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State Supreme Court halts implementation of managed care for Medicaid
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State Supreme Court halts implementation of managed care for Medicaid

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Editor's note: A statement from Gov. Kevin Stitt was added after publication.


OKLAHOMA CITY — The Oklahoma Supreme Court has put the brakes on Gov. Kevin Stitt’s managed care plan for Medicaid.

The court in a 6-3 ruling determined that the Oklahoma Health Care Authority did not have the authority to implement managed care, according to an opinion released Tuesday.

A number of entities, including the Oklahoma State Medical Association, Oklahoma Dental Association and Oklahoma Osteopathic Association, filed a lawsuit to stop implementation of the governor’s plan. The Oklahoma Health Care Authority and its CEO, Kevin Corbett, are named as defendants.

The governor has pursued managed care despite the objections of numerous lawmakers. He says he believes it will improve Oklahoman’s health, while critics say the state has tried it in the past and it failed.

Critics also say it will force doctors and other health care providers to drop out of the program due to lower fees, causing a shortage of medical services, especially in rural areas.

The state has already selected contractors to proceed with managed care for more than $2 billion, and the court ruled that the contracts are invalid.

Under managed care, a fixed dollar amount per month per Medicaid enrollee is provided for services by providers who contract with managed care organizations.

Oklahoma currently operates a fee-for-service program.

The court found that there was no express grant of legislative authority to move to managed care. It also found that state law does not already authorize it.

The Legislature “did not intend to give carte blanche authority to the OHCA (Oklahoma Health Care Authority) to create managed care plans,” the order says.

Furthermore, the court held that the passage of State Question 802, through which Oklahoma voters expanded Medicaid, did not authorize managed care.

In a statement Wednesday, Stitt said the move with "unnecessarily delay Oklahoma’s efforts to improve health outcomes. ... I will continue to work with the Oklahoma Health Care Authority to determine the next steps in the process.”

Dr. Mary Clarke, Oklahoma State Medical Association president, said the ruling is an important victory for transparency in government and Oklahoma taxpayers.

Physicians were virtually united against managed care, said Allison LeBoeuf, Oklahoma Osteopathic Association executive director.

“Oklahomans are best served when medical decisions are made between doctor and patient, and without interference from insurance bureaucrats,” LeBoeuf said.

Lynn Means, Oklahoma Dental Association executive director, said: “The managed care plan would’ve jeopardized health care for all Oklahomans by driving out providers of general health care, as well as dentists and specialists across the state. … This lawsuit was one part of a physician-led effort to ward off privatization to insurance companies and keep Oklahomans in charge of health care in Oklahoma.”

Featured video:

Video from May 13, 2021. Voters passed State Question 802 in June 2020, which expands Medicaid to include many people who previously were ineligible due to income limits on the program.

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