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SoonerCare agency seeks $44 million to increase provider pay

Oklahoma City — The Oklahoma Health Care Authority is asking for $44 million more this year to increase pay for SoonerCare providers and to deal with expected growth in usage.

The authority, which administers Oklahoma's Medicaid program, received $1.02 billion for the fiscal year that will end June 30. Tasha Black, senior director of financial services, said the requested funds would raise its budget to $1.06 billion. Most of that money is paid to doctors, nursing homes and other providers who serve SoonerCare patients.

Providers received a 3 percent increase in October, said Jo Stainsby, spokeswoman for the Oklahoma Health Care Authority. If the Legislature funds the request, rates will be back to where they were in 2010, when the authority passed the first of several cuts, she said.

Black cautioned that the request could change if the Legislature passes any laws that require the authority to spend more next year.

“This really is a point in time” estimate, she said.

The request would actually be closer to $152 million if Oklahoma weren't scheduled to get an infusion of cash next year, when the federal government increases what it pays for Oklahoma's Medicaid program starting Oct. 1.

Federal dollars pay for about 62 percent of approved expenses now, but that will rise to 66 percent, bringing in about $127 million more. The federal government pays more for states with lower average incomes.

Other changes the authority is proposing in its budget include: removing the prior authorization requirement for medications to treat addiction, which could make it easier for patients to get into treatment; allowing adults to get a tooth extracted when it is medically necessary, rather than waiting until it becomes an emergency; increasing authority employees' pay by about $1.5 million; and increasing the availability of nutrition counseling for recipients with obesity.

Meg Wingerter

Meg Wingerter has covered health at The Oklahoman since July 2017. Previously, she lived in Topeka, Kansas, and worked at Kansas News Service and The Topeka Capital-Journal, where she earned awards for business coverage. She graduated from... Read more ›