OK
Oklahoma Senate Bill SB434

Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB434 Compare Versions

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3+ENGR. H. A. to ENGR. S. B. NO. 434 Page 1 1
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28+ENGROSSED HOUSE AMENDME NTS
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30+ENGROSSED SENATE BILL NO . 434 By: McCortney of the Senate
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34+ McEntire of the House
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4-An Act
5-ENROLLED SENATE
6-BILL NO. 434 By: McCortney and Floyd of the
7-Senate
38+An Act relating to the state Medicaid program;
39+stating purpose of act; creating the I/T/U Shared
40+Savings Program; providing that c ertain services may
41+be subject to certain reimbursement; providing for
42+certain distribution and deposit of savings;
43+prohibiting certain use of fund; requiring certain
44+actions and distributions to be conducted in
45+accordance with certain federal guidance; sp ecifying
46+criteria of care coordination agreements; providing
47+for promulgation of rules and execution of contracts
48+in accordance with certain requirements; requiring
49+the Oklahoma Health Care Authority to seek certain
50+federal approval; providing for terminat ion of the
51+I/T/U Shared Savings Program under certain
52+conditions; creating the I/T/U Shared Savings
53+Revolving Fund; specifying purpose of fund and
54+revenue sources; requiring submission of certain
55+annual report; specifying criteria of report;
56+providing for codification; providing an effective
57+date; and declaring an emergency.
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62+AUTHOR: Add the following House Coauthor: Pittman
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64+AMENDMENT NO. 1. Page 1, Lines 6 through 15 1/2, strike the title
65+to read:
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67+"[ Medicaid – creating the I/T/U Shared Savings
68+Program – specifying criteria of care coordination
69+agreements – creating the I/T/U Shared Savings
70+Revolving Fund – specifying purpose of fund and
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72+ENGR. H. A. to ENGR. S. B. NO. 434 Page 2 1
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97+revenue sources – effective date -
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99+AMENDMENT NO. 2. Page 1, Line 1 8, strike the enacting clause
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101+Passed the House of Representatives the 21st day of April, 2021.
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107+Presiding Officer of the House of
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111+Passed the Senate the ____ day of __________, 2021.
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145+ENGROSSED SENATE
146+BILL NO. 434 By: McCortney of the Senate
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9148 and
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11- McEntire, Pittman and
12-Fugate of the House
150+ McEntire of the House
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16154
17155 An Act relating to the state Medicaid program;
18156 stating purpose of act; creating the I/T/U Shared
19157 Savings Program; providing that certain services may
20158 be subject to certain reimbursement; providing for
21159 certain distribution and deposit of savings;
22160 prohibiting certain use of fund; requiring certain
23161 actions and distributions to be conducted in
24162 accordance with certain federal guidance; specifying
25163 criteria of care coordination agreements; providing
26164 for promulgation of rules and execution of contracts
27165 in accordance with certain requirements; requiring
28166 the Oklahoma Health Care Authority to seek certain
29167 federal approval; providing for termination of the
30168 I/T/U Shared Savings Program under certain
31169 conditions; creating the I/T/U Shared Savings
32170 Revolving Fund; specifying purpose of fund and
33171 revenue sources; requiring submission of certain
34172 annual report; specifying criteria of report;
35173 providing for codification; providing an effective
36174 date; and declaring an emergency.
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41-SUBJECT: Medicaid
42-
43179 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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46-ENR. S. B. NO. 434 Page 2
47180 SECTION 1. NEW LAW A new section of law to be codified
48181 in the Oklahoma Statutes as Section 5061.1 of Title 63, unless there
49182 is created a duplication in numbering, reads as f ollows:
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51183 A. The purpose of this act is to maximize and direct the
52184 reinvestment of any savings to the Oklahoma Health Care Authority
53185 generated by enhanced federal matching authorized under Section
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54212 1905(b) of the Social Security Act at a rate of one hundred percent
55213 (100%) for covered services received through participating Indian
56214 Health Service, Tribal and Urban Indian (I/T/U) facilities.
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58215 B. There is hereby created the I/T/U Shared Savings Program.
