Bill > HB3626

This bill modifies existing Oklahoma Medicaid laws to improve the appeals process for adverse determinations and to adjust reimbursement for psychologists. Specifically, it expands the types of professionals who can review appeals of adverse determinations, which are decisions by a contracted entity (like an insurance company managing Medicaid benefits) to deny or limit a requested service or claim, to include licensed psychologists, provided they meet certain training and experience requirements. The bill also amends provisions related to payment methodologies, directing the Oklahoma Health Care Authority (OHCA), the state agency that administers Medicaid, to establish a reimbursement rate for psychologists who successfully appeal an adverse determination, compensating them for the time spent on the appeal that would otherwise be used for patient care. Additionally, it clarifies that psychologist reimbursement should reflect outcomes and cover services beyond just therapy, including patient intake, testing, and assessment. This act is set to become effective on November 1, 2026.

http://www.oklegislature.gov/BillInfo.aspx?Bill=hb3626&Session=2600