Attorney General Gentner Drummond is requesting an independent audit of the Oklahoma Health Care Authority, which oversees SoonerCare, the state’s Medicaid program.
Drummond’s office stated it has substantial cause to believe the agency is failing to oversee its contracted managed care organizations.
Through a transition to managed care, or SoonerSelect, OHCA went from paying providers directly to paying private companies to coordinate some enrollees’ care. The state contracted with the managed care organizations Humana Healthy Horizons, Aetna Better Health and Oklahoma Complete Health and went live in April 2024.
In an April 24 letter to State Auditor and Inspector Cindy Byrd, Drummond said his office has monitored this transition with “growing concern.” Drummond first sent a letter to Clay Bullard, CEO of OHCA, in October 2025, arguing providers have detailed “several alarming trends,” including significant reductions in reimbursement for direct pediatric care, payment withholdings and bureaucratic delays.
“Without immediate correction, these failures will destroy Oklahoma’s pediatric network, leaving SoonerCare children across Oklahoma’s 77 counties without access to care,” Drummond said in October.
Drummond said his office has sent two additional messages to Bullard demanding corrective action and alleged these were answered with “only verbal assurances of improvement.” On April 10, Drummond said the agency responded by defending the managed care organizations but acknowledged that “issues need to be fixed.”
Drummond’s letter to Byrd lists several concerns gathered from “mounting provider complaints.” Those include payment delays, administrative barriers to claims processing, incorrect or inconsistent reimbursement determinations and claim denials for medically necessary equipment.
Drummond requested that an audit study the following:
- Contractual compliance of managed care organizations
- OHCA oversight and accountability
- Administration of provider incentive payment program funds
- Denials of medically necessary services
- Improper claim approvals
- Stewardship of public funds
- Impact on provider participation and rural access.
“When an agency entrusted with Oklahoma’s most vulnerable citizens refuses to hold billion-dollar corporations accountable, it falls to this office to act. Providers across this state have been sounding the alarm for months. Oklahoma patients are being denied care they are legally entitled to, and OHCA has chosen to defend the MCOs rather than the people it serves,” Drummond said.
“An independent audit is not only warranted – it is essential to restore accountability and protect public funds.”
Oklahoma State Medical Association President Julie Strebel praised the audit request in a statement, saying the organization hopes it will bring “much-needed improvements.”
“Before we adopted insurance managed care, Oklahoma had one of the lowest Medicaid administrative costs in the nation – just 4%, and, in recent years, physicians were paid quickly and without frequent denials,” Strebel said. “Today, the insurance companies are taking up to 15% of taxpayer dollars to pay for less care, deny more claims and delay physician payments for months.”
An Oklahoma Health Care Authority spokesperson said in a statement the agency is committed to transparency and accountability, aware of the attorney general's request and will cooperate fully with any review process.
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