Okla. Stat. tit. 56, § 56-4002.12b: Oklahoma Health Care Authority to ensure

sustainability.

A. The Oklahoma Health Care Authority shall ensure the

sustainability of the transformed Medicaid delivery system.

B. The Authority shall ensure that existing revenue sources

designated for the state share of Medicaid expenses are designed to

maximize federal matching funds for the benefit of providers and the

state.

C. The Authority shall develop a plan, utilizing waivers or

Medicaid state plan amendments as necessary, to preserve or increase

supplemental payments available to providers with existing revenue

sources as provided in the Oklahoma Statutes including, but not

limited to:

1. Hospitals that participate in the supplemental hospital

offset payment program as provided by Section 3241.3 of Title 63 of

the Oklahoma Statutes;

2. Hospitals in this state that have Level I trauma centers, as

defined by the American College of Surgeons, that provide inpatient

and outpatient services, along with comprehensive pediatric

services, and are owned, operated, or in partnership with the

University Hospitals Trust or the Oklahoma State University Medical

Trust, or affiliates or locations of those hospitals designated by

the University Hospitals Trust or the Oklahoma State University

Medical Trust as part of the hospital trauma system. The qualified

entities in the Oklahoma City metropolitan area shall be a hospital

owned, operated, or in partnership with the University Hospitals

Authority or University Hospitals Trust. The qualified entities in

the Tulsa metropolitan area shall be a hospital owned, operated, or

in partnership with the Oklahoma State University Medical Authority,

or Oklahoma State University Medical Trust; and

3. Providers employed by or contracted with, or otherwise a

member of the faculty practice plan of:

a. a public, accredited Oklahoma medical school, or

b. a hospital or health care entity directly or

indirectly owned or operated by the University

Hospitals Trust or the Oklahoma State University

Medical Trust.

D. Subject to approval by the Centers for Medicare and Medicaid

Services, the Authority shall preserve and, to the maximum extent

permissible under federal law, improve existing levels of funding

through directed payments or other mechanisms outside the capitated

rate to contracted entities, including, where applicable, the use of

a directed payment program with an average commercial rate

methodology under the Supplemental Hospital Payment Program Act.

E. On or before January 31, 2023, the Authority shall submit a

report to the Oklahoma Health Care Authority Board, the Chair of the

Appropriations Committee of the Oklahoma State Senate, and the Chair

of the Appropriations and Budget Committee of the Oklahoma House of

Representatives that includes the Authority's plans to continue

supplemental payment programs and implement a managed care directed

payment program for hospital services that complies with the reforms

required by this act. If Medicaid-specific funding cannot be

maintained as currently implemented and authorized by state law, the

Authority shall propose to the Legislature any modifications

necessary to preserve supplemental payments and managed care

directed payments to prevent budgetary disruptions to providers.

F. The Authority shall submit a report to the Governor, the

President Pro Tempore of the Oklahoma State Senate and the Speaker

of the Oklahoma House of Representatives that includes at a minimum:

1. A description of the selection process of the contracted

entities;

2. Plans for enrollment of Medicaid members in health plans of

contracted entities;

3. Medicaid member network access standards;

4. Performance and quality metrics;

5. Maintenance of existing funding mechanisms described in this

section;

6. A description of the requirements and other provisions

included in capitated contracts; and

ption of the selection process of the contracted

entities;

2. Plans for enrollment of Medicaid members in health plans of

contracted entities;

3. Medicaid member network access standards;

4. Performance and quality metrics;

5. Maintenance of existing funding mechanisms described in this

section;

6. A description of the requirements and other provisions

included in capitated contracts; and

7. A full and complete copy of each executed capitated

contract.

G. 1. Each contracted entity shall report to the Authority in

time intervals determined by the Authority and through a process

determined by the Authority all claims data, expenditures, and such

other financial reporting information as may be required by the

Authority.

2. The Authority shall compile and analyze the information

described in paragraph 1 of this subsection and annually submit a

report summarizing such information, devoid of any personally

identifying information, to the President Pro Tempore of the Senate,

the Speaker of the House of Representatives, and the Oklahoma Health

Care Authority Board.