KGOU

Oklahoma Health Care Authority

Trevor Brown / Oklahoma Watch

The state will have to find another way to help fund graduate medical education by July 2019 if it wants to use Medicaid matching funds after the federal government denied the Oklahoma Health Care Authority’s latest bid to fix the program’s funding issues.

Sue Ogrocki / AP Images

The Oklahoma House of Representatives announced on Tuesday that it will choose one chaplain to lead its daily invocations for the rest of the legislative session.  

FILE- Oklahoma State Capitol
Brent Fuchs / The Journal Record

As the Oklahoma legislature wraps up its sixth week in special session, only one bill has made it to Governor Mary Fallin’s desk. The House of Representatives and Senate passed a bill to appropriate $23.3 million from the state’s “rainy day fund” for the Oklahoma Department of Mental Health and Substance Abuse Services.

 

 

Gov. Mary Fallin delivers her 2016 State of the State address Feb. 1, 2016.
Joe Wertz / StateImpact Oklahoma

Governor Mary Fallin says state legislators must return to the Capitol for a special legislative session. In a statement released Wednesday, Fallin said the session is the only way to fill a budget hole created when the Oklahoma Supreme Court struck down a smoking cessation fee last week.

MilitaryHealth / Flickr Creative Commons

 

The Oklahoma Supreme Court hears arguments August 8 in the case over the state’s new $1.50-per-pack cigarette fee.

Oklahoma State Capitol Building
Claire Donnelly / KGOU

Gov. Mary Fallin signed the Fiscal Year 2018 Oklahoma state budget Wednesday.

Nico Gomez, CEO of the Oklahoma Health Care Authority.
Warren Vieth / Oklahoma Watch

The CEO of the Oklahoma Healthcare Authority plans to step down at the end of September.

Nico Gomez, who has led the authority for the past three-and-a-half years, submitted his letter of resignation to the Oklahoma Health Care Authority Board, according an announcement released on Monday. He plans to pursue work in the private sector, following 20 years of public service. He has worked for the OHCA for 16 years.

Updated August 31, 9:23 a.m.

Two policy analysts say it could be a tall order to find a replacement for Gomez.

Five years ago, Tonia Sina was diagnosed with a blood-clotting disorder called atypical hemolytic uremic syndrome.
Photo illustration by Brent Fuchs and Bryan M. Richter / The Journal Record

There’s no shortage of issues to address when it comes to the $900-million-and-counting budget shortfall over the next four months of legislative session.

The number could grow larger when the Board of Equalization certifies new numbers later this month. In Gov. Mary Fallin’s executive budget unveiled Monday during her State of the State address, most state agencies will see a 6 percent cut. Some, like the Oklahoma Health Care Authority, will take a smaller 3 percent hit.

Buffy Heater, chief strategy officer of the Oklahoma Health Care Authority, is evaluating options for shifting part of Oklahoma’s Medicaid population into a “coordinated care” program using private-sector contractors.
Warren Vieth / Oklahoma Watch

At the insistence of state lawmakers, the Oklahoma Health Care Authority is exploring cost-saving options that could lead to partial privatization of the state’s $2.4 billion Medicaid program for aged, blind and disabled people.

The state tried that once before, and it didn’t work out. Costs escalated, companies dropped out, and the state pulled the plug. Supporters of the new effort predicted it might turn out better because of improvements in managed-care practices.

Demonstrators gather outside the Supreme Court on Thursday after the ruling that Affordable Care Act subsidies are constitutional.
Ted Eytan / Flickr

Thursday morning the U.S. Supreme Court upheld the constitutionality of federal tax subsidies for the federal Affordable Care Act. The 6-3 ruling affects 87,000 Oklahomans who receive the insurance subsidies designed to make access to health care cheaper.

Subsidies were also at risk in 33 other states that didn't established a state-run marketplace. Instead, residents had to purchase their insurance through a federally run program.

Toni Pratt-Reid, the owner of three medical clinics, said she could be forced to close two of those clinics if the Oklahoma Health Care Authority reduces the rates it pays nurse practitioners.
M. Scott Carter / Oklahoma Watch

A top Oklahoma health official is warning that the budget crunch may force the Oklahoma Health Care Authority to cut payments to mid-level medical providers such as nurse practitioners and physician assistants, which providers say could lead to the closing of rural clinics.

Facing a $611 million budget gap, state leaders say most agencies will see spending cuts, or at best, a flat budget. But even with a flat budget, Health Care Authority officials said, many low-income residents could see a reduction in health care access and services.

Budget documents released by the Authority indicate the agency is proposing more than $40 million in budget reductions for the 2016 fiscal year. Those cuts range from $2.9 million in administrative cuts to a $5.2 million, or 15 percent, reduction in reimbursement amounts paid to nurse practitioners, physician assistants, physical therapists and other mid-level providers.

