OHCA Provider Newsletter • May 2023

Having trouble viewing this email? View it as a Web page.

SoonerCare Provider Memo

May 2023

Included in This Edition

Be Sure to Check Your Patients' Eligibility

SoonerCare eligibility reviews are ongoing. Those members who are no longer eligible will have their coverage ended in phases over the next 8 months. If any of your patients are among the ineligible, their SoonerCare coverage will be ending or may have already ended.

It is crucial that you check your patients' eligibility. Watch this helpful video to learn more.

Eligibility must be verified on the service date before services are rendered. When checking eligibility on the provider portal, a single service date must be used; date span searches will not provide accurate information. If further education is needed or questions arise, please call the Provider Helpline at 800-522-0114 or email us at SoonerCareEducation@okhca.org.

Post-PHE Telehealth & Audio-Only Services

When the public health emergency (PHE) ended on May 11, 2023, the U.S. Department of Health and Human Services’ Office for Civil Rights stay of enforcement for using HIPAA-compliant platforms and devices for telehealth lifted. As a result, OHCA ended the expanded use of telehealth as allowed during the PHE. OHCA will continue to allow services provided via telehealth for select medical and behavioral health services. You can view the list of allowed services on OHCA's telehealth page

National Senior Health and Fitness Day

Photo of senior couple grocery shopping

National Senior Health and Fitness Day is May 31! OHCA offers a great benefit to those who need help making better choices to fight disease, lose weight and improve their health. SoonerCare members can get up to six hours of advice yearly from a registered dietitian. Learn more about the nutrition counseling benefit and refer your patients today.

Resumption of ACA Site Visits

OHCA suspended our normal site visit procedure during the public health emergency (PHE). Now that it has ended, we are required to resume our normal practice of conducting a site visit before a contract is approved.

Effective immediately, all contract types that require a site visit will be pended until the site visit has been completed and approved. Per federal requirement 42CFR §455.432, pre-enrollment site visits of providers who are designated as “moderate" or "high" categorical risks are required. The purpose is to verify that the information submitted to OHCA by a provider is accurate and to ensure compliance with federal and state enrollment requirements.

The site visit may be unannounced. Upon arrival, we will verify the physical address. If the location is closed, we will determine if the business appears to be operational. If so, we will make plans for another site visit and allow only one other opportunity for a successful site visit. If after two attempts at a site visit, the OHCA representative is unable to make contact and tour the facility, a recommendation will be made to deny enrollment.

Contracts Open for Renewal

The following provider contracts are currently open for renewal:

  • Behavioral Health Practitioners Under Supervision — will expire on May 31, 2023.
  • Board Certified Behavior Analyst (BCBA) — will expire on June 30, 2023.
  • Board Certified Assistant Behavior Analyst (BCABA) — will expire on June 30, 2023.

Please log into the provider portal and select the “Update Provider Files” link to start the renewal process.

Incentives to Encourage Patients to Quit Tobacco

Photo of Oklahoma Tobacco Helpline supply boxes

Quitting tobacco is hard. The Oklahoma Tobacco Helpline aims to make that journey easier and more accessible to all Oklahomans. For a limited time, the Helpline is offering a FREE 8-week supply of patches, gum or lozenges to any Oklahoman 18 or older looking to quit. That’s 4x the typical amount of nicotine replacement therapy!

Now through June 30, your patients can sign up to place their NRT order in one of three ways:

Once the order is placed, a coach will reach out to confirm. Members can also engage in five free coaching sessions for additional support and increased chances of quitting. See limited time offer details.

Free Materials for Your Office

Looking for a way to start the conversation about quitting tobacco? We’ve got you covered! From Helpline-branded pens and prescription pads to practical badge reels and clipboards for your staff, we have everything you need to chat with confidence.

Don't wait — equip your office with the necessary tools to help your patients live a healthier life! Order your free Helpline collateral at tset.ok.gov/order.

Post-PHE Drug Quantities

With the public health emergency (PHE) ended, OHCA is transitioning back to business protocols as they were prior to COVID. This includes returning select drugs’ quantity limits, which were allowed a 90-day supply during the pandemic, back to a 30-day supply. Learn which medications will continue to be available with a 90-day supply through our maintenance drug program.

Screening and Testing for Hepatitis C

OHCA is working on an initiative to help eliminate the hepatitis C virus (HCV) in SoonerCare patients. For this initiative to be successful, OHCA is encouraging providers to be vigilant in routine screening and testing for HCV.

The Centers for Disease Control and Prevention (CDC) recommends universal hepatitis C screening for all U.S. adults ages 18 and older and all pregnant women during every pregnancy, except in settings where the prevalence of HCV is less than 0.1%. Additionally, routine testing may be appropriate for patients with ongoing risk factors, while risk factors persist, regardless of the setting prevalence of HCV.

To learn more about HCV screening and testing, visit the FAQ page on the CDC website.

Tornado Season Prep for Your Patients

Do you have a plan for your medical equipment during storm season?

Tornados and spring storm can cause much of damage to homes and property. Your patients may have an emergency kit prepared, but they may not have thought about their durable medical equipment (DME). What do they do if their DME or assistive technology (AT) was damaged during a storm? It's important for them to think about a plan for that imperative equipment – wheelchairs, walkers, hospital beds, canes, CPAP or BiPAP machines, communication devices, hearing devices, etc. If they need assistance, Oklahoma ABLE Tech is prepared to help in the event of a disaster or evacuation! Learn more.

Poison Center Resources

Did you know nearly one-quarter of all calls to the Poison Helpline are from health care providers? The Oklahoma Poison Center has specially trained pharmacists and nurses who answer questions and provide individual training for health care providers, 24 hours a day, 365 days a year. Topics include:

  • Tablet and capsule identification
  • Toxicology resources
  • Peer-reviewed treatment recommendations and guidelines
  • Antidote agents and recommended quantities to have in stock

Their board-certified toxicologists are also available for group training on dozens of topics. Some of the medication related topics include:

  • Older adults and drug interactions
  • Problems and solutions related to opioid overuse and misuse
  • Toxicity of cardiovascular drugs
  • Antipsychotic and antidepressant drugs
  • Anticoagulants and their reversal agents

The center has fact sheets, coloring pages and brochures available at no charge to providers. These resources can be downloaded immediately or ordered in large quantities for sharing in clinics, pharmacies and other health care settings. You can also order stickers and magnets that can be posted onsite and given to patients and parents. It’s important to share these resources with parents of young children since most instances of unintended medication use involve children younger than 5 years of age. Most importantly, we encourage you to share the Poison Center helpline number 800-222-1222 with all your patients.   

For non-emergency information, you and your patients can use the Poison Center’s website and you can also find them on Facebook and Twitter. For other SoonerCare medication coverage related questions, please contact the Pharmacy Help Desk at 405-522-6205, option 4, or toll-free 800-522-0114, option 4.

Provider Resources

Web Alerts

Online Training

Order Publications

Statistics and Data

Newsletter Archive