Oklahoma providers who treat patients covered by Medicaid may soon get their first pay rate increase in nearly a decade.
The Oklahoma Health Care Authority announced Wednesday it’s considering raising rates paid to providers, the Oklahoman reported . The authority administers SoonerCare, the state’s Medicaid program covering about 796,000 people. The majority of those covered by SoonerCare are children.
The authority’s board will consider the increases Sept. 13. If approved, providers would start receiving higher rates Oct. 1, marking the first increase since 2009.
Long-term facilities are projected to receive a 4 percent rate increase. But the actual increase amount would be closer to 3.2 percent because it would be partially offset by patients paying less toward their care, said Nico Gomez, CEO of the Oklahoma Association of Health Care Providers. Nursing facilities would still have to make up the difference with the higher rate they charge private-pay residents, though the increased rate would ease that, he said.
“We’re grateful” for the increase, Gomez said. “We just have a little further to go.”
Physicians, hospitals and pharmacies would receive a 3 percent increase. After the pay rate bump, doctors treating a Medicaid-covered patient would on average be paid 89 percent of what they’re paid for treating a Medicare patient. Medicaid generally pays less than Medicare.
The plan won’t require additional state money because a new law requires the authority to use savings and drug rebates for rate increases, according to the authority’s spokeswoman Jo Stainsby.
Stainsby said most of the money comes from larger rebates on prescription drugs. Limiting prenatal cystic fibrosis screening and ending ineligible members’ coverage faster also led to more savings than expected, she said.
“Maintaining adequate provider rates is vital to ensuring Oklahomans in rural and other underserved areas have access to the health care they need,” said Wes Glinnsman, executive director of the Oklahoma State Medical Association. “After several rate cuts in recent years, we are pleased that the Legislature and the Health Care Authority are making access to care a priority for Oklahoma’s most vulnerable citizens.”