Senate Bill No. 875 amends various sections of the Oklahoma Medicaid program, focusing on capitated contracts and reimbursement rates. The bill mandates that all capitated contracts be awarded through competitive bidding, ensuring that at least three statewide contracts for comprehensive health services and two for dental coverage are established. It introduces penalties for contracted entities that fail to meet specific primary care spending requirements, including a scoring penalty for not allocating at least 11% of total healthcare expenses to primary care services. Additionally, if a contracted entity does not meet the minimum spending requirement, it will be ineligible for future contract awards and must pay liquidated damages, which will be used to fund primary care services.

The bill also modifies the powers and duties of the Medicaid Delivery System Quality Advisory Committee, which will now be responsible for recommending quality measures and developing methodologies for the use of proceeds from penalties related to primary care spending. The effective date for these changes is set for July 1, 2025, and an emergency clause is included to ensure immediate implementation upon passage. Overall, the bill aims to enhance the quality and accountability of Medicaid services in Oklahoma by establishing stricter requirements and penalties for contracted entities.

Statutes affected:
Introduced: 56-4002.12
Floor (House): 56-4002.12, 56-4002.13
Floor (Senate): 56-4002.12
Engrossed: 56-4002.12, 56-4002.13
Enrolled (final version): 56-4002.12, 56-4002.13