Program to encourage use of primary care services in lieu of emergency room services.

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A. The Oklahoma Health Care Authority and the State Department of Health, subject to the availability of funds, may develop and administer a program to encourage the timely and appropriate use of primary care services in lieu of emergency room utilization. The Authority and the Department may collaborate with city-county and county health departments and other relevant stakeholders in the development of the program. The program may include, but not be limited to, the implementation of:

1. Educational strategies to increase health literacy for participants in the Oklahoma Medicaid Program;

2. Technology-based monitoring;

3. Co-payment structures and other payment arrangements; and

4. Other policy proposals to improve the delivery of health care services to Medicaid enrollees.

B. The Oklahoma Health Care Authority may develop a pilot program utilizing state-licensed health care professionals to perform educational interventions with consumers who highly utilize emergency room services or to perform other services to reduce unnecessary emergency room visits.

C. The Oklahoma Health Care Authority shall develop and implement a telephone information health line pilot program under which physicians are available by telephone twenty-four (24) hours a day to answer medical questions and provide health information for the Medicaid population. If the Health Care Authority determines that the pilot program reduces unnecessary emergency room visits and the pilot program demonstrates a net cost-savings, the Health Care Authority shall expand the program into a statewide initiative.

D. The Oklahoma Health Care Authority and the State Department of Health shall evaluate and report findings relevant to the provisions of subsection A of this section to the Governor and the Legislature by January 1, 2019.

Added by Laws 2006, c. 315, § 8, emerg. eff. June 9, 2006. Amended by Laws 2017, c. 322, § 1, eff. Nov. 1, 2017.


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