Stitt shakes up state Health Care Authority board by dismissing its only two physician-members

The move appears to be the latest in Stitt’s unbending determination to transition the state’s Medicaid system, which is administered by the OHCA, to a privately managed model despite the opposition of much of the Legislature and medical community.

“I was called on Saturday … by a member of the governor’s staff and told I’d been removed. No reason was given,” said Dr. Jean Hausheer, a Lawton ophthalmologist with the Dean McGee Eye Institute.

Hausheer and Dr. Laura Shamblin, an Oklahoma City pediatrician, were immediately replaced by Susan Dell’Osso, a communications and marketing specialist who previously worked about two years in the health care sector, and Gino DeMarco, a retired oil and gas executive who served as Stitt’s “PPE czar” in the early days of the COVID-19 pandemic.

“It’s important you have physicians at that table,” Hausheer said. “I would say a better path forward for this governor, instead of trying to push through a managed care agenda through administrative rules and the Health Care Authority board like he’s doing, … a more successful avenue would be to collaborate (with) leadership from the Legislature, leadership from the Health Care Authority, leadership from those of us who are in health care and understand it.”

The move prompted a sharp and lengthy response from the state’s medical, dental and osteopathic associations.

In a joint letter addressed to Stitt but sent to all members of the Legislature, the organizations said that despite Corbett’s statements to the contrary, last week’s OHCA meeting “made it clear (Corbett) is moving forward with plans to implement managed care in any way possible.”

Later, the letter says the dismissal of Shamblin and Hausheer “denies physician input on … important decisions … and demonstrates a choice to ignore the wishes of Oklahomans and their healthcare providers.”

Stitt’s communications director did not respond to direct questions about why Hausheer and Shamblin were replaced in the middle of their terms and whether it was related to last week’s meeting.

At that meeting, Hausheer — as chair of the Administrative Rules Committee — had recommended the tabling of the two administrative rules. The rules would have triggered the promulgation of administrative rules for privatizing the state’s Medicaid system as called for in Senate Bill 131, which became law in May.

The state’s Medicaid system is administered by the Health Care Authority.

Hausheer said that after consultation with the OHCA’s Medical Advisory Board and the bill’s authors, Sen. Greg McCortney, R-Ada, and Rep. Marcus McEntire, R-Duncan, she concluded that the rules should not proceed because the state Supreme Court had ruled in June that managed care can not be implemented without the specific authorization of the Legislature.

The board, on a 7-1 vote, agreed.

The court’s dissenters — James Winchester, John Kane and Dustin Rowe — in June’s 6-3 state Supreme Court decision left behind brief opinions some see as a way around the court and the Legislature.

Winchester wrote that because SB 131 “recognizes” a managed model, the Health Care Authority should be allowed to proceed. Kane and Rowe, in a one-sentence dissent, said much the same.

McCortney and McEntire, who oppose managed care, said SB 131 was passed in anticipation of managed care’s implementation and was intended to restrict the Health Care Authority, not give it carte blanche. They believe that the Supreme Court’s majority decision rendered SB 131 moot.

While lawmakers are loathe to say so publicly, some speculate that Stitt may be trying to advance managed care’s implementation so that the courts and the Legislature will have little choice but to go along.

Adding to the drama is the fact that all three of the dissenting justices in the Supreme Court decisions have ties to Stitt. Winchester’s wife, former lawmaker Susan Winchester, is a member of Stitt’s Cabinet, and Kane and Rowe are Stitt appointees.

And this summer Stitt replaced the retired Justice John Reif, part of the 6-3 majority on the Medicaid decision, with Dana Kuehn.

Many states use managed care models, and Stitt contends that it would improve health outcomes in Oklahoma.

Opponents note that the state already has what is considered one of the best-managed Medicaid systems in the country and that there is no indication that privately managed systems are consistently more efficient than those operated by state agencies.

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