Blue Cross Blue Shield of Oklahoma has submitted a Qualified Health Plan application, along with rates, for certification in the federally-facilitated exchange for 2018. This is an initial indication that, for the second straight year, only one insurer in Oklahoma will offer exchange products in the individual market.
“There is an incredible amount of uncertainty in the market right now,” said Oklahoma Insurance Commissioner John D. Doak. “Insurers participating in Obamacare have experienced major losses. While we expect a full repeal of this disastrous experiment, insurers have to go by the regulations in place right now. That’s why we’ve seen so many insurers dropping out of exchanges across the country or resorting to double digit premium increases.”
The Oklahoma Insurance Department does not have statutory authority to approve or deny rate increases filed by insurers on the federal exchange. Oklahoma, along with Texas and Wyoming, is a direct enforcement state with no authority to enforce provisions of the Affordable Care Act.
The Centers for Medicare and Medicaid Services (CMS) intends to post information on proposed rate filings for consumers to review on https://ratereview.healthcare.gov on Aug. 1, 2017. In compliance with state statutes, OID cannot release or comment on the rates until that time. CMS officials will review the proposed rate changes, determine if they are justified and post final rate information on Nov. 1, 2017 in time for open enrollment.
According to the American Academy of Actuaries, individual market stability, including insurer decisions on participation for 2018, hinges on:
* Continued funding of cost-sharing reduction (CSR) reimbursements.
* Enforcement of the individual responsibility penalty.
* Risk mitigation mechanisms aimed at lowering premiums, increasing enrollment and improving the risk pool.
* Avoiding legislative or regulatory actions that could increase uncertainty or threaten stability.
State Question 756, passed in 2010, amended the Oklahoma Constitution to prohibit laws which compel individuals, employers and providers to participate in health care systems. Because of that legislative change, insurers offering products on the Oklahoma exchange are required to submit rate filing justifications to CMS for evaluation and approval.
History of Oklahoma Exchange Carrier Participation
2017 – Blue Cross Blue Shield
2016 – Blue Cross Blue Shield, United Healthcare
2015 – Blue Cross Blue Shield, Community Care, Global Health, Assurant
2014 – Blue Cross Blue Shield, Community Care, Global Health, Aetna, Coventry

by Bobby Anderson, Staff Writer

If you get the right fit, then everything else will take care of itself.
It’s the driving motto at Patriot Prosthetics in Yukon where Dallas Curtis and Michael and Michele Huggins have literally given thousands of Oklahomans a new lease on life.
In any given year, Oklahoma ranks either first or second nationally in the number of amputations.
There’s a host of health reasons behind it but what’s left every time is a person facing one of the most emotionally and physically draining experiences of their life.
That’s where Patriot comes in.
The pieces of steel, plastic and carbon fiber Huggins and Curtis create aren’t just works of art but art that truly works.
“They become one with the patient,” said Huggins, whose father had a prosthetic clinic on Oklahoma City’s south side for 16 years. “After awhile it becomes them so you take it and you work with it just like that. This is part of this patient so you carry it and work with that in mind.”
THE RIGHT FIT
Huggins knows that every prosthetic clinic in America orders parts from the same handful of manufacturers.
In that respect, most shops are the same.
But what Huggins and Curtis pride themselves on is taking the extra time to ensure the right fit.
“No matter what we put on underneath that socket it doesn’t matter,” Curtis said. “If the fit’s not good who cares if you have microprocessor-controlled knees or power ankle and feet systems. There’s so much technology out there now in our field it’s ridiculous, but it’s how you apply it.”
Growing up, prosthetics was close to home for Huggins.
He was around 10 when his father lost his leg above the knee following a car accident.
He watched his dad literally learn to walk again and often times regrets having to do so.
He saw the look on his dad’s face most mornings before he had to strap on the 16-pound apparatus that was allegedly his new leg.
After years of fit issues and being told ‘that’s the best we can do’ his father compressed four years of school into two before teaming with the legendary Ray Buddin – a below-the-knee amputee.
THE PROCESS
Patriot offers mobile, on-site, care for many of its patients. Staff can team up with your physician, therapist, or other healthcare provider to coordinate appointments near you or at your home.
Huggins says clients appreciate not having to spend the day driving across Oklahoma City for a single visit while many still enjoy coming to Patriot’s Yukon office.
The steps taken to be fit with a prosthesis or orthotic device vary from patient to patient. Commonly, patients are referred by a physician or therapist early in the healing process for an initial free evaluation to discuss their needs in detail.
Measurements and/or a casting may also occur during this initial visit.
It was while playing football at Northeastern State University in Tahlequah, Curtis found his way into the world or prosthetics.
While spearheading several community service programs with NSU athletes he literally uncovered his niche.
Spending time with a nursing home resident one day, Curtis saw a man come in, raise the man’s pant leg and uncover a prosthetic limb.
“I didn’t even know he was an amputee. He functioned really well,” Curtis said. “I had no idea until that prosthetist showed up. I was just hanging out, chatting and playing checkers.”
A new major followed for Curtis as did a career as a prosthetist.
“Back then everybody wanted it covered,” Curtis said of the stigma amputees carried. “Everybody wanted to disguise it as much as possible.”
Before opening Patriot, Curtis was the prosthetic supervisor at the Oklahoma City VA Health Care System.
Now he and Huggins have become the go-to clinic for those who have been told “that’s the best we can do.”
Huggins said the rule has and always should be “if it hurts then something’s wrong.”
THE RIGHT TECHNOLOGY
“The function of this is unbelievable,” Curtis said, holding a microprocessor prosthetic knee that has bluetooth connectability.
After fitting a client with the technology Curtis can connect wirelessly via his laptop and make a host of adjustments to match the client’s natural gait.
Patients are taught how to reprogram the joint for different activities through their smart phone.
Carbon technology allows energy to be returned to the client through rebound technology on some prosthetics.
But technology isn’t their passion.
“This stuff is not about us. This is about the amputee,” Huggins said. “We play a small part by casting and knowing how to modify and make that socket work throughout the day. The amputee takes it and does the rest.
“I don’t feel like I can take credit for a lot of what they do. That’s up to them.”

