Drummond Oklahoma Medicaid Audit Request Issued

Drummond Oklahoma Medicaid audit request targets managed care failures

A Drummond Oklahoma Medicaid audit request has been formally issued, calling for an independent review of the state’s Medicaid system.

Attorney General Gentner Drummond requested that State Auditor and Inspector Cindy Byrd conduct an audit of the Oklahoma Health Care Authority (OHCA).

The request follows mounting complaints from providers and concerns over how the state’s managed care organizations (MCOs) are operating.

Drummond Oklahoma Medicaid audit request cites provider complaints

The Drummond Oklahoma Medicaid audit request outlines a pattern of issues affecting healthcare providers and patients.

According to Drummond’s April 24 letter, providers have reported payment delays, claims processing failures, and denials of medically necessary services.

The state contracts with Humana, Aetna, and Oklahoma Complete Health to administer Medicaid services.

Medicaid oversight and program administration in Oklahoma are handled by agencies like the Oklahoma Health Care Authority (OHCA).

Drummond criticizes agency response and lack of accountability

The Drummond Oklahoma Medicaid audit request also highlights concerns about OHCA’s response to repeated inquiries.

Drummond said his office made three formal requests for corrective action directed to OHCA CEO Clay Bullard, but received limited response.

Despite requests for written answers, OHCA provided verbal assurances and defended the system, citing high claim approval rates while acknowledging issues.

“Oklahoma’s second experiment with managed care Medicaid is failing to deliver on its promises. Providers are reducing staff. Patients are being denied essential care. Out-of-state corporations are controlling access to critical services without accountability,” Drummond wrote.

Healthcare program oversight and compliance are also monitored by agencies like the Centers for Medicare & Medicaid Services (CMS).

Audit request seeks to protect patients and public funds

The Drummond Oklahoma Medicaid audit request is focused on restoring accountability and protecting vulnerable Oklahomans.

“When an agency entrusted with Oklahoma’s most vulnerable citizens refuses to hold billion-dollar corporations accountable, it falls to this office to act,” Drummond said.

“Providers across this state have been sounding the alarm for months. Oklahoma patients are being denied care they are legally entitled to, and OHCA has chosen to defend the MCOs rather than the people it serves. An independent audit is not only warranted – it is essential to restore accountability and protect public funds.”

Government accountability and financial oversight are supported by the Oklahoma State Auditor and Inspector’s Office.

Officials say the requested audit will examine both patient care outcomes and the use of public funds.

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