The bill amends various sections of the Oklahoma Medicaid program, specifically focusing on capitated contracts, reimbursement rates, and the establishment of penalties for non-compliance with primary care spending requirements. It mandates that the Oklahoma Health Care Authority (OHCA) award a minimum of three statewide capitated contracts for comprehensive health services and two for dental coverage. Additionally, it introduces a scoring penalty for contracted entities that fail to meet an 11% minimum primary care services expense requirement, which could affect their eligibility for future contracts. The bill also emphasizes the need for a scoring methodology that favors provider-led and provider-owned entities in the procurement process.

Furthermore, the bill modifies the powers and duties of the Medicaid Delivery System Quality Advisory Committee, requiring it to make recommendations on quality measures and develop a methodology for utilizing proceeds from penalties related to primary care spending. The amendments include specific definitions and stipulations regarding reimbursement rates for various healthcare providers, ensuring compliance with federal regulations. The act is set to take effect on July 1, 2025, with an emergency clause for immediate implementation upon passage.

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