Medicaid Reform Act of 2006

House Bill 2842 passed both the House and the Senate on Thursday (May 25) and now is waiting for the governor to make a final decision about signing it. (Update 6/13/2006 , the Governor has signed the bill) It's purpose is to provide Medicaid consumers younger than 65 and considered "insurable" more options in the selection of a health plan, and introduce competition as a factor to lower costs.

Pending the governor's signature, Phase One implementation is to begin July 1, 2008 within a contiguous area with rural and urban characteristics. If after evaluation it is found that this system provides improved access to health care, improved health care outcomes, and improved cost effectiveness, the components of the act shall be phased in statewide by 2013.

Some of the reforms include:

• Development of a system by the Oklahoma Health Care Authority (OHCA) to enable insurable Medicaid consumers to access commercial health insurance policies.

• Development by OHCA of an employee choice option whereby consumers would be allowed to purchase coverage through an employer-sponsored plan rather then a qualified plan.

• Development of a plan by OHCA to implement a personal health account system as an enhanced benefit. Monies deposited into said accounts shall only be used to defray costs including co-pays, non-coverage benefits and wellness benefits.

• Development of Electronic Medical Records

• Development of Electronic Prescribing capabilities

• Disease Management

• Incentive Reimbursement Plan for Nursing Facilities

• Alternatives for long-term care

• Appropriate Utilization of the Emergency Room

• Reduction in billing, payment and eligibility errors to 5% by 2009

• Extends benefits to full-time college students through age 23

• Directs OHCA to expand the Premium Assistance Program to cover parents of children eligible for Medicaid, and to employers with up to 50 employees.

• Appropriates $93 million for hospital and physician reimbursement rates.

• Directs hospitals to establish discount programs for self-pay patients with household incomes up to 300% of the federal poverty level.