OKLAHOMA CITY — A bunch of native well being care suppliers is suing the state’s Medicaid agency over its request for proposals in search of entities to implement privatized managed care.
A newly fashioned firm made up of eight Medicaid suppliers requested the Oklahoma Supreme Court compel the Oklahoma Health Care Authority to change and reissue its request for proposals to award multibillion-dollar contracts for corporations to supervise care for most of the state’s Medicaid recipients.
The state agency and its CEO, Kevin Corbett, are named within the lawsuit, filed Monday.
Equity Group Advancing Access and Services alleges that OHCA’s public bidding course of for the managed care contracts doesn’t, as was meant underneath state regulation, give preferential remedy to native suppliers already serving Medicaid sufferers.
“The OHCA released an RFP (request for proposals) that is flawed and circumvents state law,” Variety Care President and CEO Lou Carmichael mentioned in a news launch. A member of the fairness group’s board of administrators, Carmichael helped type the group in March.
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“As written, the RFP makes it impossible for any Oklahoma-based PLE (provider-led entity) established under state statute to submit a competitive bid as the requirements in the RFP are written in such a way that no newly formed entity could ever win a contract.”
Under a managed care or privatized Medicaid mannequin, the OHCA will contract with exterior corporations to supervise the supply of providers for a majority of the greater than 1 million Oklahomans receiving Medicaid advantages by way of SoonerCare.
The lawsuit argues that the language within the RFP is almost similar to a managed care RFP the agency issued previous to laws handed final yr that aimed to offer Oklahoma medical suppliers a leg up within the bidding course of that may undoubtedly embrace bids from national insurance companies.
The state Supreme Court struck down the OHCA’s earlier try to implement privatized managed care, saying the agency didn’t have the authority to behave with out approval from the Oklahoma Legislature. That led lawmakers final yr to cross Senate Bill 1337, which authorizes managed care and particulars how the OHCA ought to give preferential remedy within the bidding course of to native provider-led entities.
The OHCA stays dedicated to fulfilling the necessities of SB 1337 and different legal guidelines that direct the agency to execute managed care reforms to enhance well being outcomes for Oklahomans, mentioned spokeswoman Emily Long.
The fairness group argues that it was disenfranchised within the bidding course of as a result of the RFP sought historic documentation that no newly fashioned entity may presumably present. After considerations have been expressed to the OHCA, the agency up to date the RFP, however the lawsuit argues that the adjustments have been minor and didn’t undo the inherent bias in opposition to newly fashioned provider-led entities.
The lawsuit requires the RFP to be declared null, void and unenforceable.
The lawsuit additionally alleges that OHCA’s plans violate state regulation due to the delayed timeframe to implement managed care. SB 1337 requires that the Medicaid adjustments take impact by Oct. 1. The state pushed again implementation of managed care till April 2024, in keeping with the lawsuit.
OHCA issued its RFP in November. The agency is required by regulation to decide on at the very least three entities, together with one provider-led group, to supply well being care protection statewide. It’s unclear when OHCA will announce the chosen corporations.
Former Democratic state Rep. Collin Walke, now an legal professional at Hall Estill in Oklahoma City, is representing the group that introduced the lawsuit.
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