OK HB1552

Establishes Oklahoma Medicaid as a statewide integrated managed care program for all covered services, requiring the Oklahoma Health Care Authority to implement both a 1932(a) State Plan Amendment and 1915(b) waiver with public notice and comment periods.

Authorizes the Authority to select managed care plans through competitive invitations to negotiate, with separate procurements by region and preference given to plans with contracts for physicians and meeting quality standards including accreditation and fraud prevention policies.

Requires managed care plans to cover minimum services including emergency care, hospitalizations, prescription drugs, mental health services, dental care, and transportation, with contracts establishing physician/hospital compensation, network adequacy standards, encounter data collection, and performance measures.

Creates a long-term care managed care program for eligible Medicaid recipients age 65+ or disabled individuals requiring nursing facility care, with plans covering nursing home care, assisted living, hospice, adult day care, and home-based services at blended payment rates.

Becomes effective November 1, 2013.