OHCA Dental Checkup, winter 2018

Proposed dental rate increase; spring training dates; tobacco cessation for your patients; and more!

Having trouble viewing this email? View it as a Web page.

Oklahoma Health Care Authority Dental Checkup

Winter 2018

OHCA reverses provider rate reductions decision

The Oklahoma Health Care Authority (OHCA) board met in special session on Dec. 29, 2017, and voted to reverse provider rate reductions which were approved on December 1 and scheduled to go into effect January 1.

During the second special session, the Oklahoma legislature passed an additional appropriation providing the agency with $17.7 million. These funds coupled with the $22.8 million that was provided when Governor Mary Fallin approved sections of the appropriations bill on November 17 give the agency enough funds to operate at current levels until April.

The OHCA had already taken several budget balancing actions preparing for the agency’s $70 million reduction to its appropriation due to the loss of the smoking cessation fee and in order to submit a balanced budget. Several program changes have been implemented in state fiscal year (SFY) 2018 that produce savings of approximately $3.2 million for SFY18. In addition, $4.65 million in 2017 general revenue was returned to the agency in SFY18 and the agency had $12 million in carryover from SFY17.  

On December 1, the OHCA board approved across-the-board provider rate reductions of 6 percent and 1 percent for nursing facilities as well as eliminating Medicare crossover coinsurance and deductible payments for nursing facilities to be effective Jan.1, 2018. Read more.

Back to top

Strategic planning sets OHCA, Oklahoma on road to success

The word Strategy highlighted in green with felt tip marker

The OHCA invited approximately 100 key stakeholders to provide input for its five-year Strategic Plan (2018-2022) during an on-site forum at the agency. The October 11-12 session focused on developing action plans for the OHCA and creating outcome measurements for goals and objectives. Focus areas for this strategic plan include:

  • Access to health care in rural areas;
  • Economic and racial disparities in health status and outcomes;
  • Effectively changing individual health-related behaviors;
  • Quality improvement in OHCA’s programs and processes; and
  • Budget effectiveness, including revenue implications of any new state or federal action.

Vision of Success 

The group developed a vision of success in response to this question: “Assuming the agency had necessary resources and made significant progress towards its goals, what would Oklahoma’s health care environment be like at the end of 2022?” The vision included culture and behavior changes resulting in healthier Oklahomans, a stable and coordinated provider network, a focus on preventive care and care coordination, and an outstanding agency fully funded because of its administrative excellence and clear contribution to health outcomes.

Employee Engagement and More Critical Components

Using all this input, as well as feedback from the October 2017 OHCA Annual Tribal Consultation, the agency held three employee planning sessions in November; more than 60 people participated. 

Staff reviewed and enhanced the ideas developed during the Strategy Forum and added some of their own. In addition, these small groups of employees further developed specific action plans including implementation milestones, risk analysis and contingency planning. 

The OHCA also invited SoonerCare/Insure Oklahoma members and additional stakeholders to provide input through online surveys held in September and December, respectively. 

Next Steps

The OHCA is on schedule to have a draft strategic plan in February 2018. The Dental Checkup will bring you more details as they become available. 

Back to top

Dental Checkup For the record

Dental program updates

Dental policy now includes language allowing dental providers to submit the diagnostic cast or photographic images as evidence of medical necessity for dental services. This program update took effect Sept. 1, 2017.

This affects policy at OAC 317:30-5-696OAC 317:30-5-698 and OAC 317:30-5-700.1. The OHCA encourages you to read each rule in its entirety. More information can be found in Provider Letter OHCA 2017-15 at www.okhca.org/providerletters

If you have any questions regarding this rule change, please call the OHCA Provider Helpline at 1-800-522-0114.


Back to top

Proposed rate increase for outpatient dental services

OHCA Permanent Rulemaking Process Flow Chart

Permanent rulemaking process in effect 

OHCA’s permanent rulemaking process is underway. The first set of proposed rules were made available for comment at www.okhca.org/rule-changes on Dec. 15, 2017. The second round of proposed rules posted Jan. 17, 2018.

The public, SoonerCare members and providers, other state agencies and OHCA staff and leadership may request changes in policy. Proposed permanent rules may include proposals for new programs and/or policies or amendments to current policies. They also include rules previously promulgated on an emergency basis.

Permanent rule recommendations go to the Legislature and governor for action in the spring. We encourage you to review the proposed rules and give your input.

Outpatient hospital dental and ENT rates

The OHCA proposes an increase in the reimbursement rate for certain outpatient dental services provided in an outpatient hospital. These services will be reimbursed on a cost basis effective on or after Jan. 1, 2018. Dental and ear, nose and throat (ENT) surgical procedures will be classified into a payment group based on CPT codes. 

All procedures within this payment group will be paid a single rate. The new rate for these services will be cost-based and will equalize the rates to improve access for dental services rendered in the hospital setting.

