OHCA Provider Checkup

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May Provider

May 2021

Provider Notes

SoonerSelect Basics Webinars

OHCA will continue to present SoonerSelect Basics webinars in June. The trainings are tailored to specific provider types and provide and overview of the upcoming managed care organization (MCO) changes. Topics include transitioning to managed care, member populations affected by the transition, contracting with an MCO, requirements of the MCOs and responsibilities of OHCA.

Please visit https://oklahoma.gov/ohca/providers/provider-training.html to see the upcoming schedule.

Global Messages

Are you keeping up with the most recent global messages? We have posted global messages about MCO prior authorization, SoonerCare trainings, important upcoming dates and more. 

Please visit https://oklahoma.gov/ohca/providers/updates/global-messages/global-messages.html to stay current with our most recent information. 

Providers May Now Submit Their Program Year 2021 Attestations

Program year 2021 is the last year to participate. As outlined in statute, all incentive payments must be issued by Dec. 31, 2021. Therefore, this will impact the typical attestation timeframe for program year 2021. Providers will have until Aug. 31 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.

The reporting timeframe will be any 90-day period between Jan. 1 and Aug. 31, 2021. Providers attest to a 90-day reporting period for both meaningful use and clinical quality measures, and all 2021 attestations must be submitted by Aug. 31.

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.

Dental Checkup

Dental Update

Dental prior authorizations will no longer be pended back to providers for additional documentation that is needed or missing. All documents are required at the time of submission.


Prenatal Vitamin Update

SoonerCare providers received a prenatal vitamin (PNV) update in June 2020, and this month’s SoonerCare member newsletter further highlights the importance of PNVs throughout pregnancy and the postnatal period. Despite robust clinical evidence, most pregnant members covered by SoonerCare had only two paid claims for any PNV during a pregnancy.

Studies consistently affirm the importance of frequent, clear, and open provider communication in improving PNV use. SoonerCare providers are encouraged to discuss PNV use throughout prenatal and postnatal care. Preferred PNVs with a prescription are available at no cost for female members age 10 to 50 years and do not count towards monthly prescription limits.

For additional member resources, please visit OHCA Pregnancy Services and FAQ: Nutrition During Pregnancy.

Pediatric Psychotropic Medication Resource Guide

A multidisciplinary task force, led by OHCA, recently published the first edition of the Oklahoma Pediatric Psychotropic Medication Resource Guide. The guide was developed by child and adolescent psychiatrists, pediatricians, and pharmacists from the University of Oklahoma Health Sciences Center, the Oklahoma State University Center for Health Sciences, OHCA and the Oklahoma Department of Human Services.

The task force included the most up-to-date, evidence-based mental health recommendations encompassing diagnosis, screening, treatment and monitoring for nearly 20 mental health conditions for patients age 0 to 18 years, with specific focus on the needs of primary care providers and their pediatric patients.

Medication Therapy Management Update

During the March meeting of the Drug Utilization Review Board, the University of Oklahoma College of Pharmacy presented an update of the Medication Therapy Management (MTM) program. Eligible adult SoonerCare members are identified to receive MTM services based on patterns of chronic medication use and recent emergency department and/or hospital admission. To date, more than 1,100 members have benefitted from MTM services.

In delivering MTM services, clinical pharmacists communicate drug-related problems (DRPs) to the providers treating these members. While many of these DRPs are due to complex clinical situations, a large percentage are much more commonplace and impact SoonerCare members across the state. The most frequent DRPs address the following:

  1. Paid claims for a 30-day supply of medications eligible for a 90-day supply.
  2. Pneumococcal vaccine for members age 19 to 64 years with a qualifying comorbidity.
  3. Zoster vaccine (shingles) for members age ≥50 years.
  4. Smoking cessation medication(s) for members expressing a desire to pursue smoking cessation.
  5. Influenza vaccine during current influenza season.
  6. Cervical cancer screening for female members age 21 to 65 years.
  7. Annual spirometry test for members with chronic obstructive pulmonary disease (COPD).
  8. Annual urine albumin screening for members with diabetes.
  9. Statin therapy for members with atherosclerotic cardiovascular disease (ASCVD) or cardiovascular (CV) risk factors.
  10. Uncontrolled hypertension according to member’s home monitoring records.

SoonerCare members continue to benefit from this program. If you would like additional information or would like to refer a member to SoonerCare’s MTM program, please call the SoonerCare pharmacy helpdesk at 1-800-522-0114, option 4.

Tobacco CessationMy Life, My Quit 2

My Life, My Quit Is Here

My Life, My Quit

Oklahoma teens 13-17 who want to quit vaping, smoking or chewing tobacco can now access FREE tools to help them quit. Evidence links youth tobacco use to addictive behaviors later in life, so it’s critical to get teens the support they need today.

The trained, compassionate coaches at My Life, My Quit provide personalized help to support a tobacco-free life. These services are confidential and do not include patches, gum or lozenges.

Teens can text “Start My Quit” to 36072 for supportive text messages and web chat, or visit MyLifeMyQuit.com to learn more.

Just One Conversation

Talk to your patients about tobacco use and recommend My Life, My Quit for support to quit. One conversation can make all the difference.

Get FREE Materials for Your Office

A variety of promotional materials are now available from My Life, My Quit. Choose from posters, pens and brochures. Plus, you can access a wide variety of additional resources from the Oklahoma tobacco helpline and Shape Your Future.

These free materials encourage your patients to quit tobacco and pursue healthier choices. Check out and order free materials for your office here.

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