The bill amends Section 4002.12 of Title 56 of the Oklahoma Statutes, extending the deadline for the Oklahoma Health Care Authority to establish minimum rates of reimbursement from contracted entities to providers from July 1, 2027, to July 1, 2035. The reimbursement rates for participating providers will remain at 100% of the applicable service fee schedule, while non-participating providers will receive 90%. Additionally, the bill mandates that contracted entities offer value-based payment arrangements to all capable providers, with incentives tied to quality metrics, and ensures compliance with federal payment methodologies for specific provider types.

Furthermore, the bill outlines various provisions regarding reimbursement for services, including those for Certified Community Behavioral Health Clinics, psychologists, and ground transportation services. It establishes requirements for annual updates to capitation rates, the monitoring of primary care spending, and the implementation of penalties for contracted entities that do not meet medical loss ratio standards. The act is set to take effect on November 1, 2026.

Statutes affected:
Introduced: 56-4002.12