59216 Pursuant to guidance of the Centers for Medicare & Medicaid Services
60217 (CMS), authorized services provided by a non -I/T/U Medicaid provider
61218 to an American Indian or Alaska Native (AI/AN) Medicaid beneficiary
62219 as a result of a referral from an I/T/U facility provider may be
63220 eligible for the enhanced federal matching r ate of one hundred
64221 percent (100%).
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66222 C. 1. The Authority shall distribute up to fifty percent (50%)
67223 of any savings that result from the I/T/U Shared Savings Program
68224 provided for in this section to participating I/T/U facilities that
69225 have complied with the terms of this act and applicable federal law,
70226 but only after administrative costs incurred by the Authority in
71227 implementing the I/T/U Shared Savings Program have been fully
72228 satisfied.
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74229 2. Distributions to participating I/T/U facilities shall be
75230 used to increase care coordination and to support health care
76231 initiatives for AI/AN populations.
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78232 3. The Authority shall deposit any shared savings that remain
79233 after administrative costs have been fully paid, and after
80234 distributions have been made to participating I/ T/U facilities, into
81235 the I/T/U Shared Savings Revolving Fund created in Section 2 of this
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82262 act for the purpose of increasing Medicaid provider rates. Monies
83263 in the fund shall not be used to replace other general revenues
84264 appropriated and funded by the Legi slature or other revenues used to
85265 support Medicaid.
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87266 D. 1. All actions taken by the Authority in implementing the
88267 I/T/U Shared Savings Program shall be made in accordance with
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90-ENR. S. B. NO. 434 Page 3
91268 applicable state and federal Medicaid law and CMS State Health
92269 Official letter (SHO) #16-002, issued on February 26, 2016, and CMS
93270 Frequently Asked Questions (FAQs) regarding "Federal Funding for
94271 Services 'Received Through' an IHS/Tribal Facility and Furnished to
95272 Medicaid-Eligible American Indians and Alaska Natives (SHO #16 -002)"
96273 issued on January 18, 2017, and as such guidance may be hereinafter
97274 amended or modified.
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99275 2. The Authority shall make distributions to a participating
100276 I/T/U facility in accordance with paragraph 1 of subsection C of
101277 this section, contingent upon the producti on of executed copies of
102278 Care Coordination Agreements (CCAs) for all services billed to
103279 Oklahoma Medicaid that were received through the I/T/U facility.
104280 CCAs must be executed between the I/T/U facility and the non -I/T/U
105281 provider and must include, at a min imum, assurances that care
106282 coordination shall involve:
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108283 a. the I/T/U facility practitioner providing a request
109284 for specific services by electronic or other
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110311 verifiable means and relevant information about the
111312 practitioner's patient to the non -I/T/U provider,
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113313 b. the non-I/T/U provider sending information about the
114314 care the non-I/T/U provider provides to the patient
115315 including the results of any screening, diagnostic or
116316 treatment procedures, to the I/T/U facility
117317 practitioner,
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119318 c. the I/T/U facility practitioner continuing to assume
120319 responsibility for the patient's care by assessing the
121320 information and taking appropriate action including,
122321 when necessary, furnishing or requesting additional
123322 services, and
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125323 d. the I/T/U facility incorporating the patient's
126324 information in the medical record through the
127325 statewide health information exchange or other agreed -
128326 upon means.
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130327 E. The Oklahoma Health Care Authority Board is authorized to
131328 promulgate administrative rules and to enter into contractual
132329 agreements with I/T/U facilitie s as needed to effectuate the
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135330 provisions of this act. As part of the rulemaking process, the
136331 Authority shall comply with the Tribal Consultation Requirements
137332 provided by the Medicaid State Plan.
