Oklahoma: Medicaid cuts don't take rural challenges into consideration

OKLAHOMA CITY, Okla. - Steep Medicaid cuts are scheduled to take effect July 1, despite multiple meetings with Medicaid officials, leading HME providers here to feel their concerns have “fallen on deaf ears.”

To comply with the 21st Century Cures Act, the Oklahoma Health Care Authorityplans to take the lowest Medicare competitive bidding rates and apply them across the board, resulting in cuts of up to nearly 50% for some product categories, says Katie Roberts, director for Stillwater-based Cimarron Medical Services and a board member of the Oklahoma Medical Equipment Providers Association.

“We've been working with OHCA,” she said. “We've had several meetings and face-to-face discussions, and talked about how detrimental these cuts would be. It's fallen on deaf ears.”

As an example, the current rural reimbursement rate for oxygen is $136.77; the new rate would be $74.22.

The reduced reimbursement is unrealistic for providers trying to service rural areas, says Larry Dalton, OMEPA president.

“There's lot of areas that don't have GPS or cell service, so we spend a lot of time on detours or just searching people down,” said Dalton, who is COO Of Durant-based Advanced Care Medical Equipment. “There's no way.”

The Medicaid budget is also facing additional pressure: Oklahomans on June 30 will vote on a bill that would expand Medicaid coverage to certain low-income adults previously not covered by the program, says Dalton.

“They didn't want to add additional funds (to pay for expanded services),” he said.

In addition to the increased cost of serving a more rural population, Medicaid officials aren't taking into account the impact of the current coronavirus pandemic, Roberts says.

“If we were to have these (new) rates and we're talking about COVID, we'll either have to have patients come to our office, or they are going to go without or be back in the ER,” she said.

A recent letter to Gov. Kevin Stitt, spearheaded by state Rep. JJ Humphrey and signed by 38 representatives and 10 senators, asks the state to follow federal reimbursement rates that recognize the need for higher rural rates. Copied on the letter: OHCA's board and executive team, says Roberts.

“Members of the OHCA Board asked the executive team at OHCA to provide more information prior to implementation of the cuts,” she said.“That gives us hope they'll take another look.”