgeons, that provide inpatient
and outpatient services, along with comprehensive pediatric
services, and are owned, operated, or in partnership with the
University Hospitals Trust or the Oklahoma State University Medical
Trust, or affiliates or locations of those hospitals designated by
the University Hospitals Trust or the Oklahoma State University
Medical Trust as part of the hospital trauma system.  The qualified
entities in the Oklahoma City metropolitan area shall be a hospital
owned, operated, or in partnership with the University Hospitals
Authority or University Hospitals Trust.  The qualified entities in
the Tulsa metropolitan area shall be a hospital owned, operated, or
in partnership with the Oklahoma State University Medical Authority,
or Oklahoma State University Medical Trust; and
3.  Providers employed by or contracted with, or otherwise a
member of the faculty practice plan of:
a. a public, accredited Oklahoma medical school, or
b. a hospital or health care entity directly or
indirectly owned or operated by the University
Hospitals Trust or the Oklahoma State University
Medical Trust.
D.  Subject to approval by the Centers for Medicare and Medicaid
Services, the Authority shall preserve and, to the maximum extent
permissible under federal law, improve existing levels of funding
through directed payments or other mechanisms outside the capitated
rate to contracted entities, including, where applicable, the use of
a directed payment program with an average commercial rate
methodology under the Supplemental Hospital Payment Program Act.
E.  On or before January 31, 2023, the Authority shall submit a
report to the Oklahoma Health Care Authority Board, the Chair of the
Appropriations Committee of the Oklahoma State Senate, and the Chair
of the Appropriations and Budget Committee of the Oklahoma House of
Representatives that includes the Authority's plans to continue
supplemental payment programs and implement a managed care directed
payment program for hospital services that complies with the reforms
required by this act.  If Medicaid-specific funding cannot be
maintained as currently implemented and authorized by state law, the
Authority shall propose to the Legislature any modifications

necessary to preserve supplemental payments and managed care
directed payments to prevent budgetary disruptions to providers.
F.  The Authority shall submit a report to the Governor, the
President Pro Tempore of the Oklahoma State Senate and the Speaker
of the Oklahoma House of Representatives that includes at a minimum:
1.  A description of the selection process of the contracted
entities;
2.  Plans for enrollment of Medicaid members in health plans of
contracted entities;
3.  Medicaid member network access standards;
4.  Performance and quality metrics;
5.  Maintenance of existing funding mechanisms described in this
section;
6.  A description of the requirements and other provisions
included in capitated contracts; and
7.  A full and complete copy of each executed capitated
contract.
G.  1.  Each contracted entity shall report to the Authority in
time intervals determined by the Authority and through a process
determined by the Authority all claims data, expenditures, and such
other financial reporting information as may be required by the
Authority.
2.  The Authority shall compile and analyze the information
described in paragraph 1 of this subsection and annually submit a
report summarizing such information, devoid of any personally
identifying information, to the President Pro Tempore of the Senate,
the Speaker of the House of Representatives, and the Oklahoma Health
Care Authority Board.

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