Getting patients to your office is easier than ever!

Getting members to their appointments; FEEDBACK WANTED on Medicaid community engagement requirements; NEW SoonerCare PAYMENT CHANGES; and more!

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Summer 2018

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Increased provider rates among legislation approved at the Capitol

State budget issues continue to impact operations at the Oklahoma Health Care Authority

Legislative Updates

Sine Die Adjournment
The 56th Legislature adjourned sine die on May 3, 2018. The governor had through May 18 to sign or veto bills passed in the final week of session. After sine die, bills that are not signed by the governor are considered vetoed.

State Fiscal Year 2019 Appropriations
SB 1600, which makes appropriations to state agencies for the upcoming fiscal year, was signed by the governor on April 30. The Oklahoma Health Care Authority (OHCA) state fiscal year appropriations total $1.13 billion.

Work Requirements
Gov. Fallin issued a work requirements executive order (EO) on March 5 to direct OHCA to develop recommendations for a Medicaid work requirements program.

In addition to the governor’s EO, the following companion legislation was passed:

  • HB 2932 – Directs OHCA to seek a work requirements waiver and specifies program criteria. (Signed by governor, May 7, 2018)

Other OHCA Legislation

  • SB 972 – Requires OHCA to examine the feasibility of a state plan amendment for diabetes self-management training. (Governor signed, April 12, 2018)
  • SB 1053 –Authorizes Oklahoma Department of Veterans Affairs to obtain certification through the federal Centers for Medicare & Medicaid Services (CMS) and accept payments/reimbursements from Medicare and Medicaid programs for services provided through Oklahoma veterans centers. (Governor signed, April 24, 2018)
  • SB 1591 – Provides authority for OHCA to establish a supplemental reimbursement program for certain ground emergency medical transportation services. (Signed by governor, May 8, 2018)
  • SB 1605 – Directs OHCA to increase provider reimbursement rates and provides other legislative direction for SFY19. (Signed by governor, May 10, 2018)

Upcoming Dates
The 57th Legislature will convene Jan. 8, 2019, at noon and recess no later than 5 p.m. the same day. The governor’s state address will be Monday, Feb. 4, 2019, at noon.

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Weigh in on Oklahoma’s Medicaid community engagement requirements

Policy word in vintage metal

Beginning on or after Feb. 1, 2019, the state of Oklahoma will implement community engagement requirements for certain individuals related to SoonerCare (Oklahoma Medicaid) eligibility upon approval from the Centers for Medicare & Medicaid Services (CMS). As a condition of eligibility for benefits, applicants or existing members - not otherwise exempted - age 19-50 must provide verification of employment or community engagement in specified educational, job training or job search activities for at least 80 hours per month. This equates to approximately 6,000 current members who would be subject to these requirements. Members who fail to meet these requirements for three months during a plan year will be dis-enrolled from SoonerCare until requirements are met.


Certain individuals are exempted from the above requirements. Those individuals include, but are not limited to:

  • pregnant women
  • individuals with a disability
  • a parent caretaker responsible for the care of a  dependent child under age 6
  • individuals enrolled in Insure Oklahoma
  • American Indians and Alaska Natives

This new eligibility criterion was directed by an executive order signed by Gov. Mary Fallin on March 5, 2018. Additionally, the state legislature passed House Bill (HB) 2932, which the governor also signed into law. HB 2932 mandated SoonerCare eligibility include criterion for work or job activities as required for the Supplemental Nutrition Assistance Program (SNAP).

Please visit the OHCA website for more information, including FAQs, timelines and other resources.

Public Comment and Input

The OHCA welcomes comments from the public regarding this amendment to the SoonerCare Choice and Insure Oklahoma 1115(a) Demonstration Waiver program. The full application waiver is available for viewing on our website through Sept. 3, 2018.

Submit your comments and questions through the OHCA Policy Change Blog or by contacting the OHCA Federal & State Reporting Division by phone at 405-522-7914 or via email:

The OHCA also expects to conduct several public meetings around the state July-September. Please check the agency’s website for specific dates, times and locations.

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OTC teething product warning

Adorable Indian baby laughing. Shows baby teeth.

The U.S. Food and Drug Administration (FDA) has warned against using over-the-counter (OTC) oral drug products containing benzocaine for anyone younger than two years. These products are of questionable efficacy and carry an increased risk of methemoglobinemia (a blood disorder in which too little oxygen is delivered to your cells), which may be fatal.

These products are currently still commercially available with the new contraindication against using the product for teething and for use in infants and children younger than two years for any indication.

Parents and caregivers are encouraged to follow the American Academy of Pediatrics' recommendations to ease teething pain. The safety announcement follows a previous recall recommendation concerning elevated levels of belladonna (a poisonous plant) in homeopathic teething tablets.

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For the record header

Changes to your direct deposits

finger presses green computer key marked "Electronic Funds Transfer"

Effective Aug. 1, 2018, OHCA will implement a change to the addenda record attached to your EFT (direct deposit) payment. This change is to comply with HIPAA-mandated health care EFT standards. It will not affect the EFT payment itself. 

The current addenda record for payments made by SoonerCare:


Will become:


(TRN *1* + warrant [payment] number +*1, followed by OHCA’s Federal Tax ID Number [no dash] + *)  

PLEASE NOTE: It is important that you contact the financial institution where your SoonerCare payments are deposited to notify them of this upcoming change. Doing so will help to ensure your EFT payments received beginning August 1 will process properly and will not delay your funds availability.

