OK SB1559

Oklahoma Health Care Authority must establish a 36-month pilot program testing direct primary care for Medicaid members, beginning no later than 6 months after the November 1, 2026 effective date

Pilot program limited to up to 1,000 Medicaid beneficiaries, using per-member-per-month payments to direct primary care providers with quality benchmarks for value-based care

Contracts must be executed directly between the Authority and direct primary care providers, separate from existing capitated managed care contracts under the Ensuring Access to Medicaid Act

Direct primary care providers selected through competitive bidding must meet federal enrollment and quality standards under 42 C.F.R. Section 455.410 and Part 438

Annual reports required to the Governor and legislative leadership covering access to care, patient satisfaction, clinical and cost outcomes, and recommendations for integrating direct primary care into Medicaid