Oklahoma – Governor Kevin Stitt signed an executive order aimed at addressing concerns about the administration of Medicare Advantage plans in Oklahoma, particularly the burden placed on healthcare providers and the reduced access to care for consumers across the state.
The order seeks to strengthen protections for both consumers and providers, while increasing transparency and accountability in how Medicare Advantage plans operate. Officials said the move is intended to ensure that plans are meeting their obligations to beneficiaries and to prevent practices that could limit care or create financial strain for providers, especially in rural and underserved areas.
In announcing the order, Governor Stitt said the goal is to protect vulnerable Oklahomans and ensure that healthcare providers can deliver care wherever and whenever it is needed. He said the state has seen a need for stronger oversight to ensure that Medicare Advantage plans operate with transparency and fulfill their promises to consumers.
“This is about protecting vulnerable Oklahomans and ensuring our healthcare providers can provide them with the care they need, wherever and whenever they need it,” Stitt said. “It’s become increasingly apparent that guardrails are necessary to ensure Medicare Advantage is fulfilling its promise to consumers and is operating with full transparency in our marketplace.”
Clay Bullard, Oklahoma’s Secretary of Health, said the executive order will require Medicare Advantage companies to communicate clearly with seniors and to uphold their commitments. Bullard said the state will work within the existing state-federal partnership while increasing direct oversight through the Oklahoma Insurance Department and the Oklahoma Health Care Authority.
“This executive order will require Medicare Advantage companies to keep their promises to our seniors, in plain language,” Bullard said. “Oklahoma’s seniors and healthcare providers deserve better. With direct state governance from the Oklahoma Insurance Department and Healthcare Authority, while working within our state-federal partnership, we believe more transparency and better contracting will secure the care and payments they deserve.”
The executive order establishes several key requirements for Medicare Advantage plans operating in Oklahoma:
Consumer protections: Medicare Advantage plans and their representatives are barred from offering inducements, bribes, or other benefits to influence beneficiaries’ plan selections. They may only offer supplemental benefits that have been approved by the Centers for Medicare & Medicaid Services. Plans must also be truthful in marketing and enrollment practices and are prohibited from using high-pressure tactics or misleading information.
Provider protections: The order requires Medicare Advantage plans to make prompt payments within 14 days and bans improper denials for services covered under Traditional Medicare. Officials said this measure is intended to reduce financial strain and administrative hurdles for providers, especially those in rural areas.
Patient access to care: Plans must maintain provider networks that are sufficient to ensure access to care in the counties where the plans are sold.
Annual transparency reports: Medicare Advantage plans must submit annual data to the Oklahoma Insurance Department on payments, networks, and denials. The Oklahoma Insurance Department and the Oklahoma Health Care Authority are also required to provide the governor’s office with a report on enforcement actions and the impact on providers.
The executive order is part of a broader effort by state officials to address complaints about Medicare Advantage plan practices, including concerns that some beneficiaries face restricted access to care or difficulty getting claims paid. Officials said the new requirements are intended to ensure that Medicare Advantage plans operate with accountability and that seniors receive the care and coverage they were promised.
Oklahoma governor signs executive order tightening rules for Medicare Advantage plans
