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December 2020
OHCA global messages update providers on upcoming trainings, policy changes, billing reminders and agency news. Providers can view global messages on the public website at okhca.org/global and you can also sign up to receive messages via email by enrolling in Web Alerts. Recent notable global messages include:
- The US Dept. of Health and Human Services has extended the public health emergency through Jan. 21, 2021. Due to the extension, telehealth services are available for most SoonerCare services through Jan. 31.
- Effective Oct. 31 and for as long as the COVID-19 public health emergency lasts, therapy providers should no longer request the GT modifier for telehealth services on prior authorization submissions.
- Effective Nov. 1, claims for dual-eligible members who also have a Medicare Part C HMO policy will need to be filed as a crossover rather than as an HMO co-pay claim.
Physician renewals have been extended through Dec. 31 due to the public health emergency. If you are a physician and have not completed a contract renewal, you will receive a letter with instructions on how to complete the renewal process. To avoid any delay in reimbursement, we encourage physicians to submit their renewals as soon as possible.
If you have any questions, please contact Provider Enrollment at 800-522-0114, option 5, or email ProviderEnrollment@okhca.org.
Below are contract renewal and expiration dates. You may begin renewing 75 days prior to expiration.
2020 electronic health record attestations are now being accepted for all eligible professionals.
Providers will attest to a 90-day reporting period for both meaningful use and clinical quality measures, and all 2020 attestations must be submitted by March 31, 2021.
Please note: Program year 2021 is right around the corner and will be the last year to participate in the program. As outlined in statute, all incentive payments must be made by Dec. 31, 2021; therefore, this will impact the typical attestation timeframe for program year 2021. Providers will have between April 1 and July 31, 2021 to submit their program year 2021 attestation to allow OHCA ample time to review the attestation and pay the incentive to the provider by the Dec. 31 deadline. No payments will be made after this date.
If you have any questions or concerns regarding this program, please contact the EHR incentive team at EHRIncentive@okhca.org or by phone at 405-522-7347. You can also visit us online at www.okhca.org/ehr.
The SoonerCare education phone number, 405-522-7422, has been discontinued. To request training on a particular topic, please email the training request to SoonerCareEducation@okhca.org and include the provider’s name, SoonerCare provider ID number, a return phone number and a contact name. Providers can continue to call the OHCA provider helpline at 800-522-0114 for immediate claims or policy assistance.
OHCA is offering the Introduction to Oklahoma SoonerCare class via webinar as an alternative to the on-site training in Oklahoma City and Tulsa. This class is an overview of Oklahoma Medicaid that includes information on member eligibility, coverage and exclusions, programs, and claim submission. The SoonerCare Provider Portal: Medicaid on the Web training will not be part of this webinar.
Please register for the Dec. 3 webinar offered from 2-3 p.m. here.
As OHCA continues the going green initiative, effective Jan. 1, 2021, special processed claims must be submitted using the provider portal HCA-17A function. Paper claims that require special processing will no longer be accepted as of Dec. 31, 2020.
Webinar trainings will be offered regarding the HCA-17A feature, which is now included on the provider portal. The trainings will discuss and demonstrate the process of completing a claim for special processing via the provider portal. Policy or other types of claim submission will not be covered. To register for the Special Claims Process webinars on Dec. 10 and 29, please visit the Provider Training page at okhca.org/provider-training.
Effective Jan. 1, 2020, maintenance medications began processing for a 90-day supply without an override. There are many categories eligible for 90-day supply, so please check before prescribing to see if the member’s medication qualifies.
Most adult members have a six prescription limit each month; therefore, prescribing or dispensing 90-day supplies of chronic maintenance medications will help members on multiple medications obtain the maintenance medications necessary. A complete list of maintenance medications that will process for a 90-day supply can be found on our website at www.okhca.org/rx.
The U.S. Food and Drug Administration recently updated the boxed warning for benzodiazepines (BZDs) due to safety concerns. These changes further strengthen existing warnings for combining BZDs with opioid medications, including those for cough suppression and medication-assisted therapy. The National Institute on Drug Abuse reports more than 30% of opioid overdoses also involve BZDs.
For each patient receiving BZDs, the FDA advises health care providers to:
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Assess the risk of drug abuse, addiction, physical dependence and withdrawal reactions. Physical dependence can occur in less than seven days of use.
- Advise patients to seek immediate medical attention for difficulty breathing.
- Gradually taper to discontinuation of BZDs whenever possible. Sudden discontinuation may be life-threatening.
- Limit the dose and duration of BZDs to the minimum needed to achieve clinical improvement.
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Refer patients for substance abuse treatment when appropriate.
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Strongly consider prescribing naloxone when patients are receiving opioids and BZDs simultaneously.
BZD medications include:
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Generic Name
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Brand Name(s)
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alprazolam
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Xanax®, Xanax XR®
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chlordiazepoxide HCl/clidinium bromide
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Librax®
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chlordiazepoxide HCI
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Librium®
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chlordiazepoxide HCI/amitriptyline HCl
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Limbitrol®, Limbitrol DS®
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clobazam
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Onfi®
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clonazepam
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Klonopin®
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clorazepate
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Gen-Xene®, Tranxene®
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diazepam
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Diastat®, Diastat® Acudial®, Valium®, Valtoco®
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estazolam
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No brand name currently marketed
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flurazepam
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No brand name currently marketed
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lorazepam
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Ativan®
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midazolam
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Nayzilam®, Seizalam®
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oxazepam
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No brand name currently marketed
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quazepam
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Doral®
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temazepam
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Restoril®
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triazolam
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Halcion®
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