Doctors could see reimbursement rate cuts of about 2 percent, lawmakers said.

The reductions would lower fee-for-service payments to 85 percent of the Authority’s physician fee schedule.

About 3,250 providers would be affected.

creationc / Stock.XCHNG

The operator of an Oklahoma mental health care facility has been sentenced to five years in prison for allegedly billing fraudulent claims to the Oklahoma Health Care Authority.

Oklahoma Attorney General Scott Pruitt's office announced the sentence Wednesday for John Michael Doneti, a licensed professional counselor who ran Central Oklahoma Behavioral Health Services, LLC. Doneti was also sentenced to five years of probation and ordered to pay $194,000 in restitution.

Oklahoma Health Care Authority

Oklahoma's top Medicaid officer says the health care program needs $120 million more state dollars next year to maintain services at current levels for the more than 800,000 young, elderly and disabled Oklahomans it serves each month.

Oklahoma Health Care Authority CEO Nico Gomez spoke Wednesday to members of the Senate Committee on Appropriations while outlining the agency's budget request for the fiscal year that begins July 1. The agency's current budget is about $953 million.

Joy Hofmeister, superintendent of public instruction, listens to a question from the audience during the "Oklahoma Watch-Out" forum on March 3.
Ilea Shutler / Oklahoma Watch

Updated 11:06 a.m.

Oklahoma's state schools superintendent says a 4 percent cut in the Department of Education's budget would reduce funding for the state's public schools by $100 million next year.

Superintendent Joy Hofmeister outlined her agency's budget request Wednesday for members of the Senate Committee on Appropriations. Lawmakers must deal with a budget shortfall of $611 million as they work to craft a budget for state government for the fiscal year that begins July 1.

The Oklahoma School for the Deaf in Sulphur, Oklahoma.
The Oklahoma School for the Deaf

The trend in requesting budget increases continued into the second day of budget hearings presented to the Senate Appropriations Subcommittee on Health and Human Services.

All four agencies presenting Tuesday requested significant increases to their fiscal year 2016 budgets.

The Oklahoma State University Medical Authority requested a $4.9 million increase, $4 million of which would be a one-time appropriation to replenish funds for the Rural Residency Expansion Act.

Oklahoma Health Care Authority

Talk of transforming the way health care is provided, paid for and implemented in the state has begun in Oklahoma.

The Oklahoma Health Care Authority board on Thursday heard a presentation by Oklahoma Hospital Association President Craig Jones about the future of the state’s health care system. Oklahoma was ranked 46th in overall health by America’s Health Rankings in its 2014 report.

“We believe this will be an important part of the discussion going into the next legislative session,” OHCA Chief Executive Officer Nico Gomez said.

SoonerCare Department Tackles Complex Health Issues

Dec 11, 2014
a stack of dollar bills with a stethoscope and bottle of pills
James Martin / Flickr

Overall enrollment in SoonerCare programs increased in October, Population Care Management Director Marlene Asmussen said Thursday during a meeting of the Oklahoma Health Care Authority board. 

The net enrollee count change from the previous month was 842. There are 16,219 new enrollees - members that have not been enrolled in the past six months.

ok.gov/health

Members of the Oklahoma State Board of Health heard reports Tuesday on the 2015 legislative and budget priorities for the state health department. 

Deputy Secretary for Health and Human Services and Senior Deputy Commissioner Julie Cox-Kain said they will be requesting $18,523,641 to add to their base appropriations for fiscal year 2016.

The health department, she said, has four main budget requests, more than they have had in recent years. These requests are for the public health laboratory, vaccine purchasing, adolescent and children’s health and reducing hospitalizations.

Addressing the state’s public health laboratory, which has gone through some flooding recently and is in need of repair and updating is a top priority, Cox-Kain said. The facility is about 40 years old, and while they have been repairing it “piecemeal,” a large scale restoration effort is also needed.

More Money Needed For Oklahoma Health Care Authority

Oct 10, 2014
Charles Ed McFall, Chairman, The Oklahoma Health Care Authority Board of Directors
Oklahoma Health Care Authority

The Oklahoma Health Care Authority Board approved a request to the legislature to increase funding by $275 million for next fiscal year. Of that increase, nearly 60% would fund the agency’s priority items and maintain their existing program in fiscal year 2016.

The increase would add to the base funding of around $953 million in state funds.

Oklahoma Forum: Medicaid And Insure Oklahoma

Sep 8, 2014

Oklahoma Forum host Dick Pryor discusses recent changes in SoonerCare, Oklahoma’s Medicaid program, and Insure Oklahoma with Nico Gomez, Chief Executive Officer, Oklahoma Health Care Authority.

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