A local art show raised more than $3440 for Mercy’s stroke education, treatment and prevention programs. The benefit, which was organized by Oklahoma Artists Invitational (OAI), featured original works from 24 artists, including Mercy’s Dr. Dustan Buckley. To date, OAI has donated more than $16,617 to Mercy’s stroke center.
Mercy Hospital Oklahoma City is currently home to the state’s largest group of neuroscience specialists in the southwestern United States, and the state’s largest number of neurohospitalists – physicians dedicated solely to providing neurological care for patients admitted into the hospital. In February, Mercy was named a top stroke center in the nation.

The Oklahoma City Community Foundation recently awarded $97,500 to six charitable organizations in central Oklahoma providing services for elderly citizens.
“Seniors are in need of programs that help them to live happy, healthy lives,” says Whitney Moore, development director for recent grant recipient Oklahoma City Ballet. “Remaining active as seniors age is very important in maintaining their independence and health.”
The Community Foundation’s Services for the Elderly iFund program supports organizations that provide direct services for our community’s older citizens who still live in their homes. By supporting wellness and exercise activities, this program helps to allow independent living to continue and provides positive social and recreational opportunities improving their quality of life.
“Oklahoma City is continually listed as one of the nation’s least healthy cities. The Oklahoma City Community Foundation is actively working to change this by creating a culture of health and wellness in central Oklahoma,” Oklahoma City Community Foundation President Nancy B. Anthony said. “We are pleased to work with charitable organizations that share our vision and provide creative solutions to improve the lives of citizens in our community.”
The following grants were awarded through the Services for the Elderly iFund:
American Red Cross of Central Oklahoma – $12,500 for a campaign to prevent home fires among elderly residents.
NewView Oklahoma – $20,000 for a medication management program for seniors who are vision-impaired.
Oklahoma City Ballet – $10,000 for the Golden Swans program providing ballet classes to help improve senior mobility.
Rebuilding Together OKC – $20,000 to provide critical heating, cooling and electrical repairs to low-income seniors allowing them to remain safe, warm and dry in their homes.
Regional Food Bank of Oklahoma – $20,000 to provide nutritious food and healthy living resources to low-income seniors.
The Salvation Army Central Oklahoma Area Command – $15,000 to support the Senior Watch program that provides immediate, short-term assistance for seniors in need of additional household, emotional or spiritual support.
An initiative of the Oklahoma City Community Foundation Trustees, the iFund program utilizes gifts from donors to support services for children and elderly, as well as provide access to health care. Since 2011, the iFund program has awarded more than $2.5 million to charitable organizations serving central Oklahoma. For more information, visit www.iFundokc.org.
Founded in 1969, the Oklahoma City Community Foundation is a 501(c)(3) public charity that works with donors to create charitable funds that will benefit our community both now and in the future. To learn more about the Oklahoma City Community Foundation, visit www.occf.org.

