Medicaid home- and community-based services; requiring Oklahoma Health Care Authority to seek certain exemption. Effective date.

SB 1837 requires the Oklahoma Health Care Authority (OHCA) to seek a federal exemption allowing Medicaid providers in rural counties (population ≤60,000) to provide case management and develop person-centered plans for home- and community-based services. This directly affects rural healthcare providers who currently face restrictions under federal regulation 42 C.F.R. §441.301(c)(1)(vi). The bill mandates OHCA to establish conflict-of-interest protections for exempt providers, separating case management and provider functions within organizations. The exemption would permit these rural providers to deliver services without federal barriers, effective November 1, 2026.