1| STATE OF OKLAHOMA | | | 2| 2nd Session of the 60th Legislature (2026) | | | 3|HOUSE BILL 3699 By: Pogemiller | | | 4| | | | 5| | | | 6| AS INTRODUCED | | | 7| An Act relating to Medicaid; directing the Oklahoma | | Health Care Authority to apply for waivers or state | 8| plan amendments; providing services the supplemental | | reimbursement rate shall be used for; providing that | 9| the rate shall be reviewed periodically; directing | | certain physician practices and other entities or | 10| individuals to work with certain entities; directing | | the Oklahoma Health Care Authority to keep certain | 11| letter on file; and providing an effective date. | | | 12| | | | 13| | | | 14|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 15| SECTION 1. NEW LAW A new section of law to be codified | | | 16|in the Oklahoma Statutes as Section 4010 of Title 56, unless there | | | 17|is created a duplication in numbering, reads as follows: | | | 18| A. On or before January 1, 2027, the Oklahoma Health Care | | | 19|Authority (OHCA) shall submit and apply for any federal waivers, | | | 20|state plan amendments, or other authority necessary to: | | | 21| 1. Provide a supplemental reimbursement rate for physician | | | 22|practices, community health workers, nonprofits, or other entities | | | 23|or individuals enrolled in the patient-centered medical home program | | | 24|that currently and actively participate in a team-based, | | | Req. No. 14410 Page 1 ___________________________________________________________________________
1|evidence-based pediatric practice or family practice transformation | | | 2|model of care; and | | | 3| 2. Collaborate with experts in pediatric health care to select | | | 4|team-based, evidence-based pediatric practice transformation models | | | 5|of care most appropriate for use with the patient-centered medical | | | 6|home program. | | | 7| B. The supplemental reimbursement rate described in subsection | | | 8|A of this section shall: | | | 9| 1. Supplement fee-for-service wellness visit rates in a child's | | | 10|medical home program from birth until a child's fourth birthday; | | | 11| 2. Support the physician practices, community health care | | | 12|workers, nonprofits, or other entities or individuals enrolled in | | | 13|the patient-centered medical home program to employ | | | 14|interdisciplinary staff required to implement the patient-centered | | | 15|medical home program, including screening completion, or follow the | | | 16|Bright Futures recommendations for screenings at nine (9) months, | | | 17|eighteen (18) months and thirty (30) months or as stated by American | | | 18|Academy of Pediatrics Bright Future guidelines with fidelity; and | | | 19| 3. Be reviewed periodically in conjunction with future Medicaid | | | 20|rate reviews for physician services. | | | 21| C. A physician practice, community health worker, nonprofit, or | | | 22|other entity or individual enrolled in the patient-centered medical | | | 23|home program shall work with an entity that utilizes data and | | | 24|outcomes to demonstrate adherence to a team-based, evidence-based | | | Req. No. 14410 Page 2 ___________________________________________________________________________
1|pediatric practice transformation model of care focused on young | | | 2|children and families. | | | 3| D. The OHCA shall keep on file a letter, updated annually, | | | 4|verifying that the physician practice, community health worker, | | | 5|nonprofit, or other entity or individual enrolled in the | | | 6|patient-centered medical home program actively participates in a | | | 7|team-based, evidence-based pediatric practice transformation model | | | 8|of care. | | | 9| SECTION 2. This act shall become effective November 1, 2026. | | | 10| | | | 11| 60-2-14410 CMA 01/07/26 | | | 12| | | | 13| | | | 14| | | | 15| | | | 16| | | | 17| | | | 18| | | | 19| | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | Req. No. 14410 Page 3