There is no guidebook or manual covering all the complexities associated with getting older. The self-help section of every bookstore boasts several topics ranging from helping aging parents and financing retirement, to health and wellness advice or dealing with those ever returning boomerang kids, but there is no one-size-fits-all model for aging successfully.
It is with this in mind that Nikki and Chris Buckelew and their real estate team’s mature moves division launched the “Senior Living Truth Series” back in 2016. The series includes a monthly educational program made up of seminars and expert panels dealing with topics important to mature homeowners.
“Because our team specializes in helping people who have lived in the same home for many years, we field questions daily on a range of topics. It’s important to be aligned with highly competent professionals we can recommend,” says Nikki Buckelew. “We introduce seminar attendees to these professionals through our expert panels.”
Seminar attendees are often either looking ahead to prepare for their own post-retirement lifestyle or are caring for an aging relative or friend. They are seeking answers to questions like what types of 55+ housing options are available, where to get support, how to pay for long-term care needs, ways to simplify and de-clutter, and more.
“Our attendees are smart people and when they have the resources they need, they feel more capable of making decisions. We all feel that way and that’s why we developed the series,” adds Buckelew.
Those attracted to the seminars appreciate the professional and organized fashion in which the seminars are delivered.
“The seminars are well-organized and well presented,” said Frank Andrews, a retired corporate trainer.
Frank and Carol are familiar faces at the truth series events and began attending after seeing an article in the paper.
“It’s about learning that you have to plan early and about understanding what you need and what you don’t,” added Carol. Jennifer Forrester, Community Relations Director with Oklahoma Hospice Care, a regular sponsor of the event, said the series has a way of helping people deal with the hard questions a lot of people tend to avoid.
“Nikki is the only Realtor I know who has a background in both counseling and gerontology, and as the moderator she has a way of taking hard topics and making them lighter and easier to talk about,” Forrester said. “She just says it like it is and doesn’t apologize for it.”
The Buckelews and their specialized team have made it their personal and professional mission to educate and guide consumers about best practices related to post-retirement living.
“People are doing the best they can and credible information is hard to find. Our attendees tell us they appreciate meeting local people with whom they can have a personal conversation without feeling pressured or rushed,” says Chris Buckelew.
James and Joan DonDero began attending the seminars a year ago.
“We attend frequently and chose to meet with the Buckelews personally to talk about downsizing in the future. It was just what they said – no pressure and no sales pitch,” said James.
The seminars serve to empower, equip, and educate by providing information to help people think about what their next steps might be and the timing to begin taking them.
“Going to the seminars helped us realize we had some things to think through,” added Joan.
The next event is titled “The Truth About Successfully Aging in Place” on July 13th from 10:00am – 11:30am and from 2pm – 3:30pm. The morning event has reached capacity and reservations are being accepted for the afternoon event.
“We know that people prefer to remain in their own homes and neighborhoods for as long as possible. The challenge is many have not prepared and need information on best practices for ‘staying put’,” Buckelew said.
The August event is titled “The Truth About De-cluttering Your Home.” With morning and afternoon sessions starting at 10am and 2pm.
Events are held at the MAPS3 Senior Health & Wellness Center located at 11501 N Rockwell in Oklahoma City. Pre-registration is required and space is limited. Admission is free for those 55 or older and their guests. Professionals pay $25. Go to www.seniorlivingtruthseries.com or call 405-563-7501 to register.

