It's Checkup time! OHCA budget update, contract renewals and more news for you!

Budget info, contract renewals, nominate a nurse, online training and more!

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oklahoma health care authority provider checkup

Spring 2016, Vol. 2

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Budget agreement

Against overwhelming circumstances, the governor and the legislature are protecting health care access for thousands of Oklahoma kids, pregnant moms, seniors and individuals with disabilities. We are incredibly grateful for their hard work. Their budget agreement focuses on protecting the health care of Oklahomans, and nearly fills the required budgetary needs of our agency. 

It is now time for the Oklahoma Health Care Authority to deliver on leadership’s priority declaration and minimize the impact to the health care professionals we count on to serve our SoonerCare members. If this budget is approved, it may be close enough for OHCA to avoid any additional provider rate cuts by first looking at deeper administrative cuts and current savings. 

Nico Gomez

Click here to read more on the Oklahoma 2017 state fiscal year budget agreement.

provider notes

Physicians' contract renewals, more

Physicians’ contracts are set to expire on Sept. 30, 2016. However, these providers can log on to the secure OHCA Provider Portal to start renewing their contracts on July 18, 2016. Physicians are OHCA's larger provider type. If you are a physician, please begin your renewal as early as possible.

Additionally, contracts for anesthesiologist assistants and clinical services providers expire June 30, 2016.

New cesarean section rates retrieval process

As part of our “green” process, quarterly C-section rates letters will only be available electronically, through the OHCA Provider Portal letters, effective June 30, 2016. Eliminating printing and postage for these letters are a few of the agency’s best ways to reduce some of our administrative costs.

You may also view the release schedule on the OHCA webpage at

If you need help to retrieve your letters, please call 800-522-0114, option 2, for the Internet Helpdesk; choose option 1 for your questions concerning the Provider Portal. 

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SoonerRide updates

SoonerRide car icon

SoonerRide is a program that helps our members to get to and from their SoonerCare appointments. Recently, some important changes have been made to the program, of which our providers need to be aware (including the hours of operation). Click here for complete details.

Also, be sure to check out the new fact sheet about our SoonerRide stretcher services. For members who have problems with their mobility, stretcher services may offer additional assistance. The fact sheet explains 1) exactly how to schedule these services and 2) what is and is not covered under them.

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Turn a sports physical into a well-child checkup

Children ready to play sports

If a child plays sports, in most cases, he or she is required to get a sports physical. Many people mistakenly assume that a sports physical and a well-child checkup are the same thing.

As the summer nears, more and more families will be scheduling sport physical exams. It is imperative that health care providers communicate the importance of a well-child checkup because it addresses the overall well-being of a child’s health; whereas, sports physicals are much more limited in scope.

SoonerCare only pays for well-child checkups; sports physicals are not separately compensable. However, as a courtesy, providers may fill out a sports physical form for a member (the form may be provided by the parent or the provider may have the form available in the practice). The best part is this can all be done in one office visit.

Providers should encourage parents and guardians to make sure their children and teens receive their recommended well-child checkups, regardless if they play sports. To check our periodicity schedule and learn more about what SoonerCare covers, click here.

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Provider training is just a click away

Did you miss the Spring 2016 SoonerCare Provider Training Workshop? Would you like to find out what’s new in SoonerCare programs, policy and procedure? Click here to download the presentations of your choice from the OHCA website.

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Durable medical equipment

Man's fingerprint

DME provider fingerprinting requirement effective
June 1, 2016

OHCA Provider Enrollment will be providing instructions for durable medical equipment (DME) providers who may need to be fingerprinted as part of the enhanced screening provisions contained in Section 640 of the Affordable Care Act. The fingerprint-based background check (FBBC) is required for all individuals with a 5 percent or greater ownership interest in a supplier that falls into the high-risk category, such as DME. This may affect providers who joined the SoonerCare network on or after Aug. 1, 2015.

Providers enrolled by Medicare may be exempt from this requirement. Look for additional guidance related to this requirement.

Incontinence supplies reminder

People First Industries (Durant, Okla.) is the contractor for incontinence supplies for children ages 4-20. Please contact PFI regarding supplies such as diapers, pull-ons, reusable underpads and wipes.

People First Industries
3324 Enterprise Blvd.
Durant, OK  74701
866-895-9956 or 580-924-8509

PFI will contact physicians’ offices regarding prior authorization (PA) renewals that are expiring in June 2016. Please schedule your patients to expedite the PA request, since they are required annually or as the member’s needs change.

