Okla. Stat. tit. 56, § 56-4002.3a

delivery of Medicaid services.

A. 1. The Oklahoma Health Care Authority (OHCA) shall enter

into capitated contracts with contracted entities for the delivery

of Medicaid services as specified in the Ensuring Access to Medicaid

Act to transform the delivery system of the state Medicaid program

for the Medicaid populations listed in this section.

2. Unless expressly authorized by the Legislature, the

Authority shall not issue any request for proposals or enter into

any contract to transform the delivery system for the aged, blind,

and disabled populations eligible for SoonerCare.

B. 1. The Oklahoma Health Care Authority shall issue a request

for proposals to enter into public-private partnerships with

contracted entities other than dental benefit managers to cover all

Medicaid services other than dental services for the following

Medicaid populations:

a. pregnant women,

b. children,

c. deemed newborns under 42 C.F.R., Section 435.117,

d. parents and caretaker relatives, and

e. the expansion population.

2. The Authority shall specify the services to be covered in

the request for proposals referenced in paragraph 1 of this

subsection. Capitated contracts referenced in this subsection shall

cover all Medicaid services other than dental services including:

a. physical health services including, but not limited

to:

(1) primary care,

(2) inpatient and outpatient services, and

(3) emergency room services,

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b. behavioral health services, and

c. prescription drug services.

3. The Authority shall specify the services not covered in the

request for proposals referenced in paragraph 1 of this subsection.

4. Subject to the requirements and approval of the Centers for

Medicare and Medicaid Services, the implementation of the program

shall be no later than April 1, 2024.

C. 1. The Authority shall issue a request for proposals to

enter into public-private partnerships with dental benefit managers

to cover dental services for the following Medicaid populations:

a. pregnant women,

b. children,

c. parents and caretaker relatives,

d. the expansion population, and

e. members of the Children’s Specialty Plan as provided

by subsection D of this section.

2. The Authority shall specify the services to be covered in

the request for proposals referenced in paragraph 1 of this

subsection.

3. Subject to the requirements and approval of the Centers for

Medicare and Medicaid Services, the implementation of the program

shall be no later than April 1, 2024.

D. 1. Either as part of the request for proposals referenced

in subsection B of this section or as a separate request for

proposals, the Authority shall issue a request for proposals to

enter into public-private partnerships with one contracted entity to

administer a Children’s Specialty Plan.

2. The Authority shall specify the services to be covered in

the request for proposals referenced in paragraph 1 of this

subsection.

3. The contracted entity for the Children’s Specialty Plan

shall coordinate with the dental benefit managers who cover dental

services for its members as provided by subsection C of this

section.

4. Subject to the requirements and approval of the Centers for

Medicare and Medicaid Services, the implementation of the program

shall be no later than April 1, 2024.

E. The Authority shall not implement the transformation of the

Medicaid delivery system until it receives written confirmation from

the Centers for Medicare and Medicaid Services that a managed care

directed payment program utilizing average commercial rate

methodology for hospital services under the Supplemental Hospital

Offset Payment Program has been approved for Year 1 of the

transformation and will be included in the budget neutrality cap

baseline spending level for purposes of Oklahoma’s 1115 waiver

renewal; provided, however, nothing in this section shall prohibit
a managed care

directed payment program utilizing average commercial rate

methodology for hospital services under the Supplemental Hospital

Offset Payment Program has been approved for Year 1 of the

transformation and will be included in the budget neutrality cap

baseline spending level for purposes of Oklahoma’s 1115 waiver

renewal; provided, however, nothing in this section shall prohibit

the Authority from exploring alternative opportunities with the

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Centers for Medicare and Medicaid Services to maximize the average

commercial rate benefit.