HB3699 directs the Oklahoma Health Care Authority (OHCA) to seek any federal waivers, state plan amendments, or other approvals needed to create a supplemental Medicaid reimbursement rate for certain participants in the patient-centered medical home program. The targeted participants include physician practices, community health workers, nonprofits, and other entities or individuals that are actively engaged in a team-based, evidence-based pediatric or family practice transformation model of care.
The bill specifies that the supplemental rate is intended to supplement fee-for-service wellness visit payments for children from birth through age four. It also ties the reimbursement to support for interdisciplinary staffing and implementation activities, including completion of screenings and adherence to Bright Futures screening recommendations at 9, 18, and 30 months, or comparable American Academy of Pediatrics guidance. OHCA would also be required to review the rate periodically alongside future Medicaid physician fee reviews.
HB3699 would further require participating providers and entities to work with an organization that uses data and outcomes to demonstrate adherence to the relevant pediatric care transformation model. OHCA would have to keep on file an annually updated letter verifying active participation in such a model. The bill takes effect November 1, 2026.
The bill’s impact would be to add a new Medicaid-related statutory requirement in Title 56, expanding OHCA’s duties and potentially increasing reimbursement for qualifying pediatric medical home participants. It would affect Medicaid administration, physician practices, community health workers, nonprofits, and other enrolled entities serving young children, while also creating documentation and verification obligations for OHCA and participating providers.
The available legislative history suggests generally favorable sentiment, with the bill receiving a unanimous 6-0 do pass vote in the House Appropriations and Budget Health Subcommittee and being recommended to the full committee. No committee transcript is available, so the record does not show detailed debate, but the vote indicates broad support at the subcommittee level.
The main points of contention, based on the bill text, are likely to center on Medicaid waiver approval, the administrative burden of verifying participation and maintaining annual letters, and the cost or budget impact of a new supplemental reimbursement rate. Another possible issue is how OHCA will define qualifying team-based, evidence-based pediatric transformation models and which providers or entities will be eligible to receive the enhanced payment.
HB3699 would create a new section of law in Title 56 directing OHCA to pursue federal and state approval mechanisms to establish a supplemental Medicaid reimbursement rate for qualifying patient-centered medical home participants focused on pediatric and family practice transformation. It would also impose periodic review requirements, participation standards, and annual verification documentation, thereby expanding OHCA’s administrative responsibilities and potentially increasing Medicaid payments for eligible providers and organizations serving young children.
The bill appears to have favorable early legislative support, as reflected by the unanimous 6-0 do pass vote in the House Appropriations and Budget Health Subcommittee and the recommendation to the full committee. No transcript is available, so there is no recorded floor or committee debate to indicate opposition, but the vote history suggests the measure was viewed positively at the subcommittee stage.
Potential contention points include the fiscal effect of creating a supplemental reimbursement rate under Medicaid, the need for federal waivers or state plan amendments, and the administrative complexity of documenting compliance. Stakeholders may also differ over which pediatric transformation models should qualify, how OHCA should evaluate evidence-based participation, and whether the annual letter requirement is an appropriate oversight tool or an added burden for providers and nonprofits.