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Medicaid cuts may affect care in Oklahoma

BY JULIE BISBEE Modified: February 12, 2010 at 6:34 am •  Published: February 12, 2010
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Budget cuts at the agency that administers the state’s Medicaid program could make it more difficult for patients to get the medical care they need, members of the state’s medical association said Thursday.

Cuts to Medicaid reimbursements approved by the Oklahoma Health Care Authority on Thursday will mean doctors get paid less for providing care to people enrolled in SoonerCare.

Doctors that provide care to SoonerCare patients will see their reimbursement rates cut by 6.75 percent beginning April 1.

Nearly 700,000 people are enrolled in the SoonerCare health care program each month. More than half of those enrolled in the state’s Medicaid program are children.

"We are in a tough, tough situation,” board chairman Lyle Roggow said. "This was an order that came down to us. It is huge, it really is. Someone else put us in this position.”

A recent survey of members of the Oklahoma State Medical Association showed that about 46 percent said they would stop seeing new Medicaid patients if the initial 3.25 percent rate cut remained in place. About 66 percent of those surveyed said they would stop seeing Medicaid patients altogether if cuts to providers approached 10 percent.

The medical association said 204 doctors responded to the survey.

"Nobody wants to turn patients away, but if the reimbursement, as proposed, becomes less than the cost of providing the care, physicians who see large numbers of Medicaid patients will be faced with very hard choices if they want to stay in business,” said Dr. Duane Koehler, president of the Oklahoma Osteopathic Association.

The cuts approved are part of an overall plan to trim $12.


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Cuts worry advocates
Advocates for people with mental illness are concerned about a cost-cutting measure that will go next month before the Oklahoma Health Care Authority.

The proposal would create a tier system for a group of drugs called atypical antipsychotics. Medicaid patients would have to try the cheapest medication first, a generic, even if a doctor prescribed a more expensive brand-name drug.

If the medication fails, a patient can move up the tier system and try the next cheapest drug.

Advocate Paul Davis said that could be dangerous because if a drug fails, the patients may become violent or suicidal. He said newer and more expensive drugs work quicker and have fewer side effects.

Some law enforcement officials also are concerned about the change.

Stacey Puckett, director of the Oklahoma Association of Chiefs of Police, said officers will be responding to more mental health crisis calls.

"We are putting people at risk, law enforcement, clients, family members and the community as a whole,” she said. "Those dollars (saved) aren’t just dollars. Those are human beings we are sending further into the darkness of mental illness.”

The Drug Utilization Board, a recommending group to the Oklahoma Health Care Authority, has approved the change. The next authority meeting is March 11 in Oklahoma City.

Susan Simpson, Staff Writer

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