State receives CMS approval, advances Medicaid transformation with SoonerSelect
The Centers for Medicare & Medicaid Services (CMS) has granted approval for Oklahoma's 1915(b) waiver for delivery system reform and the proposal to increase supplemental payments to hospitals. These approvals mark a significant milestone in the transition from a fee-for-service system to the new comprehensive health delivery system, SoonerSelect.
The Centers for Medicare & Medicaid Services (CMS) has granted approval for Oklahoma’s 1915(b) waiver for delivery system reform and the proposal to increase supplemental payments to hospitals. These approvals mark a significant milestone in the transition from a fee-for-service system to the new comprehensive health delivery system, SoonerSelect.
‘The swift approval of these milestones is a testament to the tireless efforts of the OHCA team and our CMS partners,’ said Ellen Buettner, OHCA Chief Executive Officer. ‘This achievement brings us one step closer to our vision of a comprehensive health delivery system designed to improve the quality of care and services to enhance the health and lives of Oklahomans.”
1915(b) waivers provide states with the flexibility to modify their delivery systems by allowing CMS to waive certain federal regulatory requirements. This waiver is the initial phase of collaboration between OHCA and CMS in transitioning to the SoonerSelect program.
The hospital payment proposal outlines the transition from current supplemental payments to directed payments based on average commercial rates under SoonerSelect, which will substantially increase the pool of funds available for participating hospitals.
OHCA, in close coordination with the provider community, contracted entities and CMS, is diligently preparing for a seamless transition with rigorous testing of systems, provider network development and on-site readiness reviews. SoonerSelect will allow OHCA to strengthen the quality of services SoonerCare members receive by leveraging the resources of the contracted entities, investing in enhanced care coordination and addressing social determinants of health, while maintaining program and contractual oversight to ensure SoonerSelect goals are met.
All health and dental plans will be required to provide SoonerSelect members the same health care services currently offered by SoonerCare but may offer additional benefits.
SoonerSelect dental plans are expected to launch Feb. 1, 2024, with medical and children’s specialty plans expected to launch April 1, 2024.
For more information and updates about delivery reform in Oklahoma, visit https://oklahoma.gov/ohca/about/delivery-reform.html.
