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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (2022)
SENATE BILL 1337 By: McCortney
AS INTRODUCED
An Act relating to the state Medicaid pr ogram;
amending 63 O.S. 2021, Section 5005 , which relates to
definitions used in the Oklahoma Health Care
Authority Act; deleting obsolete definition; amending
63 O.S. 2021, Section 5006 , which relates to the
Oklahoma Health Care Authority ; removing certain
obsolete powers and duties; amending 63 O.S. 2021,
Section 5008, which relates to the Administrator of
the Authority; eliminating certain obsolete power and
duty; amending 63 O.S. 2021, Section 5009 , which
relates to the Oklahoma Medicaid program; removi ng
obsolete provisions relating to co nversion of
delivery system; repealing 56 O.S. 2021, Sections
1010.2, 1010.3, 1010.4, and 1010.5 , which relate to
the state Medicaid program; repealing 63 O.S. 2021,
Sections 5009.5, 5011, and 5028 , which relate to the
state Medicaid program; and provi ding an effective
date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Section 5005, is
amended to read as follows:
Section 5005. For purposes of the Oklahoma Health Care
Authority Act:
1. “Administrator” means the chief executive officer of the
Authority;
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2. “Authority” means the Oklahoma Health Care Authority;
3. “Board” means the Oklahoma Health Care Au thority Board; and
4. “Health services provider” means health insurance carri ers,
pre-paid health plans, hospitals, physicians and other health care
professionals, and other entities who contract with the Authority
for the delivery of health care services to state and education
employees and persons covered by the state Medicaid pr ogram; and
5. “State-purchased health care ” or “state-subsidized health
care” means medical and health care, pharmaceuticals and medical
equipment purchased with or supported by sta te and federal funds
through the Oklahoma Health Care Authority, the Depar tment of Mental
Health and Substance Abuse Services, the State Department of Health,
the Department of Human Services, the Department of Corrections, the
Oklahoma Department of Veterans Affai rs, other state agencie s
administering state-purchased or state-subsidized health care
programs, the Oklahoma State Regents for Higher Education, the State
Board of Education and local school districts.
SECTION 2. AMENDATORY 63 O.S. 2021, Section 5006, is
amended to read as follows:
Section 5006. A. There is hereby created the Ok lahoma Health
Care Authority. The Authority shall have the power and duty to:
1. Purchase health care benefits for Medicaid recipient s, and
others who are dependent on the st ate for necessary medical care, as
specifically authorized by law;
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2. Enter into contracts for the delivery of state -purchased
health care and establish standards and criteria which must be met
by entities to be el igible to contract with the Authority for the
delivery of state-purchased health care;
3. Develop a proposed standard ba sic health care benefits
package or packages to be offered by health services providers, for
Medicaid recipients;
4. Study all matters connected with the provision of state -
purchased and state-subsidized health care coverage;
5. 3. Develop and submit pla ns, reports and proposals, provide
information and analyze areas of public and private health care
interaction pursuant to the provisions of the Oklahoma Health Care
Authority Act;
6. 4. Serve as a resource for information on state-purchased
and state-subsidized health care access, cost containment and
related health issues;
7. 5. Administer programs and enforce laws placed under the
jurisdiction of the Authority pursuant to t he Oklahoma Health Care
Authority Act, and such ot her duties prescribed by law;
8. Collaborate with and assist the Insurance Comm issioner in
the development of a Uniform Claim Processing System for use by
third-party payors and health care providers;
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9. Collaborate with and assist the State Department o f Health
with the development of licensure standards and criteria for pre -
paid health plans; and
10. 6. Exercise all incidental powers which are necessary and
proper to carry out the purposes of the Oklaho ma Health Care
Authority Act.
B. All positions wi thin the Authority shall be un classified
until approval of the annual business a nd personnel plan submitted
by January 1, 1995, by the Governor and the Legislature. In the
annual business plan submitted Ja nuary 1, 1995, the Board shall
include a personnel plan which shall list, descri be and justify all
unclassified positions within t he Authority and their compensation.
All other employees and positions shall be classified and s ubject to
the provisions of the Merit System of Personnel Administration as
provided in the Oklahoma Personne l Act.
SECTION 3. AMENDATORY 63 O.S. 2021, Section 5008, is
amended to read as follo ws:
Section 5008. A. The Administrator of the Oklahoma Health Ca re
Authority shall have the training and experienc e necessary for the
administration of the Authority. The Administrator s hall be
appointed by the Governor with the advice and consent of the Senate
and shall serve at the pleasure of the Governor and may b e removed
or replaced without cause. Compensation for the Administrator shall
be determined by the Governor. The Administ rator may be removed
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from office by a two -thirds (2/3) vote of the members elected to and
constituting each chamber of the Legislatur e.
