July 2, 2014

State board approves Medicaid provider cuts

July 2, 2014 Associated Press

OKLAHOMA CITY — Pediatricians and wheelchair providers warned Oklahoma leaders who oversee Medicaid on Tuesday that cuts to reimbursement rates could force them to stop providing services to some of the state’s neediest citizens.

The Oklahoma Health Care Authority Board unanimously approved the 7.75 percent provider rate cut during a special meeting in Oklahoma City as it grapples with a $104 million hole in its budget for the new fiscal year. The reduced provider rate and other program cuts are in addition to changes approved last week to increase copays for Medicaid participants and things such as limiting payments for glasses for children, and hospital readmissions.

The change could force doctors in semi-rural communities such as Enid to stop accepting Medicaid patients, said Dr. Eve Switzer, who works with two other pediatricians at her clinic, where Medicaid patients make up 60 percent of their practice.

“When you start cutting rates, we have to start cutting patients,” Switzer told the board. “It’s just basic economics.”

Although the Legislature this year used a series of budget maneuvers to preserve the Health Care Authority’s $950 million state budget for the current fiscal year, the agency still has a shortfall because of an increase in Medicaid participants, a $13 million decrease in tobacco tax revenue and a reduction in the rate for federal matching funds. The reduction in federal funds is, ironically, the result of Oklahoma’s economy improving.

There are currently about 800,000 Oklahomans enrolled in Medicaid, which is called Soonercare. Of those, 65 percent are children and about 17 percent are blind or disabled adults.

Children qualify if household income is 185 percent of the federal poverty level, or about $44,000 annually for a family of four. A single pregnant woman can qualify with an income of about $15,516. Non-pregnant, non-disabled adults would have to earn below $8,200 per year to be eligible.

Aracely Baeza, a 23-year-old Oklahoma City woman with a rare form of muscular dystrophy who needs a motorized wheelchair, told the board she fears what may happen if she can’t get her wheelchair repaired. When the chair’s motor went out recently, she had to use a manually operated one for about three days.

“I don’t have the strength to push myself,” she said. “I felt very vulnerable. I was at the mercy of others.”

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