October 9, 2014
OHCA Contacts: Jo Kilgore - (405) 522-7474, Jennie Melendez - (405) 522-7404
OHCA presents SFY16 budget request
CITY – The Oklahoma Health Care Authority (OHCA) board was presented with the
agency’s State Fiscal Year (SFY) 2016 budget
request at their October 9 meeting.
In addition to the agency’s base funding of approximately $953 million in
state funds, OHCA is requesting an additional $163.6 million needed to maintain
the existing program. This includes replacement of lost federal dollars, four
percent program growth, a federal mandate for an in-house administrative law
judge and replacement of one-time carryover funds—representing the top four
budget priorities for the agency.
Medical Assistance Percentage (FMAP) used to determine the amount of federal
matching funds for state Medicaid expenditures will continue its downward trend
for Oklahoma by decreasing in SFY2016. The rate will decrease from 62.30
percent to 61.25 percent and create a need for $39 million in additional state
funds. This follows a reduction of 1.72 percentage points in SFY 2015. FMAP is
the federal funding formula based on a state’s per capita income relative to
that of other states using a three-year rolling average.
The request also
includes $14.4 million to cover children who qualify for SoonerCare through the
Children’s Health Insurance Program (CHIP). CHIP provides an increased
match rate of 72.88 percent for services provided to children from 133 percent
to 185 percent of the Federal Poverty Level, and is currently before Congress
for possible reauthorization. If the program is not reauthorized, these
children will remain in the SoonerCare program, but will receive the regular
match of 61.25 percent. However, if CHIP is reauthorized through Federal Fiscal
Year 2019, the match rate will increase to approximately 96 percent and the
OHCA’s request for additional state funds will decrease by $42 million.
A projected growth
rate of four percent in the SoonerCare (Oklahoma Medicaid) program would
require an additional $45 million. One-time carryover funding of $61
million makes up a large part of the agency’s current SFY15 budget, and must be
replaced in SFY16.
In addition to
maintenance of the existing program, OHCA is asking for almost $102 million to restore
provider rates to pre-SFY 2010 levels. The agency cut rates for most provider
groups by 3.25 percent in SFY 2010 and an additional 7.75 percent on July 1.
The agency is also asking
for an additional $7.6 million to increase Disproportionate Share Hospital
(DSH) funding to the maximum allowable level. Federal law requires state
Medicaid programs make DSH payments to qualifying hospitals that serve a large
number of Medicaid and uninsured individuals.
The remaining budget
request items total approximately $1.5 million and include advanced genetic
testing for developmental delays, contract expenditures, software and removal
of monthly limits for certain medications. The request includes a total of 11
priorities totaling an additional $275 million in state funds.
Oklahoma Health Care Authority (OHCA) administers Oklahoma’s Medicaid program,
known as SoonerCare, and Insure Oklahoma, a premium assistance program funded
by tobacco tax revenue. SoonerCare works to improve the health outcomes of
Oklahomans by ensuring that medically necessary benefits and services are
responsive to the health care needs of our members. Qualifying Oklahomans
include low-income children, pregnant women, seniors, the disabled, those being
treated for breast or cervical cancer and those seeking family planning services.
All must meet income guidelines. Insure Oklahoma assists qualifying adults and
small business employees in obtaining health care coverage for themselves and
their families. OHCA works with our current 818,100 members, our statewide
network of 39,614 health care providers and numerous state and local partners
to promote responsible health care
service utilization, healthy behaviors and improved health outcomes. For more
information, visit www.okhca.org or www.insureoklahoma.org.