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139333 F. The Authority shall promptly seek any necessary federal
140334 approval for the implementation of this act. In the event that any
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141361 necessary federal approval is not obtained, or in the event funding
142362 of Oklahoma Medicaid from state, federal or other sources is
143363 withdrawn, reduced or limited in any way that affects imple mentation
144364 of the I/T/U Shared Savings Program, the I/T/U Shared Savings
145365 Program may be terminated immediately by the Authority, and no court
146366 or tribunal shall have jurisdiction to review such termination.
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148367 SECTION 2. NEW LAW A new se ction of law to be codified
149368 in the Oklahoma Statutes as Section 5061.2 of Title 63, unless there
150369 is created a duplication in numbering, reads as follows:
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152370 A. There is hereby created in the State Treasury a revolving
153371 fund for the Oklahoma Health Care Author ity to be designated the
154372 "I/T/U Shared Savings Revolving Fund". The fund shall be a
155373 continuing fund, not subject to fiscal year limitations, and shall
156374 consist of all monies received by the Authority pursuant to this act
157375 and otherwise specified or authoriz ed by law.
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159376 All monies accruing to the credit of the fund are hereby
160377 appropriated and shall be budgeted and expended by the Authority to
161378 increase Medicaid provider rates, unless otherwise provided by law.
162379 Expenditures from the fund shall be made upon warra nts issued by the
163380 State Treasurer against claims filed as prescribed by law with the
164381 Director of the Office of Management and Enterprise Services for
165382 approval and payment.
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167383 B. An annual report shall be prepared by the Authority's Chief
168384 Financial Officer an d shall be submitted to the Governor, the
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169411 President Pro Tempore of the Senate and the Speaker of the House of
170412 Representatives no later than thirty (30) days following the end of
171413 each State Fiscal Year. The annual report shall account for:
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173414 1. The savings realized by the Authority as a result of the
174415 I/T/U Shared Savings Program;
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178416 2. The administrative costs incurred by the Authority as a
179417 result of the I/T/U Shared Savings Program;
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181418 3. The monies distributed to participating I/T/U facilities as
182419 a result of I/T/U Shared Savings Program including, but not limited
183420 to, a summary of all specific distributions;
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185421 4. The balance of savings realized by the Authority as a result
186422 of the I/T/U Shared Savings Program and accruing to the credit of
187423 the fund after payment of administrative costs and distributions to
188424 participating I/T/U facilities; and
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190425 5. The monies expended on increasing Medicaid provider rates
191426 including, but not limited to, identification of the types of
192427 providers affected and the percentage by which the pr oviders' rates
193428 were increased.
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195429 SECTION 3. This act shall become effective July 1, 2021.
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197430 SECTION 4. It being immediately necessary for the preservation
198431 of the public peace, health or safety, an emergency is hereby
199432 declared to exist, by reason whereof this act shall take effect and
200433 be in full force from and after its passage and approval.
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203-ENR. S. B. NO. 434 Page 6
204-Passed the Senate the 19th day of May, 2021.
460+Passed the Senate the 10th day of March, 2021.
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208464 Presiding Officer of the Senate
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211-Passed the House of Representatives the 25th day of May, 2021.
467+Passed the House of Representatives the ____ day of _ _________,
468+2021.
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215472 Presiding Officer of the House
216473 of Representatives
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218-OFFICE OF THE GOVERNOR
219-Received by the Office of the Governor this _______ _____________
220-day of _________________ __, 20_______, at _______ o'clock _______ M.
221-By: _______________________________ __
222-Approved by the Governor of the State of Oklahoma this _____ ____
223-day of _________________ __, 20_______, at _______ o'clock _______ M.
224475
225- _________________________________
226- Governor of the State of Oklahoma
227-
228-
229-OFFICE OF THE SECRETARY OF STATE
230-Received by the Office of the Secretary of State this _______ ___
231-day of __________________, 20 _______, at _______ o'clock _______ M.
232-By: _________________________________