| Opinion: | Oklahoma State Medical Association v. Corbett, 2021 OK 30 |
| Subject matter: | Original Proceeding for Declaratory Relief and/or Mandamus |
| Date Decided: | June 1, 2021 |
| Trial Court: | N/A |
| Route to this Court: | OKSCT assumed original jurisdiction upon Petitioner’s motion. |
| Facts: | In July 2020, soon after SQ 802 mandated the expansion of Medicaid coverage, the Oklahoma Health Care Authority (OHCA) acted to implement a new managed care program known as SoonerSelect to provide Medicaid services to approximately 773,000 Oklahomans (roughly 1/5th of the State’s population). Following an RFP process and competitive bidding, in January 2021 the OHCA selected four managed care organizations out of seven that bid to provide SoonerSelect services. |
| Standard of Review: | None specified. |
| Analysis: | The question before the Court is whether or not Oklahoma’s statutes authorizing managed care, passed almost 28 years ago, provide legislative authorization for the OHCA to create a wholly new fully capitated managed care program. “We find no express grant of legislative authority to create the SoonerSelect program nor do we find the extant statutes implicitly authorize its creation…A review of the OHCA Act and OMHOA demonstrate the Legislature did not intend to give carte blanche authority to the OHCA to create managed care plans…The purpose of the extant statutes was to ‘convert[]’ the then ‘present delivery of the state’s Medicaid program to a managed care system…This case accomplished in 1995 and 1996 by the creation of SoonerCare Plus and SoonerCare Choice.” Subsequent legislative action to amend the OMHOA and OHCA Act to provide specific authorizations for OHCA to engage in certain activities demonstrates that the Legislature had not already granted the OHCA the broad authority it now claims. |
| Outcome: | “We find the actions of the OHCA to implement SoonerSelect by entering into RFPs and awarding contracts was not authorized by the Legislature and is ultra vires. We hold the resulting contracts invalid.” |
| Vote: | 6-3. Opinion by Combs, J. Concur: Darby, C.J., Kauger, Edmonson, and Combs, JJ.; Reif, S.J. and Goree, S.J. Dissent: Kane, V.C.J., Winchester (by separate writing) and Rowe (by separate writing), JJ. (Gurich, J., disqualified) |
| Other: | The written dissents point to the recent passage of S.B. 131, which the dissenters contend recognizes a managed care model, thus making the issue before the Court moot. |