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The Oklahoma Supreme Court ruled on June 1 that the Oklahoma Health Care Authority (OHCA) cannot create a managed care program as part of the state’s voter-approved Medicaid expansion — on the same day that enrollment for the expanded Medicaid program began. The decision is the result of a suit brought by medical professional associations including the Oklahoma State Medical Association and groups representing dentists, pediatricians, osteopaths and anesthesiologists. The court held that OHCA acted improperly in awarding MCO contracts to payers because “the Legislature has not authorized the creation of the SoonerSelect [Medicaid managed care] program.” For now, the state is obliged to avoid a capitated model for the program, as the authorizing initiative “in no way authorize[s] this course of action. The OHCA, through an RFP process and competitive bidding, awarded contracts to MCOs without legislative authorization or required rules in place. In effect, the OHCA moved ahead without the required legislative authorization.” OHCA in January selected four MCOs to begin serving enrollees in October.

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AIS Health Staff

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