Oklahoma seeks Medicaid expenditure cap for low-income adults

The Oklahoma Health Care Authority this week asked the Centers for Medicare & Medicaid Services to approve a Healthy Adult Opportunity demonstration waiver for its new low-income adult Medicaid population.

CMS in January issued Medicaid guidance allowing states to apply for 1115 waiver authority to receive a defined amount of federal funding to cover services for certain healthy adults, an approach commonly referred to as a block grant or per capita cap.

As part of the Healthy Adult Opportunity waivers, states can request changes in eligibility, covered benefits and cost-sharing, among other provisions. If approved, the Oklahoma demonstration would begin July 1, 2021.