Oklahoma Gov. Kevin Stitt criticized Attorney General Gentner Drummond for his independent audit request of the state’s Medicaid agency in a letter Wednesday. This follows the launch of a federal review targeting Medicaid Fraud Control Units across the U.S.
Drummond requested the Oklahoma Health Care Authority audit at the end of April, arguing his office has substantial cause to believe the agency, which oversees SoonerCare, is failing to oversee its contracted managed care organizations.
Through a transition to managed care, or SoonerSelect, the Health Care Authority 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.
Drummond's letter to State Auditor and Inspector Cindy 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.
He asked for an audit covering several subjects, including the contractual compliance of managed care organizations and Health Care Authority oversight and accountability.
“An independent audit is not only warranted – it is essential to restore accountability and protect public funds,” Drummond said.
Stitt has long supported the transition to managed care, making it one of his administration’s top priorities during his first term. He called Drummond’s request “concerning” and said it doesn’t align with recent actions from the Trump administration to address fraud.
Vice President JD Vance announced last week the administration plans to audit all 50 states’ federally funded Medicaid Fraud Control Units to determine if they are fulfilling statutory functions and responsibilities. The units investigate and prosecute Medicaid fraud, abuse, neglect and exploitation of patients by providers and facilities.
Oklahoma’s fraud unit operates within Drummond’s office. It recently concluded investigations in 10 counties, including charges of Medicaid fraud, exploitation of elderly persons or disabled adults and identity theft, among others.
Vance told reporters last week if units are found to “not aggressively prosecute Medicaid fraud,” the administration will “turn off the money that goes to these anti-fraud units.”
Stitt said his administration welcomes the federal audit, but called Drummond’s audit request for the Oklahoma Health Care Authority “politically motivated” and “aligned with the interests of major donors.” Drummond is currently running for governor.
“Locally run managed care is bringing greater transparency, accountability, and early fraud detection to Medicaid. It gives the State clearer standards and stronger tools to identify warning signs of fraud and troubling utilization trends before tax dollars are lost,” Stitt said. “The tone of your audit request and subsequent public statements suggests an effort to unwind the progress Oklahoma has made over the past 18 months to put these new safeguards in place.”
Stitt directed Drummond to fully cooperate with the Trump administration’s audit.
“At a time when President Trump is demanding stronger Medicaid enforcement nationwide, your political theater risks sending the opposite message: that Oklahoma should loosen standards, provide an open checkbook, and retreat from managed care accountability,” Stitt said. “That would be the wrong direction for our state.”
Drummond responded to the letter in a statement, arguing the governor and Health Care Authority “have chosen to defend the insurance companies rather than the people they serve.”
“This is not the Medicaid accountability President Trump is calling for, and it is not the accountability Oklahomans deserve,” Drummond said.
“Instead of providing answers, the governor is telling Oklahomans to stop asking questions,” he added. “I will leave the public to draw its own conclusions about why the governor is so determined to keep them from learning the truth.”
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