By Fox23.com News Staff
OKLAHOMA — Attorney General Gentner Drummond has requested a state audit of the Oklahoma Health Care Authority (OHCA).
Drummond formally requested that State Auditor and Inspector Cindy Byrd conduct the independent audit.
The request reflects mounting provider complaints and OHCA’s repeated failure to respond adequately to the AG’s former inquiries about the state’s contracted managed care organizations (MCOs), Drummond’s Office said.
The letter, dated April 24, details a pattern of payment delays, claims processing failures, inappropriate denials of medically necessary services and a lack of substantive corrective action by OHCA.
The three MCOs contracted to administer Oklahoma’s Medicaid managed care program are Humana, Aetna and Oklahoma Complete Health.
“Oklahoma’s second experiment with managed care Medicaid is failing to deliver on its promises. Providers are reducing staff. Patients are being denied essential care. Out-of-state corporations are controlling access to critical services without accountability…,” Drummond wrote in the letter.
Despite repeated requests for written responses, Drummond’s Office said OHCA only provided verbal assurances, and on April 10, responded by defending the MCO’s and citing high claim approval rates, rather than identifying specific corrective measures, while acknowledging that “issues need to be fixed.”
“When an agency entrusted with Oklahoma’s most vulnerable citizens refuses to hold billion-dollar corporations accountable, it falls to this office to act,” said Drummond. “Providers across this state have been sounding the alarm for months. Oklahoma patients are being denied care they are legally entitled to, and OHCA has chosen to defend the MCOs rather than the people it serves. An independent audit is not only warranted – it is essential to restore accountability and protect public funds.”
OHCA shared a statement with FOX23 on the audit request:
“The Oklahoma Health Care Authority is committed to transparency and accountability in all that we do. We are aware of the Attorney General’s request and will cooperate fully with any review process.”
