Reimbursements for Oklahoma mental health providers under scrutiny from lawmakers

Yahoo

12-05-2025

Oklahoma Chief Financial Officer Aaron Morris, back, and specially appointed financial expert, David Greenwell, front, testify at a select committee of lawmakers investigating finances of the Oklahoma's mental health department on Monday. (Photo by Emma Murphy/Oklahoma Voice)
OKLAHOMA CITY — Lawmakers expressed concerns Monday about whether the state's mental health department is adequately reimbursing a group of specialized providers who care for uninsured Oklahomans.
Lawmakers peppered the state's chief financial officer and a special expert appointed by Gov. Kevin Stitt with questions about whether providers who operate certified community behavioral health centers are being correctly compensated for services after Oklahoma Voice last week reported that several providers said they're owed close to $150 million in unreimbursed costs during the 2024 and 2025 budget years.
Aaron Morris, the state's CFO, and David Greenwell, who has temporarily been appointed by Stitt to oversee the Oklahoma Department of Mental Health and Substance Abuse Services' finances, were the latest officials called to testify before a special legislative committee probing the agency's financial shortfalls and ongoing disarray that's resulted in contracts being cut or canceled and warnings that the department can't afford to pay its nearly 2,000 employees.
Both men said the state agency would need a supplemental appropriation to make ends meet and make payroll for the rest of the current fiscal year, but said they were still trying to determine what that amount is. They said that supplemental request would not include the $150 million that several providers have said hasn't been reimbursed by the state agency.
While these providers haven't historically been reimbursed for 100% of these services and the agency isn't contractually obligated to do so, reimbursements have been made when funds are available, Morris said.
Rep. Mark Lawson, R-Sapulpa, who chairs the select committee, said many providers have received these payments for years and built them into their business models. Lawmakers will consider including funds for these reimbursements in a supplemental appropriation, he said, but paying state employees and 'getting through' the current fiscal year comes first.
Joy Sloan, president of the Alliance of Mental Health Providers of Oklahoma, a coalition of eight certified community behavioral health centers, has said that providers generally aren't reimbursed for all claims and don't expect to be.
In a letter addressed to Mental Health Commissioner Allie Friesen and sent to lawmakers on Monday, Sloan wrote that while she understands Friesen's burden, the recent financial cuts have placed an 'unprecedented strain' on Oklahoma's certified community behavioral health centers.
'Without financial support to offset the costs for those unable to pay, our ability to sustain this open-access model is in jeopardy,' she wrote. 'Some of us may be forced to reduce services, lay off staff, or close programs. None of us want that. Therefore, considering this challenging budget year, and in the spirit of shared responsibility, charity and compromise, we request that ODMHSAS consider funding some portion of these services.'
In total, the eight providers have over $84 million in services not reimbursed this fiscal year. Slightly over 1 in 4 clients was uninsured, according to the letter.
Following the hearing, the mental health department released a statement that said the agency has not traditionally budgeted separately for the payments but instead used funds still available at the end of the year.
Friesen had asked a former employee to create 'an algorithm to assist providers in estimating and planning' for those payments, but it wasn't completed, said Maria Chaverri, the agency's spokesperson, in a statement.
She acknowledged 'significant and sometimes unrealistic mandates' that make the current payment model 'challenging' for providers, and said the department is working to 'restore the model's original fidelity' to ensure the monthly contract rates are sufficient.
'Several factors have contributed to the current rise in pended payment amounts, including systemic shifts such as the transition to managed care, broader state-level reforms, and increased service mandates placed on (certified community behavioral health centers),' Chaverri said in a statement.
Senate Minority Leader Julia Kirt, D-Oklahoma City, said she's worried that those provider payments are being viewed as 'optional' when the Legislature mandates that the services be provided. It has increased the number of uninsured receiving treatment, she said.
'I'm worried that we're going to view it as optional when actually they've built this capacity based on our requirements,' she said.
Rep. Anthony Moore, R-Clinton, asked that Morris and Greenwell consider including the payments in the supplemental budget request for the current fiscal year and in the budget request for the upcoming fiscal year.
He said the budget request would not be accurate without them.
'We will be back here next year with a giant headache on our hands if we shut these providers down,' he said. 'Because we all know that we're going to treat these people somewhere, and it's going to be somewhere in the system, and I'd much rather be in the mental health system than in jails and in the court system.'
Morris, the state CFO, said they will provide lawmakers with the 'support' to make that determination.
Immediate needs and obligations, like making payroll, are the priority, Morris said. One lawmaker said around $1.5 million has been added to the mental health department's payroll by new executive staff hires.
Morris and Greenwell did not offer a dollar amount on how much would be needed for a supplemental appropriation at Monday's hearing, but said they planned to get a number to lawmakers later that day.
The two financial experts said they would be meeting with leaders from the Legislative Office of Fiscal Transparency to finalize and compare numbers Monday.
'There are human beings behind every single dollar we're looking at,' Sen. Paul Rosino, R-Oklahoma City, said. 'People in crisis, people in need of services, and please don't lose focus of that.'
After lawmakers are presented with a request for an appropriation, they will internally review it before it can go through a joint committee on appropriations and budgets.
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