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Medicaid Reform Task Force to Gather Insights From Across State of Oklahoma

Posted on: Wednesday, 20 July 2005, 21:01 CDT

If there is $100 million worth of savings to be found within Oklahoma's Medicaid system, the newly created Medicaid reform task force will find them, state House leadership said Tuesday. The task force will travel the state, touring medical facilities and holding town hall meetings in communities.

We're going to identify innovative reforms, as well as targeting waste and abuse in the system, said state Rep. Kris Steele, R- Shawnee, chair of the House Health and Human Services Committee. When we're talking about savings, we're not talking about reducing Medicaid's budget. We're talking about redirecting those dollars and utilizing those dollars in the best possible way.

The current structure of the state's Medicaid system leads to inefficiencies and abuses, said state Rep. Doug Cox, R-Grove, who works in the private sector as a physician. Among a list of problems with the system, some patients use Medicaid when they have other insurance coverage, or use more expensive emergency rooms instead of making regular visits to the doctor's office, said legislators.

House Speaker Todd Hiett, R-Kellyville, pointed to a federal court ruling from March ordering the Oklahoma Health Care Authority to increase Medicaid reimbursement rates for physicians. Oklahoma's low reimbursement rate, which repays health care providers roughly 70 cents on every dollar spent caring for Medicaid patients, discourages physicians from participating in the plan, and thus has resulted in reduced access to care for children on Medicaid, ruled Chief Judge Claire Eagan.

The $100 million in savings sought by the task force represents about 4 percent of the state's entire Medicaid budget, said Steele.

We feel like that should be a reasonable number to obtain to ensure that our system - works the way it's supposed to, said Steele, though the task force has yet to determine exactly how much money could be saved by increasing efficiency.

Though the Republican leadership in the House of Representatives has been critical of the Oklahoma Health Care Authority's handling of the program, Nico Gomez, director of governmental and public affairs for OHCA, was named to the task force.

This is an opportunity for the agency to showcase and build on some of our successful reforms we have implemented over the past couple of years, said Gomez. We want to make sure the citizens have accountability over what is now over a $3 billion expense for the state.

Task force members include Steele as chair; state Rep. Doug Cox, vice chair, R-Grove; state Rep. Thad Balkman, R-Norman; state Rep. Lee Denney, R-Cushing; state Rep. Pam Peterson, R-Tulsa; state Rep. Dan Sullivan, R-Tulsa; state Rep. John Auffet, D-Stillwell and state Rep. R.C. Pruett, D-Antlers.

Though the task force includes two Democrat legislators, political consultant Sean Mossman noted that the balance of the membership is heavily tilted toward Republicans. Mossman also noted that, though Cox highlighted the need to enroll more dentists in the state's Medicaid program, the Legislature's only dentist, state Rep. Bill Nations, D-Norman, was not appointed to the task force.

Other members include Patricia Anderson, vice president of financial services, Oklahoma Hospital Association; Calvin Anthony, president of Tiger Drug Co. in Stillwater; Tulsa orthopedic surgeon James Cash, M.D., Central States Orthopedic Specialists; Tom Coble, president of the Oklahoma Association of Health Care Providers; Nico Gomez, director of governmental and public affairs for the Oklahoma Health Care Authority; David Hadley, M.D., medical director for Unity Health Center in Shawnee; C. Bruce Lawrence, president and chief operating officer of Integris Baptist and Southwest Medical Centers, in Oklahoma City; Marc Marion, senior vice president of health services for Oklahoma City-based insurance company C.L. Frates & Co.; and attorney and Oklahoma Board of Health secretary- treasurer Barry Smith.

Jeff Hughes, of Norman-based independent living center Progressive Independence, said the task force's membership seems to indicate a top-down approach to the issue, as government agencies, health care providers and insurance companies are represented, but not patients groups. Steele said the task force can get input from consumers at biweekly meetings that will be open to the public.

Tuesday afternoon, state Sen. Tom Adelson, D-Tulsa, chair of the Senate Appropriations Subcommittee on Health and Social Services, criticized Hiett for increasing Medicaid funding by 33 percent in 2005 while claiming the agency mismanaged $100 million.

It's part of Speaker Hiett's schizoid behavior - spend money like a Ted Kennedy liberal while employing the rhetoric of a Grover Norquist, said Adelson.

Source: Journal Record - Oklahoma City

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