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Young boy in hospital bed

FDA warnings: tramadol, fluconazole and aripiprazole

The FDA recently issued a warning concerning the use of tramadol in children age 17 and younger, especially following surgery to remove the tonsils and/or adenoids. While not FDA-approved for any pediatric use, reports show tramadol is being used off-label.  

Parents, caregivers and health care professionals are advised to watch for these warning signs and seek emergency medical attention if they occur:

  • slow or shallow breathing
  • difficult or noisy breathing
  • confusion
  • unusual sleepiness

The American Academy of Pediatrics currently recommends ibuprofen and good hydration as the preferred treatment for post-operative tonsillectomy care. Additionally, some children may be ultra-rapid metabolizers due to a genetic variation and may require emergency medical intervention with as little as one dose of tramadol.

The FDA is also evaluating the results of a recent study describing the potential for increased risk of miscarriage with the use of low dose oral fluconazole. Until the review is complete, health care professionals are advised to use a topical antifungal product to treat pregnant women with vulvovaginal yeast infections. Topical treatment may extend beyond the usual treatment period for persistence or recurrence.

Lastly, another recent FDA-issued warning states that use of aripiprazole may lead to compulsive or uncontrollable urges to gamble, binge eat, shop and have sex. These behaviors may affect any patient taking this medication. In the majority of cases, patients had no prior history of compulsive behaviors.

These urges were reported to stop when the medication was discontinued. Patients should not stop taking aripiprazole suddenly. Health care providers are encouraged to consider dose reduction or discontinuation taper if such urges develop.

Please report any side effects to the FDA MedWatch program. You may find more information at


Tramadol: Drug Safety Communication – FDA Evaluating Risks of Using in Children Aged 17 and Younger. Available at: May 4, 2016.

Tonsillectomy Care for the Pediatrician. Isaacson G. Pediatrics. August 2012: 130(2). Available at: Accessed May 4, 2016.

Fluconazole (Diflucan): Drug Safety Communication – FDA Evaluating Study Examining Use of Oral Fluconazole (Diflucan) in Pregnancy. Available at: Accessed May 4, 2016.

FDA Drug Safety Communication: FDA Warns About New Impulse-Control Problems Associated with Mental Health Drug Aripiprazole (Abilify, Abilify Maintena, Aristada). Available at: Accessed May 4, 2016.

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Health Promotion

Pregnant woman using mobile phone

Mobile messaging for healthy babies dials it up a notch

OHCA is a partner inText4baby (T4B) - the nation’s largest and only free mobile health messaging service for pregnant women and mothers with infants under age one. We recently received word that one of Oklahoma’s Text4baby outreach materials, the T4B pharmacy bags (through partnership with TSET) has been selected for inclusion in the forthcoming exhibition “Design with the Other 90%: USA,” organized by Cooper Hewitt (, at the Smithsonian Design Museum. The pharmacy bags were branded with Text4baby information and were distributed via pharmacies across the Oklahoma.

“Design with the Other 90%: USA” is the third exhibition in the groundbreaking “Design with the Other 90%” series (, which explores the intersection of poverty, prosperity, innovation and design in the U.S. Scheduled to open in September 2016 in New York, the exhibit will then travel to two to three other venues.

Also recently, the one millionth mother enrolled into T4B. There were actually three moms who time-stamped at the same time – one of them from Oklahoma City! OHCA celebrates this milestone with all of our state and national partners in the Text4baby initiative. These mobile messages continue to put the power to raise healthy babies at the fingertips of those responsible for their care.

To learn more about Text4baby, or to access provider-specific fact sheets, free promotional materials and staff training tips, please visit

Help celebrate Oklahoma's outstanding nurses

The March of Dimes is accepting nominations from across the state for its Nurse of the Year Awards. Honor a nurse who has touched your life by nominating him/her by June 22, 2016, at Nurses will be recognized in a variety of categories.

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Newly activated dental codes

As of May 1, 2016, OHCA now covers dental codes D0601, D0602 and D0603. The codes are available for reimbursement once per 12 months for members. More information is provided in provider letter OHCA 2016-05, which can be accessed on our website.

provider toolkit

OHCA Provider Helpline: 800-522-011

Provider Resources

Web Alerts

Online Training

Order Publications

Statistics and Data

Newsletter Archive

appointment reminders

June 8

Drug Utilization Review (DUR) Board Meeting

June 30
OHCA Board Meeting

July 5
Tribal Consultation

View complete OHCA calendar here

checkup statement

Information contained within is subject to change. Be sure to check OHCA Provider LettersGlobal Messages and Web Alerts at for the most up-to-date information.