SoonerCare payment rate cut Jan. 1 while lawmakers’ blame game continues

Posted on: 12/6/17

SoonerCare payment rates for hospitals, physicians, and most other providers will be cut 6 percent effective Jan. 1, 2018. This cut replaces a 9 percent rate cut the Oklahoma Health Care Authority (OHCA) board approved on Nov. 9 for a Dec. 1 effective date. On Dec. 1, the OHCA board decided to reduce the cuts and postpone them one month. Nursing home payment rates had been scheduled for a 4 percent reduction, but will be reduced 1 percent instead. Craig Jones, OHA president, spoke at the OHCA board meeting against the cuts. To view a portion of his remarks, read the press statement.  

In a special session that ended Nov. 17, the Legislature restored $22.8 million to OHCA of the $70 million the agency lost when the $1.50-per-pack cigarette “fee” was invalidated by the Oklahoma Supreme Court. The Oklahoma Department of Mental Health and Oklahoma Department of Human Services will also receive a partial replacement of lost cigarette funding from the special session. For now, both agencies have reversed plans to curtail specific services.

In the wake of the Health Care Authority Board meeting Dec. 1, Gov. Mary Fallin and House Speaker Charles McCall issued public statements blaming one another for their actions during the eight-week Special Session called to address the $215 million loss of revenue for the health agencies. In a press statement issued by Speaker McCall, he said, “The bill the governor vetoed would have stabilized the Health Care Authority’s budget until a more sustainable solution could be reached during the upcoming legislative session or a later special session. If the governor had signed the budget agreement, those cuts to provider rates and any potential cuts to other health care services in the coming months would have been avoided.”

In response, Gov. Fallin reiterated her view that the budget bill (HB 1019X) “…was a short-time fix to a long-term problem. . . When we return to regular session next year to begin work on the 2019 fiscal year budget, we will be facing a budget gap of as much as $600 million and the reality that provider rates would be cut again. I believe we missed an opportunity to address our long-term structural budget problems in special session by continuing to kick the can down the road and failing to develop a predictable solution to fix our budget and fund our core services.”  

She added, “We didn’t get our job done. Unfortunately, it took my veto pen to bring the proper focus and attention to this matter. I am committed to addressing the health care needs of Oklahoma as I always have, and I look forward to working further with legislators to find solutions.”

After the Nov. 17 veto, the governor, in a Nov. 21 press conference, said she planned to call legislators into a second special session to address the revenue shortfall. After the OHCA cut provider rates, the governor said, “Discussions are continuing with legislative leaders, legislators and Oklahomans in all types of professions from across the state on a long-term, predictable solution to fix our budget and fund core services. Being in a state of constant crisis is hurting Oklahoma’s people, its image and its brand as a state. Ideas and offers of support have poured into my office. It is taking longer than anticipated to develop budget plan estimates and gauge support for various revenue proposals. That information should be available for my review in the days ahead. I’ll announce very soon the start date of the second special session.” (Lynne White)