HB3626

Oklahoma HB3626 amends Medicaid procedures, including review and appeal processes for adverse determinations, reimbursement rates, and value-based.

Oklahoma HB3626 modifies Medicaid regulations by establishing uniform procedures for contracted entities to follow when making adverse determinations. It mandates that contracted entities offer value-based payment arrangements to providers, which are optional but incentivized by quality metrics. The bill also requires contracted entities to ensure that all appeals of adverse determinations are reviewed by licensed physicians or mental health professionals.