To view and/or leave comments about these changes, please visit the OHCA Proposed Changes webpage.

To learn more about OHCA's rulemaking processe, click the flow chart image.


Save-the-date! Spring 2018 Provider Training Workshops

The word "Workshop" of Red Color (illustration)

You and your staff are invited to attend  one of the spring 2018 SoonerCare Provider Training Workshop hosted by OHCA and DXC Technology (formerly Hewlett Packard Enterprise). 

  • Durant - May 1
  • Tulsa - May 9 and 10
  • Lawton - May 17
  • OKC - May 23 and 24
  • Guymon - June 20

OHCA and DXC highly recommend that all providers attend a workshop in their area. Be sure to mark your calendar!  

Watch for class descriptions, recommended audiences and registration details in the spring 2018 Provider Checkup (April). Updates will also post to the provider training page of our website.

There is additional training available online specific to dental providers.

Back to top

Help your patients quit tobacco

Provider uses 5As approach to counsel patient using Oklahoma Tobacco Helpline resources


The New Year is a time for healthy resolutions, which makes it the perfect time to discuss  how patients can quit, or stay tobacco free.

You’ve probably discussed the need to quit smoking with your patients. Maybe some are already in the process of quitting. Your professional advice and words of encouragement could be just the push they need.

For starters, you can review the 5As approach to tobacco cessation. SoonerCare reimburses dentists for performing the 5As counseling with patients. Additionally, there are a few tips you can share to help them fight stress, avoid triggers and battle cravings. Here are a few:

A good night’s sleep helps reduce stress.

Too much coffee amplifies stress levels

Water calms cravings and flushes toxins.

Encourage your patients to change up their morning routines by brushing their teeth first thing.

Talking to loved ones helps overcome stress and cravings. It also lets family and friends know they’re quitting.

When people eat poorly, they give themselves permission to do other unhealthy things.

Make sure your patients know about the Oklahoma Tobacco Helpline. FREE, nonjudgmental support is available 24/7. For more tips and information, visit OKhelpline.com.

Back to top

OKMOM wants to heal their smiles!

Oklahoma Mission of Mercy logo

The 2018 Oklahoma Mission of Mercy (OKMOM) two-day, free dental clinic is February 2-3 at the Choctaw Event Center in Durant. OKMOM offers dental treatment to patients who are uninsured, under-insured or who have trouble accessing care. Services provided include oral surgery, extractions, restorations, pediatrics and hygiene.

OKMOM is staffed by volunteers, and patients are seen on a first-come, first-served basis. There are no eligibility or income requirements to be treated.

Organizers anticipate 2,000 patients to be seen and need volunteers to serve in numerous roles, including dentists, hygienists, dental assistants, front office staff, nurses, physicians, translators, food  service, crowd control and more.

To register as a volunteer, donate or refer someone in need, please visit the OKMOM website.


OKMOM is produced by the Oklahoma Dental Association, Oklahoma Dental Foundation, Delta Dental and Delta Dental Foundation. The Oklahoma State Department of Health endorses the event.

Back to top

Dental Checkup Provider Toolkit

OHCA Provider Helpline: 800-522-0114

Dental Prior Authorization Unit: 405-522-7401

Provider Resources

Web Alerts

Online Training

Dental Checkup Statement

Information contained within is subject to change. Be sure to check OHCA Provider LettersGlobal MessagesWeb Alerts and news releases at okhca.org for the most up-to-date information.

Word of mouth banner

Hot topics in dentistry ...


**Editor’s note: The opinions in these articles are those of the author(s) and do not necessarily represent the views of SoonerCare Dental or the Oklahoma Health Care Authority.

Back to top

Order Publications

OHCA Calendar

Newsletter Archive 

Dental Checkup At the root

Answers to your frequently asked questions

1.      Are adults eligible for D7241 (Removal of impacted tooth – completely bony, with unusual surgical complications)? 

Answer: This surgical extraction code requires a prior authorization for members older than age 21.

2.      Are adults eligible for an examination?


Answer: Adult dental services are limited to emergency care. SoonerCare members older than age 21 may be eligible for a limited oral evaluation – problem focused, based on emergency dental needs.

Back to top


National Children’s Dental Health Month

Young girl smiles into small mirror after receiving a dental checkup from OHCA Dentist Dr. Courtney Barrett.

February is National Children’s Dental Health Month (NCDHM) – a time for dental professionals, health care providers, parents and other caregivers to promote healthy oral habits to the children in their lives.

The American Dental Association’s 2018 campaign focuses on creating sensational smiles and its NCDHM Program Planning Guide offers free resources and easy-to-do activities to help achieve them. Posters, available in both English and Spanish, are also available for ordering online. Visit the NCDHM website at www.ADA.org/ncdhm to download materials.

SoonerCare also has online resources to help your patients keep their teeth in tip top shape. Check them out at www.okhca.org/dental.

Back to top