{"data":{"id":"us-ok/okla.-stat.-tit.-56-56-4002.3b","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 56, § 56-4002.3b","heading":"Capitated contracts – Requests for proposals –","body":"Competitive bids.\n\nA. All capitated contracts shall be the result of requests for\n\nproposals issued by the Oklahoma Health Care Authority and\n\nsubmission of competitive bids by contracted entities pursuant to\n\nthe Oklahoma Central Purchasing Act.\n\nB. Statewide capitated contracts may be awarded to any\n\ncontracted entity including, but not limited to, any provider-led\n\nentity or provider-owned entity, or both.\n\nC. The Authority shall award no less than three statewide\n\ncapitated contracts to provide comprehensive integrated health\n\nservices including, but not limited to, medical, behavioral health,\n\nand pharmacy services and no less than two statewide capitated\n\ncontracts to provide dental coverage to Medicaid members as\n\nspecified in Section 4002.3a of this title.\n\nD. 1. Except as specified in paragraph 3 of this subsection,\n\nat least one capitated contract to provide statewide coverage to\n\nMedicaid members shall be awarded to a provider-led entity, as long\n\nas the provider-led entity submits a responsive reply to the\n\nAuthority’s request for proposals demonstrating ability to fulfill\n\nthe contract requirements.\n\n2. Effective with the next procurement cycle, and except as\n\nspecified in paragraph 3 of this subsection, at least one capitated\n\ncontract to provide statewide coverage to Medicaid members shall be\n\nawarded to a provider-owned entity, as long as the provider-owned\n\nentity submits a responsive reply to the Authority’s request for\n\nproposals demonstrating ability to fulfill the contract\n\nrequirements.\n\n3. If no provider-led entity or provider-owned entity submits a\n\nresponsive reply to the Authority’s request for proposals\n\ndemonstrating ability to fulfill the contract requirements, the\n\nAuthority shall not be required to contract for statewide coverage\n\nwith a provider-led entity or provider-owned entity.\n\n4. The Authority shall develop a scoring methodology for the\n\nrequest for proposals that affords preferential scoring to provider-\n\nled entities and provider-owned entities, as long as the provider-\n\nled entity and provider-owned entity otherwise demonstrate an\n\nability to fulfill the contract requirements. The preferential\n\nscoring methodology shall include opportunities to award additional\n\npoints to provider-led entities and provider-owned entities based on\n\ncertain factors including, but not limited to:\n\na. broad provider participation in ownership and\n\ngovernance structure,\n\nb. demonstrated experience in care coordination and care\n\nmanagement for Medicaid members across a variety of\n\nservice types including, but not limited to, primary\n\ncare and behavioral health,\n\nc. demonstrated experience in Medicare or Medicaid\n\naccountable care organizations or other Medicare or\n\nMedicaid alternative payment models, Medicare or\n\nMedicaid value-based payment arrangements, or Medicare\n\nor Medicaid risk-sharing arrangements including, but\n\nnot limited to, innovation models of the Center for\n\nMedicare and Medicaid Innovation of the Centers for\n\nMedicare and Medicaid Services, or value-based payment\n\narrangements or risk-sharing arrangements in the\n\ncommercial health care market, and\n\nd. other relevant factors identified by the Authority.\n\nE. The Authority may select at least one provider-led entity or\n\none provider-owned entity for the urban region if:\n\n1. The provider-led entity or provider-owned entity submits a\n\nresponsive reply to the Authority’s request for proposals\n\ndemonstrating ability to fulfill the contract requirements; and\n\n2. The provider-led entity or provider-owned entity\n\ndemonstrates the ability, and agrees continually, to expand its\n\ncoverage area throughout the contract term and to develop statewide\n\noperational readiness within a time frame set by the Authority but\n\nnot mandated before five (5) years.\n\nF. At the discretion of the Authority, capitated contracts may\n\nbe extended to ensure there are no gaps in coverage that may result\nity or provider-owned entity\n\ndemonstrates the ability, and agrees continually, to expand its\n\ncoverage area throughout the contract term and to develop statewide\n\noperational readiness within a time frame set by the Authority but\n\nnot mandated before five (5) years.\n\nF. At the discretion of the Authority, capitated contracts may\n\nbe extended to ensure there are no gaps in coverage that may result\n\nfrom termination of a capitated contract; provided, the total\n\ncontracting period for a capitated contract shall not exceed seven\n\n(7) years.\n\nG. At the end of the contracting period, the Authority shall\n\nsolicit and award new contracts as provided by this section and\n\nSection 4002.3a of this title.\n\nH. At the discretion of the Authority, subject to appropriate\n\nnotice to the Legislature and the Centers for Medicare and Medicaid\n\nServices, the Authority may approve a delay in the implementation of\n\none or more capitated contracts to ensure financial and operational\n\nreadiness.","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":"d58ef4470284ce545ca402ab58aea51435e4aa0c72a9edd64bdea45c0093f9c2","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-56-56-4002.3a","next":"us-ok/okla.-stat.-tit.-56-56-4002.3c"},"notice":"GroundRules: Original legal text. Not legal advice."}