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June 2022
Reasons for submitting an action form include:
- Adding an immediate family member of an established patient when the panel is at capacity.
- Adding an established patient when the panel is at capacity.
Age overrides are no longer available. Please update your age restrictions via the provider portal.
Action forms should not be submitted when the panel size is below 95% capacity. No action is taken by OHCA on action forms submitted when the panel size is below 95% capacity.
PCP change requests for all other reasons must be initiated online at www.mysoonercare.org or by calling the SoonerCare helpline at 800-987-7767.
*If your panel is grossly exceeding your set panel size, we kindly ask you to update this information via the provider portal to allow for those additional members to be added to your panel.
*Some action form requests may be denied if you are extraordinarily exceeding the set panel size, and we may require you to update your panel size via the provider portal.
The U.S. Food and Drug Administration (FDA) has issued drug safety alerts addressing newly identified or heightened concerns for medications across multiple classes. The following table summarizes these recommendations. A complete listing of affected medications is included in the links for each alert.
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June 2021 to June 2022 FDA Safety Alerts
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Ukoniq® (umbralisib)
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Patients should talk to their health care professionals about alternative treatments and stop taking Ukoniq®. Patients should dispose of Ukoniq® using a drug take-back location such as a pharmacy.
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Iodine-containing contrast media
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Within 3 weeks of contrast media exposure, health care professionals should monitor at-risk patients from birth through 3 years of age for a decrease in thyroid hormone levels.
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Orally absorbed buprenorphine medications
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Health care professionals should discuss oral health and the potential for dental problems with patients considering or receiving these medications. Patients should receive baseline and ongoing dental care. After medication is dissolved, patients should gently rinse teeth and gums with water and then swallow. Patients should then wait 1 hour before brushing teeth.
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JAK inhibitors
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Patients who have ever smoked, have cardiovascular risk factors, or have an existing malignancy other than a successfully treated nonmelanoma skin cancer should have had an inadequate or intolerable response to 1 or more TNF blockers before using a JAK inhibitor. Counsel patients about the benefits and risks of JAK inhibitors and advise them to seek emergency medical attention if they experience signs and symptoms of a heart attack, stroke, or blood clot.
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Statins
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The FDA is requesting removal of its strongest warning against use of cholesterol-lowering statin medications in pregnant patients. Despite the change, most patients should stop statins once they learn they are pregnant. Because of the chronic nature of cardiovascular disease, treatment of hyperlipidemia is not generally necessary during pregnancy.
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New dental prior authorization guidelines and quick references are now available on OHCA’s public dental webpage. Click here for helpful resources, policy and fee schedules.
Pharmacy, Durable Medical Equipment (DME) and medical supplies contracts expire June 30. To avoid any delay in reimbursement, OHCA encourages providers to begin the renewal process as soon as possible. Visit the provider training page for a how-to video on renewing your SoonerCare contract. The video is located under the SoonerCare How-To Videos dropdown titled “Renewing your SoonerCare contract”.
Providers unable to access the OHCA secure provider portal to submit a contract renewal must complete a PIN reset form. The global message dated March 19, 2021, provides instructions on how to complete the PIN reset form.
If you have any questions, please contact provider enrollment at 800-522-0114, option 5 or e-mail providerenrollment@okhca.org.
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