Thousands of Oklahoma Medicaid patients would see benefits reduced as the state agency that manages the federal program grapples with required 5 percent budget cuts, according to a spending-cut proposal presented Wednesday to a House budget subcommittee. Proposals include limiting paid emergency room visits to three a year, eliminating outpatient adult therapies, such as speech and physical therapy, eliminating reimbursement for newborn circumcision and reducing the number of brand-name prescriptions from three to two for adults, said Mike Fogarty, chief executive officer of the Oklahoma Health Care Authority. Final approval of those and other cuts in benefits will be presented next week to the authority’s board of directors for approval, he said. Fogarty said the authority had considered a 1 percent cut in reimbursement rates to hospitals, physicians, nursing facilities, behavioral health services and other providers, which could generate $4 million in annual savings. He said that appears to be unnecessary now, but that option will be considered if deeper cuts are required before the end of this fiscal year. The Oklahoma Health Care Authority, which serves more than 809,000 Oklahomans through its SoonerCare program, must cut nearly $27 million from its $581 million in state funds appropriated by the Legislature for the fiscal year which ends June 30. The 5 percent cuts in monthly appropriations began in August when state tax collections fell more than 20 percent below estimates. That trend has continued, and through the first four months of this fiscal year, revenue has come in about 22 percent below estimates. With legislators not in session, state budget officials only can order across-the-board cuts. The revenue shortfall has been managed so far by the 5 percent cuts and borrowing $155.5 million from other accounts. That money must be paid back by June 30.
Figures ‘don’t add up’Rep. Doug Cox, chairman of the House appropriations and budget subcommittee on public health, warned agency heads that deeper cuts may be necessary this fiscal year. "Five percent cuts and 20 percent less income — the numbers don’t quite add up,” said Cox, R-Grove. Fogarty said the Health Care Authority has been able to get by so far without making any cuts because it had about $7.3 million in carryover funds and received about $1.8 million as a result of a national class-action lawsuit dealing with pharmacy pricing. Cutting benefits was necessary to come up with the remaining $16.8 million, he said. Any reduction in state dollars in Oklahoma’s Medicaid program results in a reduction in federal dollars to operate the program, he said. A $1 cut in state funds means a loss of $3 in federal funds, meaning a total loss of $4. Vicki Kuestersteffen, deputy director of J.D. McCarty Center for Children with Developmental Disabilities, said her agency has used its carryover funds built up over the past three years to deal with the 5 percent budget reduction. Most of the money had been intended to build a summer camp for patients, she said. She said the agency will do "whatever it takes” to keep its inpatient services at its Norman hospital. State Mental Health Commissioner Terri White told committee members of plans to lay off about 100 employees of the Mental Health and Substance Abuse Services Department as it cuts another $7.3 million. The department also will close a Norman substance abuse treatment center for adults and eliminate all of the state’s 40 mental health beds for children at another Norman facility. A men’s treatment center in Tahlequah will be closed, and operations will be streamlined at Griffin Memorial Hospital in Norman. White said she’s concerned about increases in employee health insurance and retirement costs. "We will have to cut services to pay for them.”