The Second Session of the 55th Oklahoma Legislature adjourned on May 27, 2016.

With a $1.3 billion budget hole in an election year, the Legislature had their work cut out for them before they arrived on day 1. The state experienced not just one but two revenue failures during state fiscal year (SFY) 2016 (July 1, 2015 – June 30, 2016). These mid-fiscal year cuts impacted agencies differently and set up the legislature with more work than anticipated. The Oklahoma Health Care Authority (OHCA) lost approximately $63 million in state appropriations due to the revenue failures.

From a legislative standpoint, OHCA was involved with the requests for two high-profile measures – the “Medicaid Rebalancing Act of 2020” and the $1.50 cigarette tax increase. Throughout the first few weeks of the legislative session, budget cuts to most agencies were projected to be between 10 to 15 percent of the previous year’s appropriation. For OHCA, a cut of this magnitude equated to a large provider rate cut - up to 25 percent. State legislators heard directly from SoonerCare providers, members and the business community on their shared concerns of how a 25 percent provider rate cut would impact patients, facilities and communities as a whole. While our request bills did not receive final passage from the legislature, health care was prioritized in the state’s upcoming budget. 

Senate Bill (SB) 1616, the SFY 2017 general appropriations bill, was introduced on May 17, 10 days before the state constitutionally required adjournment (also known as sine die). SB 1616 appropriated $6.8 billion out to agencies for SFY 2017. With an appropriation of $991 million, OHCA was one of only a handful of agencies that received an increase in appropriations and/or a flat appropriation. There are no provider rates cuts scheduled due to the approved budget agreement.

Click here for an issue statement on the budget agreement from OHCA CEO Nico Gomez.

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In this newsletter, I wish to make you aware of the Oklahoma Oral Health Coalition (OOHC). Maybe you have heard of this organization. If not, perhaps this will give you a reason to check them out and join! 

This group was formally established in early 2003. Led by Sally Selvidge, family outreach coordinator, Sooner SUCCESS, and Kay Floyd, director of the Head Start State Collaboration Office, the group chose to initially operate under the name Children's Oral Health Coalition with its attention and intentions focused on the dental health of children. 

Over the years, the coalition has worked to bring together representatives from various state and local organizations that address children's oral health. However, the group is now known as the all-encompassing Oklahoma Oral Health Coalition.

The Coalition's mission is to impact the oral health of all Oklahomans by facilitating collaboration and encouraging improved oral health education. OOHC is managed by a volunteer executive committee, comprised of the following:

Chair
Marsha Wilkes Beatty, B.S., M.PH
Assistant Professor of Research, Community Dentistry Division
Oklahoma University College of Dentistry

Vice-Chair
Melissa Reese
Manager, MobileSmiles Oklahoma
Oklahoma Dental Foundation

Secretary
Brandon Oshel
Foundation Specialist
Delta Dental of Oklahoma Oral Health Foundation

Immediate past chair
Patricia Christensen
Program Development Specialist
Oklahoma Primary Care Association

The Coalition meets quarterly, and their website provides members with opportunities to coordinate their efforts and maximize their outcomes. The website also provides reliable, accessible dental health information and resources for obtaining dental care and education.

Click the links below to learn more about:

• how to join
• free oral health resources
• Coalition member organizations

Dr. Leon Bragg
Chief Dental Officer

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Gov. Mary Fallin signed and certified the OHCA’s 2016 permanent rule changes on June 9, 2016. All policy changes are effective Sept. 1, 2016, and will post to the policy webpage on that date. 

2016 changes to the OHCA’s permanent rules were available for review and input in two rounds - Dec. 16, 2015, - Jan. 15, 2016, or January 15 - Feb. 16, 2016. The rules include new regulations requested by the public, members, providers, other state agencies and OHCA staff and leadership. (Visit our Proposed Policy Changes Archive for rule impact summaries.)

Simultaneously, we considered rules previously promulgated on an emergency basis.

The OHCA Board considered and voted on the rules at the Feb. 11, 2016, and March 24, 2016 meetings. Afterward, the rules were forwarded to the Legislature and governor for action. 

There is a total of 43 permanent rule changes for 2016. Those specific to dental providers are as follows: 

Dental policy at OAC 317:30-5-696 is amended to add limited dental services for adult SoonerCare members who meet all medical criteria, but need dental clearance to obtain organ transplant approval. The rule states that services must be prior authorized and are limited to: Comprehensive oral evaluation, two radiographic bitewings, prophylaxis, fluoride application, limited restorative procedures, and periodontal scaling/root planing. Policy is further revised to mirror new terminology from the Code on Dental Procedures and Nomenclature (CDT) and to clean up outdated language. In addition, a change includes removing language which restricts emergency examination/limited oral evaluation from being performed within two months, the new language will allow dentists to perform emergency evaluations as medically necessary. Revisions also clarify the separate note requirement for 5As counseling. Although separate office notes must be provided for 5As counseling, only one office signature is needed at the end of the office visit (not separate signatures for the office visit and the 5As counseling).

(Reference APA WF #15-01)

Dental policy at OAC 317:30-5-695, 317:30-5-696.1, 317:30-5-698 through 317:30-5-700.1, 317:30-5-704, and 317:30-5-705 is revised to mirror new terminology from the Code on Dental Procedures and Nomenclature (CDT), to clean-up outdated terms, and to add oversight requirements for dentists who supervise certified registered nurse anesthetists during the administration of anesthesia to members. The oversight requirement would align OHCA policy with requirements set forth by the Oklahoma Board of Dentistry. In addition, revisions include updating policy to reflect that diagnosis codes must appear on the dental form when requesting a prior authorization and the removal of language for the recoupment of restoration services. The removal of recoupment language will mirror other policy sections concerning dental services that are silent to the recoupment process. Recoupment for inappropriate restorations will still occur as deemed appropriate by the agency's Program Integrity Division.

(Reference APA WF #15-28) 

There are also many OHCA program and policy updates, including rules related to Program Integrity audits.

OHCA will send you complete details on all 2016 permanent rule changes in the next few weeks.

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The OHCA would like to welcome Dr. Ashley Orynich as the new dental representative on the Medical Advisory Committee (MAC).

The MAC offers recommendations to the OHCA about health and medical care services. They also help to advise the agency on issues of policy, finance and administration. The ultimate goal of the MAC is to assist the agency and its providers to achieve quality standards of the Medicaid program.

Members of the MAC are appointed on a rotating basis.

Dr. Orynich graduated from the University of Florida with a bachelor’s in nutrition, completed her doctorate in dental medicine (DMD) from the Harvard School of Dental Medicine and her Master of Public Administration from the Harvard Kennedy School of Government. She is a board-certified pediatric dentist, having completed her Master of Oral Science from the Texas A&M Baylor College of Dentistry Pediatric Department. Dr. Orynich currently works in private practice at On the Cusp Pediatric Dentistry in Tulsa, Okla., while continuing health policy research as part-time faculty with Baylor.

The MAC meets bi-monthly (starting in January of each year), at 1 p.m., on the third Thursday of the month. Meetings are typically in the OHCA boardroom. Click here for meeting dates and agendas.

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The OHCA congratulates Chief Dental Officer Leon Bragg, D.D.S., on his recent recognition by Delta Dental of Oklahoma for his service as president of the Medicaid Medicare CHIP (Children's Health Insurance Program) Services Dental Association (MSDA).

The award, presented during a luncheon at the annual MSDA Symposium in Washington, D.C., included a $10,000 sponsorship from Delta Dental of Oklahoma Oral Health Foundation to the symposium in recognition of Dr. Bragg's service and leadership. Read more about this honor here.

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