June 18, 2015

Health Agency Backs Away From Payment Cuts

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M. Scott Carter

M. Scott Carter

M. Scott Carter reports on politics, legislation and other issues from the State Capitol.

 

 

The Oklahoma Health Care Authority won’t be cutting provider rates to physician assistants and nurse practitioners, at least not during the 2016 fiscal year.

Carrie Evans, the Authority’s chief financial officer, made the announcement Thursday morning at the beginning a public hearing of the state plan amendment rate committee.

“We did finish our April financials and we are going to have enough carryover to not make this cut (for mid-level medical practitioners) this fiscal year,” Evans said.

Oklahoma Health Care Authority Carrie Evans listens to a speaker during a public hearing held by the agency Thursday.

Carrie Evans, the Oklahoma Health Care Authority’s chief financial officer, listens to a speaker during a public hearing held by the agency Thursday. (Oklahoma Watch/M. Scott Carter)

The change surprised more than two dozen nurse practitioners who attended the hearing. Toni Pratt-Reid, a nurse practitioner who operates three medical clinics in the Oklahoma City and Piedmont areas, said she was shocked by the announcement.

“I didn’t know if we would get our voices heard,” Pratt-Reid said. “But we are very pleased.”

In May, Health Care Authority chief Nico Gomez released a list of cuts the agency expected to make to help cover a $78 million shortfall in its fiscal 2016 budget.

At that time, Gomez said the agency needed to cut more than $40 million. Those cuts included a 15 percent reduction in the rates paid to physician assistants and nurse practitioners. About 3,250 providers would have been affected.

However, in early June, the Authority reduced its proposed cut to 5 percent. An Authority analysis of the cut, distributed at Thursday’s meeting, estimated the reduction would save the state more than $1.7 million and almost $5 million when combined with federal funds.

Gomez told Oklahoma Watch the proposal was tabled after the agency learned Wednesday that it had more carryover funds than expected.

“This was something we didn’t want to do in the first place,” Gomez said. “We’ve been working on various cut scenarios since March. We got some good news as we finalized our April financial statements.”

Gomez said the agency had projected about $18 million in carryover funds.

“I got good news yesterday and made the decision to apply it to our cut list,” he said. “I chose to apply it to what we had proposed for the rates for nurse practitioners and physician assistants.”

Pratt-Reid, the physician assistant, said the Authority’s decision shows that “same pay for same service is still appreciated in Oklahoma.” She said her clinics serve about 7,000 people, many from rural areas.

“I think there was a loud enough voice that they (the OHCA) were able to hear us,” she said.

Had the Health Care Authority adopted the proposed cuts, she said, it would have sent a signal to other insurance companies that the services of a physician assistant were less valuable than those of a physician.

“It would have caused a domino effect,” she said.

While Thursday’s action by the Authority means provider rate cuts are off the table for 2016, they could resurface if the state sees another budget gap next year. In June, House Budget Chairman Rep. Earl Sears, R-Bartlesville, warned the fiscal 2017 budget could have a large hole. However, Sears added he didn’t expect the hole to be as big as rthe one for the 2016 budget.