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OK SB252
OK SB252Medicaid; excluding prescription drug services from certain provisions; directing certain program delivery model. Effective date.
summary
Introduced
02/03/2025
02/03/2025
In Committee
02/04/2025
02/04/2025
Crossed Over
Passed
Dead
Introduced Session
2025 Regular Session
Bill Summary
An Act relating to the state Medicaid program; amending Section 3, Chapter 395, O.S.L. 2022, as amended by Section 2, Chapter 448, O.S.L. 2024 (56 O.S. Supp. 2024, Section 4002.3a), which relates to capitated contracts; excluding prescription drug services from certain provisions; directing certain program delivery model for prescription drug services; requiring certain transition, contracts, and reimbursement; directing amendment of specified contracts; providing certain construction; requiring the Oklahoma Health Care Authority to seek certain federal approval; amending Section 4, Chapter 395, O.S.L. 2022, as amended by Section 3, Chapter 448, O.S.L. 2024 (56 O.S. Supp. 2024, Section 4002.3b), which relates to capitated contracts; conforming language; amending 56 O.S. 2021, Section 4002.5, as last amended by Section 1, Chapter 243, O.S.L. 2023 (56 O.S. Supp. 2024, Section 4002.5), which relates to contracted entity responsibilities; conforming language; updating statutory references; amending 56 O.S. 2021, Section 4002.12, as last amended by Section 7, Chapter 448, O.S.L. 2024 (56 O.S. Supp. 2024, Section 4002.12), which relates to minimum rates of reimbursement; conforming language; and providing an effective date.
AI Summary
This bill modifies Oklahoma's Medicaid program by excluding prescription drug services from the current managed care contracts and establishing a new fee-for-service delivery model for prescription drug coverage. Specifically, the Oklahoma Health Care Authority (OHCA) will be required to transition prescription drug coverage from contracted entities to direct coverage by the Authority, directly reimbursing pharmacists and pharmacy providers. The bill allows OHCA to implement value-based payment arrangements, cost-saving measures like participating in the Medicaid Drug Rebate Program, and potentially contract with a pharmacy benefits administrator located in Oklahoma. The bill also makes conforming changes to several sections of existing law, updating language related to capitated contracts, contracted entity responsibilities, and reimbursement rates. These changes are part of the broader Ensuring Access to Medicaid Act, which aims to transform the state's Medicaid delivery system, with implementation subject to federal approval from the Centers for Medicare and Medicaid Services. The bill will become effective on November 1, 2025, providing time for the necessary transitions and approvals.
Committee Categories
Health and Social Services
Sponsors (2)
Last Action
Senate Health and Human Services Hearing (13:30:00 3/3/2025 Room 535) (on 03/03/2025)
Official Document
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