Okla. Stat. tit. 63 § 5030.4A

Current through Laws 2024, c. 453.

Section 5030.4A - Disease state management programs - Feasibility study

A. The Oklahoma Health Care Authority shall study the feasibility of implementing one or more disease state management programs.

B. The components of the study shall include, but not be limited to:

1. A description and assessment of the findings, costs of the program, savings incurred and estimated costs and savings of an expansion of the pilot program for asthma disease state management developed by the Authority;

2. An overview of disease state management programs for enrollees of health management organizations contracting with the Authority pursuant to the Sooner Care Plus Program;

3. An assessment of the adaptability of such disease state management programs for the Medicaid fee-for-service population;

4. An overview of representative vendors of the disease state management programs, including their characteristics, capabilities and charges for products and services;

5. An overview and assessment of the disease state management pilot project developed by the Oklahoma State Education Employees Government Insurance Board; and

6. A record, if available, of the savings generated by disease state management programs in other states by pharmaceutical manufacturers for Medicaid fee-for-service recipients.

C. The study shall be under the joint direction of the Disease State Management Director and the Pharmacy Director of the Oklahoma Health Care Authority. The Directors shall consult with the following entities as they deem necessary:

1. Medical, pharmacy, and nursing professionals who are experienced in disease state management programs;

2. Appropriate pharmaceutical manufacturers in connection with study components outlined in paragraphs 4 and 5 of subsection B of this section;

3. Disease state management vendors; and

4. Other resources as necessary including, but not limited to, health care advocates.

D. The Oklahoma Health Care Authority shall submit periodic progress reports to the Joint Legislative Oversight Committee. The Oklahoma Health Care Authority shall publish and submit a final report by December 1, 2002, to the Speaker of the Oklahoma House of Representatives, the President Pro Tempore of the Senate, the Governor, and the chair of the Health and Social Services Subcommittee of the Appropriation and Budget Committee of the Oklahoma House of Representatives and of the Health and Social Services Subcommittee of the Committee on Appropriations of the Oklahoma State Senate.

E. As used in this section, "disease state management program" means an integrated system of interventions, measurements and refinements of health care delivery that include:

1. Patient education and involvement in self-care techniques;

2. Clinical policies/best practices that extend across the entire continuum of care;

3. Outpatient drug management;

4. Clinical information systems with the capacity to identify, classify, and track defined patient populations;

5. Informed support of physicians;

6. Team-oriented multidisciplinary approach; and

7. Feedback or continuous review.

Okla. Stat. tit. 63, § 5030.4A

Added by Laws 2002 , HB 2763, c. 411, §1, emerg. eff. 6/5/2002.