Home / Conversation Starters / Medicaid Work Waiver, Fiscal Year Surplus, and Drug Approvals Part of Discussion at OHCA Meeting

Medicaid Work Waiver, Fiscal Year Surplus, and Drug Approvals Part of Discussion at OHCA Meeting

By Corey Perry

Journal Record Legislative Report

August 9, 2018

Implementation of the Medicaid work waiver was a major topic of discussion at OHCA’s monthly board meeting. Tywanda Cox, the Chief for Federal and State Policy at the authority, spoke on the matter for how the waiver process is proceeding. The application was made in the aftermath of the Trump Administration  saying it was open to approval of such waivers after the inauguration last year. The process was begun under Gov. Fallin the spring with an executive order, and was formalized by the approval of HB2932 this May, mandating its completion. The waiver would cover those between the ages of 19 to 50 years old, and those with kids ages 6 and above. Those not in those groups are exempt, but some additional people not covered those who are pregnant, are certified disabled, or those in TANF, amongst others, and some additionally proposed for exemption include Indians, foster parents, those in special OHCA programs like SoonerCare and Insure Oklahoma, and those newly released from incarceration in the past six months. Public comment will close on the proposal on September 3, the plan will be submitted to the federal government in October, negotiations will occur in November and December, and it goes to CMS for approval, and if approved, will thereafter be implemented. Cox noted that no non-expansion state had been approved yet, so they are trying to be very deliberate with the application to avoid any turndown by CMS.

Another topic of discussion was that the authority finished $29 million in the black for the previous fiscal year. Aaron Morris, the CFO, stated the last few months of the year had an upswing in funding, and combined with prudent management, allowed for the surplus to occur. Most of the sub-funds finished in the black, allowing for the good performance. Board members noted that even six months ago, this was considered a unlikely occurrence, so all were happy that it happened.

Several drugs were newly approved by the agency for members to use for various ailments. These include Crysvita, Imfinzi, Erleada, Yonsa, Lyrica, Restasis, Sinuva, and Ztlido. The drugs were unanimously approved by the board to add to their list.

The Medicaid Director, Melody Anthony, reported another number of significance, and that was how the total number of recipients of Medicaid programs in the state had declined since the start of last year when it reached almost 850,000. A year ago, it had been about 827,000, and now it is at 813,671, placing about equal to number that were members in in the summer of 2016. Many board members attributed that to the improving economy, and recommended that graphs tracking the state unemployment rate be included for future reference with respect to membership. Anthony took the recommendation under advisement.

Additional items of concern at the meeting included the ABD initiative, which is targeting the most sick and needy amongst the population that is being served by Medicaid programs. Screening and monitoring by professionals in the field is now being done in an effort to target the 48,000 or so in this most needy group, and care coordination is being sought. About 3,000 referrals have been done, and standardization of care and outside evaluation of their efforts will be done by the Pacific health Policy Group going forward. Another topic was the Regional Strategy Forum. The authority will take the initiative out into various regions of the state, and these events will allow walk-ins, structured and open formats, and summaries to be sent to participants, with feedback to be used for the 2019 update coming out in January. Seven regional dates have been planned in late October and early November, and outreach to the tribes is being pursued.

The next meeting will be held September 13, 2018 at the authority’s headquarters in Oklahoma City.

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