April 2021

• What You Need to Know About Medicaid Expansion
• What You Need to Know About Managed Medicaid (SoonerSelect)
• SoonerSelect Town Halls
• Adolescent Health Summit
• SoonerCare Coverage of Naloxone and Medication Assisted Treatment
• Latest FDA Updated Medication Labeling and Warnings
• National Drug Take Back Day
• Montelukast Safety Warning
• BZD Safety Alert
• Dental Reminders
• 450,000 Patients Helped and Counting

What You Need to Know About Medicaid Expansion

On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed by a majority vote to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. This equates to an estimated annual income of $17,796 for an individual or $36,588 for a family of four. The application process for Medicaid expansion opens on June 1. Those who qualify will receive coverage on July 1.

Visit https://oklahoma.gov/ohca/about/medicaid-expansion/expansion.html for more information.

What You Need to Know About Managed Medicaid (SoonerSelect)

OHCA is transitioning to a managed care model in partnership with four medical plan organizations and three dental plan organizations. SoonerCare members will be able to select whichever plan they prefer for their coverage.

When Will SoonerSelect Go Into Effect? Oct. 1, 2021

How Does This Impact Providers Who See SoonerCare Members? Providers must contract with at least one of the four health plans to continue serving SoonerCare members.

How Can I Learn More? Visit https://oklahoma.gov/ohca/about/soonerselect.html for more information. We are also hosting SoonerSelect town halls (see below).

SoonerSelect Town Halls

If you have been unable to attend one of our SoonerSelect town halls discussing managed care either in person or virtually, we will hold one on April 15 in Kingfisher and another on April 19 in Oklahoma City, and are planning more. To stay up-to-date, register for future town halls or watch replays of previous ones, visit oklahoma.gov/ohca/townhall.

Adolescent Health Summit

The Oklahoma State Health Department of Health, in collaboration with its community partners, is hosting a training event for youth-serving professionals.

Event Name: Adolescent Health Summit

Date/Time: June 23-24 from 1-5 p.m. each day

Location: Virtual

Key Note Speakers: Dr. Niobe Way, Dr. Miguel Vazquez-Rivera, Youth Panel

Registration Information: Registration is not yet available, but will be accessible from the OSDH website once it is.

Questions: Contact kamishaB@health.ok.gov with any questions.

SoonerCare Coverage of Naloxone and Medication Assisted Treatment

Did You Know?

• Patients covered through Medicaid are at a higher risk of opioid overdose than non-Medicaid patients. SoonerCare covers products and services to help treat substance use disorders, also known as medication assisted treatment (MAT).
• MAT medications have a $0 copay for all SoonerCare members. Some specific products may still require a prior authorization. SoonerCare also covers naloxone products with a $0 copay that does not count towards the member’s monthly prescription limit. To prescribe buprenorphine MAT medications for your patients, you will need a DEA X waiver.
• Methadone is also approved by the FDA to treat opioid use disorder (OUD). By law, only a Substance Abuse and Mental Health Services (SAMHSA) treatment program can dispense methadone for the treatment of OUD. There are multiple SAMHSA programs located throughout Oklahoma providing methadone treatment.

How to Obtain a DEA X Waiver:

• Qualified practitioners with a DEA X waiver can administer, prescribe and dispense MAT medications. Information on obtaining a DEA X waiver can be found here. Oklahoma-specific information and training dates can be found here. The trainings are free and CMEs are available.

How to Administer or Prescribe Naloxone:

• The American Medical Association has created a video providing naloxone administration instructions. A multi-state public health coalition has also provided assistance in prescribing the most appropriate naloxone formulation. They have paired the provider information with patient information for both the nasal spray and injection.  