B. The Administrator of the Oklahoma Health Ca re Authority
shall be the chief executive officer of the Authority and sh all act
for the Authority in all matters except as may be otherwise provided
by law. The powers and duties of the Administrator shal l include
but not be limited to:
1. Supervision of the activities of the Authority;
2. Formulation and recommendation of rules for approval or
rejection by the Oklahoma Health Care Authority Board and
enforcement of rules and standards promulgated by the Board;
3. Preparation of the plans, reports and proposals required by
the Oklahoma Health Care Authority Act, Section 500 3 et seq. of this
title, other reports as necessary and appropriate, and an annual
budget for the review and approval of the Board; and
4. Employment of such staff as may be necessar y to perform the
duties of the Authority including but not limited to an attorney to
provide legal assistance to the Authority for the state Medicaid
program; and
5. Establishment of a contract bidding pro cess which:
a. encourages competition among entiti es contracting with
the Authority for sta te-purchased and state-subsidized
health care; provided, however, the Authority may make
patient volume adjustments to any managed care plan
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whose prime contractor i s a state-sponsored,
nationally accredited medical school. The Authority
may also make education or research supplemental
payments to state-sponsored, nationally accredited
medical schools based on the level of participation in
any managed care plan by ma naged care plan
participants,
b. coincides with the state budgetary process, and
c. specifies conditions for awarding contr acts to any
insuring entity.
C. The Administrator may appoint advisory committees as
necessary to assist the Authority with the perf ormance of its duties
or to provide the Authority with expertise in technical matters.
SECTION 4. AMENDATORY 63 O.S. 2021, Section 50 09, is
amended to read as follows:
Section 5009. A. On and after July 1, 1993, the Oklahoma
Health Care Authority shall be the state entity desig nated by law to
assume the responsibilities for the preparation a nd development for
converting the present delivery of the Oklahoma Medicaid Program to
a managed care system. The system shall emphasize:
1. Managed care principles, including a capitated, prepaid
system with either full or partial capitation, provided t hat highest
priority shall be given to development of prepaid capitated health
plans;
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2. Use of primary care physicians to establish the app ropriate
type of medical care a Medicaid recipient should receive; and
3. Preventative care.
The Authority shall a lso study the feasibility of allowing a
private entity to administer all or part of the managed care system.
B. On and after January 1, 1995 , the Oklahoma Health Care
Authority shall be the designated state agency for the
administration of the Oklahoma Medicaid Program.
1. The Authority shall contract with the Department of Human
Services for the determination of Medicaid eligibility and othe r
administrative or operational functions related to the Oklahoma
Medicaid Program as necessary and appropriate.
2. To the extent possi ble and appropriate, upon the transfer of
the administration of the Oklahoma Medicaid Program, the Authority
shall employ the personnel of the Medical Services Division o f the
Department of Human Services.
3. The Department of Human Services and the Autho rity shall
jointly prepare a transition plan for the transfer of the
administration of the Oklahoma Medicaid Program to the Authority.
The transition plan shall include provisions for the retraining and
reassignment of employees of the Department of Human Services
affected by the transfer. The transition plan shall be submitted to
the Governor, the President Pro Tempore o f the Senate and the
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Speaker of the House of Repre sentatives on or before January 1,
1995.
C. B. In order to provide adequate funding for the unique
training and research purposes associated with the demonstration
program conducted by the entity described in paragraph 7 of
subsection B of Section 6201 of Title 74 of the Oklahoma Statutes,
and to provide services to persons without regard to their ability
to pay, the Oklahoma Health Care Authority shall analyze the
feasibility of establishing a Medicaid rei mbursement methodology for
nursing facilities to p rovide a separate Medicaid payment rate
sufficient to cover all costs allowable under Med icare principles of
reimbursement for the facility to be constructed or operated, or
constructed and operated, by the organization described in paragraph
7 of subsection B of Section 6201 of Title 74 of the Oklahoma
Statutes.
SECTION 5. REPEALER 56 O.S. 2021, Sections 1010.2
1010.3, 1010.4, and 1010.5 , are hereby repealed.
SECTION 6. REPEALER 63 O.S. 2021, Sections 5009.5, 5011,
and 5028, are hereby repealed.
SECTION 7. This act shall become effective Nove mber 1, 2022.
58-2-2791 DC 1/18/2022 9:38:38 AM