{"data":{"id":"us-ok/okla.-stat.-tit.-56-56-4002.12b","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 56, § 56-4002.12b","heading":"Oklahoma Health Care Authority to ensure","body":"sustainability.\n\nA. The Oklahoma Health Care Authority shall ensure the\n\nsustainability of the transformed Medicaid delivery system.\n\nB. The Authority shall ensure that existing revenue sources\n\ndesignated for the state share of Medicaid expenses are designed to\n\nmaximize federal matching funds for the benefit of providers and the\n\nstate.\n\nC. The Authority shall develop a plan, utilizing waivers or\n\nMedicaid state plan amendments as necessary, to preserve or increase\n\nsupplemental payments available to providers with existing revenue\n\nsources as provided in the Oklahoma Statutes including, but not\n\nlimited to:\n\n1. Hospitals that participate in the supplemental hospital\n\noffset payment program as provided by Section 3241.3 of Title 63 of\n\nthe Oklahoma Statutes;\n\n2. Hospitals in this state that have Level I trauma centers, as\n\ndefined by the American College of Surgeons, that provide inpatient\n\nand outpatient services, along with comprehensive pediatric\n\nservices, and are owned, operated, or in partnership with the\n\nUniversity Hospitals Trust or the Oklahoma State University Medical\n\nTrust, or affiliates or locations of those hospitals designated by\n\nthe University Hospitals Trust or the Oklahoma State University\n\nMedical Trust as part of the hospital trauma system. The qualified\n\nentities in the Oklahoma City metropolitan area shall be a hospital\n\nowned, operated, or in partnership with the University Hospitals\n\nAuthority or University Hospitals Trust. The qualified entities in\n\nthe Tulsa metropolitan area shall be a hospital owned, operated, or\n\nin partnership with the Oklahoma State University Medical Authority,\n\nor Oklahoma State University Medical Trust; and\n\n3. Providers employed by or contracted with, or otherwise a\n\nmember of the faculty practice plan of:\n\na. a public, accredited Oklahoma medical school, or\n\nb. a hospital or health care entity directly or\n\nindirectly owned or operated by the University\n\nHospitals Trust or the Oklahoma State University\n\nMedical Trust.\n\nD. Subject to approval by the Centers for Medicare and Medicaid\n\nServices, the Authority shall preserve and, to the maximum extent\n\npermissible under federal law, improve existing levels of funding\n\nthrough directed payments or other mechanisms outside the capitated\n\nrate to contracted entities, including, where applicable, the use of\n\na directed payment program with an average commercial rate\n\nmethodology under the Supplemental Hospital Payment Program Act.\n\nE. On or before January 31, 2023, the Authority shall submit a\n\nreport to the Oklahoma Health Care Authority Board, the Chair of the\n\nAppropriations Committee of the Oklahoma State Senate, and the Chair\n\nof the Appropriations and Budget Committee of the Oklahoma House of\n\nRepresentatives that includes the Authority's plans to continue\n\nsupplemental payment programs and implement a managed care directed\n\npayment program for hospital services that complies with the reforms\n\nrequired by this act. If Medicaid-specific funding cannot be\n\nmaintained as currently implemented and authorized by state law, the\n\nAuthority shall propose to the Legislature any modifications\n\nnecessary to preserve supplemental payments and managed care\n\ndirected payments to prevent budgetary disruptions to providers.\n\nF. The Authority shall submit a report to the Governor, the\n\nPresident Pro Tempore of the Oklahoma State Senate and the Speaker\n\nof the Oklahoma House of Representatives that includes at a minimum:\n\n1. A description of the selection process of the contracted\n\nentities;\n\n2. Plans for enrollment of Medicaid members in health plans of\n\ncontracted entities;\n\n3. Medicaid member network access standards;\n\n4. Performance and quality metrics;\n\n5. Maintenance of existing funding mechanisms described in this\n\nsection;\n\n6. A description of the requirements and other provisions\n\nincluded in capitated contracts; and\nption of the selection process of the contracted\n\nentities;\n\n2. Plans for enrollment of Medicaid members in health plans of\n\ncontracted entities;\n\n3. Medicaid member network access standards;\n\n4. Performance and quality metrics;\n\n5. Maintenance of existing funding mechanisms described in this\n\nsection;\n\n6. A description of the requirements and other provisions\n\nincluded in capitated contracts; and\n\n7. A full and complete copy of each executed capitated\n\ncontract.\n\nG. 1. Each contracted entity shall report to the Authority in\n\ntime intervals determined by the Authority and through a process\n\ndetermined by the Authority all claims data, expenditures, and such\n\nother financial reporting information as may be required by the\n\nAuthority.\n\n2. The Authority shall compile and analyze the information\n\ndescribed in paragraph 1 of this subsection and annually submit a\n\nreport summarizing such information, devoid of any personally\n\nidentifying information, to the President Pro Tempore of the Senate,\n\nthe Speaker of the House of Representatives, and the Oklahoma Health\n\nCare Authority Board.","path":["OK Code","Title 56"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os56.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"6b3d79b53b69f5c694673c7bf8b622a5e634aea1d63cfae7fedbe68c4cdf5148","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-56-56-4002.12a","next":"us-ok/okla.-stat.-tit.-56-56-4002.13"},"notice":"GroundRules: Original legal text. Not legal advice."}