How Will Oklahoma's New Managed Care Plan Affect Candidates?

Posted By: Hayley Twyman Brack Insurance Updates,

Two weeks after the State of Oklahoma announced which four insurance companies would be awarded contracts in the state’s new Sooner Select program, many mental health care providers are considering how the overhaul of the Medicaid program will affect their practice. Traditionally, mental health licensure candidates (practitioners under supervision) in Oklahoma provide services through Medicaid and are not awarded contracts with private insurance companies. Being that much of the traditional Medicaid population will soon be covered under private insurance, many candidates and supervisors are wondering if that will change their contracts.

As discussed in a previous OCI article, under the new managed care plan Medicaid providers will be expected to contract with the individual insurance companies in order to continue to provide services to the Medicaid population. Phone calls and emails were made to representatives of each of the four insurance companies awarded contracts with the state’s managed care program to inquire as to how the overhaul will affect candidates. Specifically, representatives were asked if candidates will be awarded contracts through the insurance companies to serve Medicaid recipients.

According to a representative from Blue Cross Blue Shield of Oklahoma, mental health care licensure candidates will be able to apply to be credentialed with Blue Cross Blue Shield of Oklahoma for the Sooner Select network only. Candidates still will not be able to be credentialed with commercial networks until they are fully licensed. The representative reported that contracts will begin to be sent out to providers once the State of Oklahoma reviews and approves them, which is expected to be at the end of the month.

A representative from United Healthcare/Optum stated that the company is continuing to work out contracts with the state of Oklahoma. The representative reported that United/Optum is actively working towards a plan for how it may include candidates in the program, but as of right now there is no definite answer as to if or how the company will contract with candidates. The representative reported that the company plans to send out more information about credentialing to providers over the next two weeks and encouraged providers to check for more information.

A representative from Humana was emailed last week, but as of the publication of this article no response has been given.

Oklahoma Complete Health, otherwise known as WellCare, is managed by Centene. The Centene corporate office, WellCare provider line, and WellCare provider chat were all contacted. However, no information was given in regards to candidates’ ability to contract with the company.

The Sooner Select program is set to take effect starting October 1st of this year. OCI will continue to reach out to representatives of the four companies for more information about Sooner Select.