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Provider enrollment and renewal application fees

As a reminder, institutional providers are responsible for application fees at the time of new and renewal enrollments. These fees are a federal requirement that went into effect  Jan. 1, 2018. A list of provider types subject to these fees is available in Provider Letter 2018-05.

Furthermore, providers can visit the Provider Enrollment webpage to find renewal dates. They can be found under Contract Types.

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Fall SoonerCare Provider Training dates

Coworkers using computer in dental clinic.

You and your staff are invited to attend the fall 2018 SoonerCare Provider Training Workshops hosted by OHCA and DXC.

- Lawton - September 27
- Durant - October 4
- Tulsa - October 10 and 11
- Guymon - October 17
- OKC - October 24 and 25

OHCA and DXC highly recommend that all providers attend this workshop. Be sure to mark your calendar! 

We will release class descriptions, recommended audiences and registration details soon. Please visit the provider Training page of our website for updates.

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Reminder: Providers can book a ride for members!

Dentist gives smiling child a toothbrush in the dental office.

SoonerRide has long helped SoonerCare members get to and from their non-emergency health care appointments. But did you know that providers now have the ability to schedule transportation for our members as well? 

TripCare is a website that allows providers to schedule rides for SoonerCare members. The service is provided by LogistiCare, which also administers OHCA's SoonerRide program.

TripCare is at no cost to providers, but you will need an EDI form to get started. 

Providers will receive a username and password after the EDI form is submitted to LogistiCare via fax at 1-800-597-2091.

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OHCA drug pricing initiative approved - First in nation

The dollar symbol made out of colorful pills isolated on white background.

The OHCA was notified June 27, 2018 that their proposal to become the first state Medicaid agency to move forward with negotiating value-based or outcomes-based contracts with pharmaceutical companies was approved by the federal government.

“In essence, this means that if a drug does not perform as claimed, the manufacturer will rebate the cost of the drug or another negotiated amount," said OHCA Pharmacy Director Nancy Nesser. "For example, if a drug claims to keep people out of the hospital and doesn't, the manufacturer may be liable for the cost of the hospitalization.”

Value-based contracts tie provider payments to successful clinical outcomes and effectiveness rather than simply paying for the medication. Rising prescription drug costs is one of the catalysts for the OHCA to find innovative ways to reduce Medicaid costs.

>>Read more. 

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Opioids restricted to a seven-day supply

In May, Oklahoma Senate Bill 1446 was signed into law and places a seven-day limit on initial opioid prescriptions.

While enforcement and other details of the law are currently pending, many pharmacies and providers are already implementing these limitations.

The Oklahoma Commission on Opioid Abuse has issued several recommendations to help curb the state's opioid epidemic. The most recent information on the Oklahoma opioid epidemic may be found in the opioid newsroom.

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  Pharmacist trainee gives a bag of prescriptions to a customer in a drugstore.

Provider toolkit

OHCA Provider Helpline: 800-522-0114

Dental Prior Authorization Unit: 405-522-7401

Provider Resources

Web Alerts

Online Training

Order Publications

OHCA Calendar

Newsletter Archive 

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Same great content, brand new look!

 It's summer, and the Dental Checkup has a hot new look. We hope you enjoy our makeover!

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Free resources for your patients

OHCA offers several free publications that feature SoonerCare and Insure Oklahoma programs. These publications can be downloaded individually or providers may order a quantity to be delivered to them.

We restocked our SoonerRide magnets, Lock-in Program cards, Online Enrollment business cards and Insure Oklahoma brochures. In addition, our Medically Fragile brochure has been updated and is now available. These items are available for order, while supplies last.

To order, download or view other helpful resources for your patients, visit our Publications Store.

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  SoonerRide magnets are available for order at Quantities are limited.
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Help your patients quit tobacco

With the recent cigarette tax increase, health care providers are likely to see an influx of patients interested in quitting tobacco. They’ll have lots of questions and they’ll look to you for answers.

As a health care professional, you play a critical role in helping your patients quit. By offering information, options and support, you can help them reduce the impact tobacco has on their health.

Along with the cessation benefits available through SoonerCare, the Oklahoma Tobacco Helpline offers helpful tools and services for tobacco users and their health care providers. They provide 24/7 nonjudgmental support and their free services are customizable to help patients quit their own way. These services include text and email support, phone and web coaching, nicotine replacement therapies and more — all free.

Female provider counsels African American woman about quitting tobacco

Even if a patient is just thinking about quitting, the Helpline offers resources to educate them about the benefits. Here are some tools to start them on their path to living tobacco free.


This quiz helps patients assess their attitudes about tobacco and willingness to quit.


This handy calculator shows patients how much they’re spending on tobacco and how much they can save by quitting.


Order or download free fact sheets, stress management flyers, tip cards and more to share with your patients. Available in English and Spanish. 

No matter how long a patient has used tobacco, quitting leads to a longer, healthier life. People who quit smoking, dipping or chewing avoid health problems, save money and take control of their lives. And those who use a quit line like the Oklahoma Tobacco Helpline are four times more likely to stop smoking than those who go it alone.

To access resources for physicians and their patients, visit or call 1-800-QUIT NOW.


*Most SoonerCare members who use tobacco and are age 12 and older are qualified to participate.

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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.

Word of mouth


Here are a few topics:


**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.

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About OHCA


Our vision is for Oklahomans to be healthy and to have access to quality health care services regardless of their ability to pay.

OHCA Core Values:
Inclusiveness | Accountability | Engagement | Innovation | Integrity

The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.

Please submit any questions, comments or content suggestions to Kelli Brodersen ( at the OHCA’s Office of Creative Media & Design: 405-522-7504.

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