McCortney: Study on Managed Care’s Service and Cost Impact

Sen. McCortney holds study on managed care’s possible impact on Indian Health Care services and costs to the state

OKLAHOMA CITY – Senate Health and Human Services Chair Greg McCortney held an interim study at the Capitol on Monday examining how the governor’s push toward a managed care system for Medicaid could have unintended yet significant financial consequences for the state if Indian health care services are not handled correctly.

Presenters for the study included health care policy experts for the Choctaw and Chickasaw Nations as well as representatives of the Oklahoma Health Care Authority (OHCA).

“Federal reimbursement rates for Medicaid are about 60 percent, and the state picks up the remaining 40 percent, but the reimbursement rate for Indian health care is 100 percent.  But if the Health Care Authority simply rolls Indian health care in with non-tribal Medicaid patients, the state could end up holding the bag for 40 percent of the cost—millions and millions of dollars we’ve not previously been responsible for,” said McCortney, R-Ada.  “That’s why it is so important for the state to get this right.  If we don’t, Oklahoma could be responsible for literally hundreds of millions of additional dollars for health care.”

McCortney said while other states have already addressed the issue of converting their own Medicaid services to managed care systems, dealing with the special circumstances of tribal health care was a smaller piece of the healthcare system compared to Oklahoma.

“We have 38 federally recognized tribes and the second highest Indian population in the country.  Oklahoma’s Indian nations know what’s good for Oklahoma is good for the tribes—and they are very concerned about how moving their health care under a new managed care system could negatively impact not only their members, but the state of Oklahoma,” McCortney said.

Possible solutions would be to completely carve out Indian health care from the managed care system, require an opt-out provision for tribal members, which would put a burden on the tribal members, or conversely, an opt-in.

“The Health Care Authority is currently drafting the requests for proposals for a managed care system, so we still don’t really know what it will look like,” McCortney said.  “We’re already facing significant increased costs as the result of the statewide vote on Medicaid expansion—costs that could go even higher if the issue of tribal health care is not addressed correctly.”

For more information, contact Sen. Greg McCortney at 405-521-5541 or email [email protected].