Common use of SOONERCARE PROGRAM OVERVIEW Clause in Contracts

SOONERCARE PROGRAM OVERVIEW. The State of Oklahoma operates a Medicaid Program to provide health care for persons eligible under 42 U.S.C. §1396 et seq. Under 42 U.S.C. §1315(a) waiver authority from the Federal government, Oklahoma operates a mandatory managed care program known as SoonerCare for a portion of its Medicaid population. The Oklahoma Health Care Authority (OHCA) operates a Primary Care Case Management (PCCM) system hereinafter referred to as "SoonerCare" for eligible individuals. SoonerCare is comprised of two components; the partially-capitated PCCM program and the voluntary American Indian Case Management PCCM program. The State’s objectives for SoonerCare include the following: A. To improve access to medical care, including preventive services, primary care and early prenatal care for Oklahoma’s Medicaid population. B. To ensure that every Medicaid beneficiary is able to choose a primary care provider who will serve as his/her provider and be responsible for providing all basic medical services. C. To better integrate Medicaid beneficiaries with the privately insured population, through enrollment into managed care delivery systems serving both populations. D. To instill a greater degree of budget predictability into the Oklahoma Medicaid program, by moving from a Fee-For-Service (FFS) system to one based on the concept of pre-payment.

SOONERCARE PROGRAM OVERVIEW. The State of Oklahoma operates a Medicaid Program to provide health care for persons eligible under 42 U.S.C. §1396 et seq. Under 42 U.S.C. §1315(a) waiver authority from the Federal government, Oklahoma operates a mandatory managed care program known as SoonerCare for a portion of its Medicaid population. The Oklahoma Health Care Authority (OHCA) operates a Primary Care Case Management (PCCM) system hereinafter referred to as "SoonerCare" for eligible individuals. SoonerCare is comprised of two components; the partially-capitated PCCM program and the voluntary American Indian Case Management PCCM program. The State’s objectives for SoonerCare include the following: A. To improve access to medical care, including preventive services, primary care and early prenatal care for Oklahoma’s Medicaid population. B. To ensure that every Medicaid beneficiary is able to choose a primary care provider who will serve as his/her provider and be responsible for providing all basic medical services. C. To better integrate Medicaid beneficiaries with the privately insured population, through enrollment into managed care delivery systems serving both populations. D. To instill a greater degree of budget predictability into the Oklahoma Medicaid program, by moving from a Fee-For-Service (FFS) system to one based on the concept of pre-payment.