SAMHSA National Helpline:

1-800-662-HELP (4357) or TTY 1-800-487-4889

The SAMHSA helpline provides 24/7, free and confidential mental and substance use disorder information and treatment referrals in both English and Spanish. This service provides referrals to local treatment facilities, support groups and community-based organizations. Callers can also order free publications and other information

Latest FDA Updated Medication Labeling and Warnings

Because some adverse drug reactions are not identified until a product is used in wider, more diverse populations, the FDA maintains a monitoring and reporting system. When problems are identified, medications may require updated labeling or warnings. In the most serious situations, the medication may be removed from the market. The table below lists recent alerts made by the FDA:

National Drug Take Back Day

April 24 is National Take Back Day! Encourage your patients and anyone you know with drug addition issues or excess drugs in their home they do not need to take advantage of this opportunity. They can learn more, including finding drop off locations near them, at takebackday.dea.gov.

Montelukast Safety Warning

The FDA recently issued a safety alert for montelukast based on safety concerns and the increased risk of potential for misuse.

During an FDA review, additional neuropsychiatric adverse event terms were added to the existing warnings and precautions for montelukast. Despite previous FDA communication efforts and information in the product label, concerns were raised that many physicians and patients are not aware of the risk for neuropsychiatric events. 

The FDA recommends providers treating allergic rhinitis use montelukast only when patients are unable to use other approved treatments. It is recommended that providers assess medication efficacy, adverse events and the need for continued montelukast therapy. Many safe and effective allergy medications are widely available, including over-the-counter (OTC) medications.

All patients should be counseled about the potential mental health side effects of montelukast and should be advised to contact a health care professional immediately if changes in behavior or new neuropsychiatric symptoms occur.

BZD Safety Alert

The FDA 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 (MAT). 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:

• 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.
• Refer patients for substance abuse treatment when appropriate.
• Strongly consider prescribing naloxone when patients are receiving opioids and BZDs concomitantly.

BZD medications include:

Dental Reminders

• Dental prophylaxis and topical fluoride applications are allowed once every 184 days.
• Routine build-up(s) are included in the fee of an approved crown per policy and are not normally approved when requested with a crown code.
• Be sure to check member’s eligibility and treatment history before preforming any dental services.

450,000 Patients Helped and Counting

The Oklahoma Tobacco Helpline offers the following services for FREE:

• 24/7 web support
• Customized quit coaching
• At least a two-week supply of nicotine replacement therapy (NRT)

Patients can pick from three different plans:

• All Access - FREE NRT, coaching calls, supportive texts, quite guides and more
• Web Coach - Same as All Access but without coaching calls
• Individual Services - FREE NRT and whichever additional services the patient selects

Let your patients know that combining NRT with quit coach support greatly increases their chances of success.

SoonerCare Members
Did you know SoonerCare members may qualify for additional benefits? Benefits include counseling as well as prescriptions and over-the-counter medications to quit tobacco. With a doctor’s prescription, SoonerCare members have access to patches, gum, lozenges, nasal spray, inhalers, Zyban and Chantix.

FREE Office Materials
Get FREE helpline materials for your office. They keep the helpline top-of-mind and encourage your patients to quit. Free materials include brochures, pens, posters and tip cards. To order your materials, go to OKhelpline.com.

View complete OHCA calendar here

Chief Executive Officer
Kevin Corbett

Managing Editor
Aaron Askew
Communications Coordinator

OHCA Board of Directors
Stanley Hupfeld, Chairman
Oklahoma City

Alex Yaffe, Vice Chairman
Oklahoma City

Dr. Jean Hausheer
Lawton

Marc Nuttle
Norman

Phillip Kennedy
Lawton

Dr. Laura Shamblin
Oklahoma City

Tanya Case
Duncan

Randy Curry, D.Ph.
Weatherford

Robert Boyd
Owasso

4345 N. Lincoln Blvd.
Oklahoma City, OK 73105

Information contained within this newsletter is subject to change. Be sure to check OHCA provider letters, global messages and web alerts at www.okhca.org for the most up-to-date information.

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 Principles:

Passion for Our Purpose

Empowerment and Accountability

Trust and Transparency

Solution-oriented

Servant Leadership

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 Aaron Askew (aaron.askew@okhca.org) from OHCA’s Strategic Communications: 405-522-7488.