The Oklahoma Medical Research Foundation has received a pair of grants totaling nearly $2.1 million from the National Institutes of Health. The projects will focus on mechanisms that underlie proper blood coagulation and ovarian cancer.
OMRF scientist Ray Rezaie, Ph.D., received a four-year, $1.74 million grant from the NIH’s National Heart, Lung, and Blood Institute that will allow him to continue research on a protein called antithrombin, which inhibits coagulation of blood.
Rezaie joined the foundation’s Cardiovascular Biology Research Program in 2017 from the St. Louis University School of Medicine. He studies blood clotting and inflammation, including how clotting factors work together to stop bleeding and how they regulate inflammatory responses when blood vessels are injured.
Antithrombin, which is located in blood plasma, is an inhibitor necessary for regulating coagulation and inflammatory pathways that are essential for maintaining healthy processes in blood vessels. “We know that antithrombin binds to molecules in the vascular system to initiate an essential anti-inflammatory response to keep vessels intact and healthy,” said Rezaie. “But we still don’t know how it works.”
Through better understanding this process, scientists ultimately hope to develop new therapeutic agents to control thrombosis, clotting and inflammatory diseases, primarily heart disease and atherosclerosis.
The second grant was awarded by the NIH’s National Cancer Institute to Magdalena Bieniasz, Ph.D. Over three years, it will provide $339,000 to study the underlying mechanisms of a receptor called sfRon, which has been implicated in aggressive ovarian cancer progression.
“This sfRon receptor actually makes the cancer aggressive and resistant to standard treatments, and that’s why we need to know how it works,” said Bieniasz, a scientist in OMRF’s Functional and Chemical Genomics Research Program.
She will also be testing drugs that inhibit this receptor in order to search for therapies that will work in targeting the receptor present on cancer cells.
Bieniasz became a principal scientist at OMRF in 2016 after completing a postdoctoral fellowship at the Huntsman Cancer Institute in Utah. She receives funding support for her research from the University of Oklahoma’s Stephenson Cancer Center, where she is also a member.
In her lab at OMRF, Bieniasz studies how ovarian cancer grows and spreads in the body, as well as the genetic changes in cancer cells that can lead to chemotherapy resistance.
This grant from the National Cancer Institute is tailored to provide new investigators with the early support to help them generate more data to be highly competitive for future grants.
“There are not many grants out there that do this,” she said. “Now I have assets to hire people for my lab and do more experiments. It’s a really great boost for this research in its early stages.”
Rezaie’s NHLBI grant designation is 2R01 HL062565-19A1 and Bieniasz’s NCI grant is1K22 CA207602-01. OMRF Vice President of Research Rodger McEver, M.D., said these grants speak volumes about the quality of research being done by these scientists in an increasingly tough climate for funding.
“The NIH is the major funder of biomedical research in the U.S. and applications for NIH grants are rigorously reviewed and highly competitive,” said McEver. “Awards like these are a testimony to the rigor and creativity of their research.”

In order to enhance the patient experience and better serve the surrounding community, St. Anthony Healthplex East is pleased to announce the opening of St. Anthony Pharmacy East.
The pharmacy is located on the first floor of St. Anthony Healthplex East, and is opened from 8 a.m. to 5:30 p.m., Monday – Friday. The pharmacy will accept most insurance prescription plans including Express Scripts, Tricare, CVS Caremark, Humana, BlueCross and many others.
The benefits of the pharmacy include convenience for ER patients and patients of St. Anthony Physicians Group, St. Anthony Healthplex East, as well as professional patient counselling services.
St. Anthony Healthplex East is pleased to offer these expanded services to patients and the community, in an effort to make health care more accessible and convenient.
St. Anthony Healthplex East is located at 3400 S. Douglas Blvd., in Oklahoma City. To contact the pharmacy please call 405-772-4034.

By Angela Brice-Smith, MPA, RN – Regional Administrator, Centers for Medicare and Medicaid Services, Region VI (AK, LA, NM, TX, OK)

Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.
CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now. We’ll start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.
CMS is committed to helping providers by giving them the tools they need. We want to make this process as easy as possible for you, your patients, and your staff. Based on feedback from healthcare providers, practice managers and other stakeholders, CMS is developing capabilities where doctors and other healthcare providers will be able to look up the new MBI through a secure tool at the point of service. To make this change easier for you and your business operations, there is a 21-month transition period where all healthcare providers will be able to use either the MBI or the HICN for billing purposes.
Even though, your systems will need the capability to accept the new MBI format by April 2018, you can continue to bill and file healthcare claims using a patient’s HICN during the transition period. We encourage you to work with your billing vendor to make sure that your system will be updated to reflect these changes as well.
Beginning in April 2018, Medicare patients will come to your office with new cards in hand. We’re committed to giving you information you need to help your office get ready for new Medicare cards and MBIs.
Here are 5 steps you can take today to help your office or healthcare facility get ready:
1. Go to our provider website and sign-up for the weekly MLN Connects® newsletter.
2. Attend our quarterly calls to get more information. We’ll let you know when calls are scheduled in the MLN Connects newsletter.
3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
4. Work with us to help your Medicare patients adjust to their new Medicare card. When available later this fall, you can display helpful information about the new Medicare cards. Hang posters about the change in your offices to help us spread the word.
5. Test your system changes and work with your billing office staff to be sure your office is ready to use the new MBI format.
We’ll keep working closely with you to answer your questions and hear your concerns. To learn more, visit: cms.gov/Medicare/SSNRI/Providers/Providers.html