Mental Health Care in Crisis Under Oklahoma’s New Managed Care System

(TULSA, Okla.) Dozens of mental health providers in the State of Oklahoma are having difficulty staying in business after the state switched from SoonerCare to Managed Care Oklahoma (MCO) on April 1, 2024. 

At that time, Oklahoma’s Medicaid Agency began contracting with traditional independent insurance companies Aetna, Humana, and Oklahoma Complete Health. The three independent insurance agencies operate Managed Care Oklahoma (MCO), and mental health professionals say the transition has been anything but smooth. 

Medicaid patients were supposed to be able to make a decision by March 15th regarding which insurance agency they wanted to use, but many said they never received any information from the state on how to go about doing so. The crisis has made it more difficult for Medicaid patients–many of whom are elderly, disabled, or single parents–to find adequate mental health and medical care. 

Leslie Smith, a licensed drug and alcohol counselor and the owner of B4ME Counseling & Recovery, Inc, and Marjorie Ray, a licensed professional counselor (LPC) who runs Hope Blooms, LLC, spoke with VNN Oklahoma about the crisis the state is facing. 

Smith said the state had about two years to make sure everything was up and running correctly, but failed to do so. 

“There was not good training, communication, preparedness, from the state, the agencies, providers and patients,” said Smith. “The campaign that they should have put out for that education purpose didn't happen. So, up until the day of April 1, we had so many questions [and] we didn't know what was going to happen. 

Since April, mental health providers and agencies in Oklahoma have not been able to adequately pay their therapists because the billing process from the providers to insurance agencies has been in chaos. 

“It's burdensome to have good workers who do the job and don't get paid,” Ray said. “[During] the first few weeks, it was horrendous for Leslie and I to see our people on payroll day with nothing, almost.” 

At that time, many mental health providers received no compensation under the new system, and when they finally received paper checks, the money was short.

“When I received letters in the mail, four were payments and ten were either complete zeros or miniscule amounts,” said Ray. “They said they would pay what OHCA paid, but they didn't have our codes…so, the payments that did come were a quarter of what they should have been.”

To remedy the situation, the State of Oklahoma has set aside money in the contract for advance payment for agencies that need it. Still, Smith and Ray say that receiving advance payment does not solve all of their problems–and that it actually creates more work for them. This advance payment is meant to be paid back in a relatively short amount of time, and providers have to hope they have received back pay so that they don’t have to pay back out of their own pockets. 

Clyde W. Wafford is the president of OrionNet Systems, LLC., a company that helps health care centers automate paperwork. He said he is aware of at least seven agencies that have been forced to close their doors and more than 100 people who have lost their jobs following the transition. 

Patients are impacted greatly, as well, as many are having to find new medical providers because their previous ones are no longer accepting Medicaid due to the issues.

Smith said the state needs to act quickly to rectify the situation and bring mental health and medical care out of a crisis. 

“The State of Oklahoma, first of all, needs to be public and validate all of these providers across the state that have had to lose their jobs, or agencies that had to go under that were with agencies that said, ‘We're not doing anymore of the Medicaid,’” said Smith. “There needs to be some kind of compensation back to these agencies, and especially the ones that closed.”

As Smith and Ray work to do everything they can to iron things out with the state and insurance companies, they’re also keeping their own mental health in mind. 

“Some of us have gotten together to where we actually do self-help groups so that we can do exactly what we know [how] to do, but it's devastating,” said Smith. “This isn't just about money. It ripples; it's gonna take months and months for us just to recover from this.”

The full interview with Smith and Ray can be accessed on VNN’s Youtube channel.