Oklahoma Supreme Court Puts Brakes on MCO Plan

State’s top court rules the state’s Oklahoma Health Care Authority cannot implement managed care for its Medicaid program.

• By David Kopf
• Jun 10, 2021

The Oklahoma State Supreme Court has ruled that the Oklahoma Health Care Authority (OHCA, the state’s Medicaid agency, does not have the authority to implement a privatized managed care plan for the state.

The plan began on a controversial footing when, without legislative input, Oklahoma Gov. Kevin Stitt worked to contract with four insurance companies to outsource patient care for more than 700,000 of Oklahoma Medicaid’s beneficiaries.

A coalition of Oklahoma healthcare providers called Stop the Healthcare Holdup, which includes the Oklahoma Medical Equipment Providers Association (OMEPA), responded with a two-pronged effort to lobby state lawmakers to legislatively prevent the adoption of the managed care program while fighting the program in the courts.

The American Association for Homecare warned that while the ruling prevents OHCA from implementing a Medicaid managed care program on its own authority, backers of such a program could still attempt to implement an MCO for the state in the future.

“OMEPA and other healthcare leaders in Oklahoma have done an exceptional job in spotlighting the potential impacts of the MCO approach on both providers and patients,” said Laura Williard, AAHomecare’s vice president of Payer Relations. “I’d especially like to acknowledge the persistence and effectiveness of OMEPA President Larry Dalton, Victor Clay of Complete Care Medical, and Katie Roberts of Cimarron Medical Services in this fight. These efforts provide a great foundation for the Oklahoma HME community to push back against future Medicaid MCO proposals in the state.”