HB 2788 Summary

• Expands the Medicaid fraud control unit's authority to investigate fraud committed by providers, recipients, or both, and requires display of hotline information in provider offices

• Establishes a statewide integrated managed care program for Medicaid, requiring the Oklahoma Health Care Authority to apply for federal waivers and implement managed care plans across all regions

• Defines eight categories of managed care entities (prepaid plans, provider service networks, specialty plans, comprehensive long-term care plans) and establishes procurement requirements for plan selection based on quality and value

• Requires all Medicaid recipients to enroll in managed care plans with choice of plans, automatic enrollment provisions, and specific enrollment protections for specialty populations and newborns

• Creates separate long-term care managed care program for eligible elderly and disabled recipients, with minimum covered services, payment rate structures based on level of care, and incentives to increase home and community-based services over institutional placement; effective November 1, 2014