Oklahoma Attorney General Gentner Drummond is calling for an independent audit of the state agency that oversees Medicaid, citing ongoing concerns from providers and a lack of response to formal inquiries.
Drummond formally requested that State Auditor and Inspector Cindy Byrd conduct the audit of the Oklahoma Health Care Authority, pointing to what he described as systemic issues within the state’s managed care program.
“Oklahoma’s second experiment with managed care Medicaid is failing to deliver on its promises,” Drummond wrote in a letter dated April 24.
The request outlines reported problems including payment delays, claims processing failures and denials of medically necessary services. The managed care program is administered through contracts with three organizations: Humana, Aetna and Oklahoma Complete Health.
Drummond said his office had previously contacted Oklahoma Health Care Authority Chief Executive Officer Clay Bullard multiple times seeking corrective action, but received limited responses.
“When an agency entrusted with Oklahoma’s most vulnerable citizens refuses to hold billion-dollar corporations accountable, it falls to this office to act,” Drummond said.
According to the letter, the agency responded April 10 by defending the managed care organizations and citing high claim approval rates, while acknowledging that issues remain.
Drummond said an independent audit is necessary to restore accountability and ensure patients receive the care they are entitled to under the law.
