Measles is a reportable disease in Oklahoma. It is a highly infectious and serious disease caused by the measles virus. Measles is also known as rubeola, 10-day measles, hard measles and red measles. Symptoms include high fever, cough, runny nose, watery eyes, and a red blotchy rash starting on the face then spreading to the rest of the body. 

The Oklahoma State Department of Health is posting exposure notifications as they are identified, and case summary information is updated on their website on Tuesdays and Fridays. As of May 9, there are 17 confirmed or probable cases of measles in the state.

With the rise in perinatal mental health across the state and nation, OHCA is interested in the practices within our state and how we can help improve screening. We have created a survey designed to gather baseline information for the Maternal Mood Disorders Workgroup within the Preparing for a Lifetime Initiative at the Oklahoma State Department of Health.

Please take a moment to complete this short, single-page survey. Once completed, you will be entered into a drawing for a $100 Amazon gift card.

More than 70,000 Oklahomans are living with Alzheimer's disease. The Oklahoma Healthy Brain Initiative Coalition (OHBI) is working diligently to bring awareness to this disease and provide education and training surrounding it. Their goal is to increase public awareness of Alzheimer's and dementia, provide easily accessible resources, and address the need for education among policymakers.

OHBI staff will be hosting a provider webinar at 2 p.m., June 10. Sign up to learn about the importance of early detection of dementia and detection strategies with Dr. Josh Chodosh of the BOLD Center of Excellence on Early Dementia Detection at NYU Langone Health.

Visit the Oklahoma Health Brain Program web page to find resources for providers and caregivers like the Basic Dementia Care Guide, as well as informational materials and training opportunities. You can also order print materials from the provider publications ordering page. 

Stroke is a leading cause of disability and death, but as a SoonerCare provider, you play a crucial role in reducing your patients’ risks by connecting them to covered benefits that support better health outcomes. SoonerCare supports better health outcomes through three programs.

• Medical Nutrition Therapy: Personalized nutrition counseling with a licensed registered dietitian that includes guidance on following a heart and brain-healthy diet to reduce the risk of stroke.
  Benefit: 6 hours per year.
• Diabetes Self-Management Education and Support:  Helps patients better manage their diabetes and learn skills to maintain healthy blood sugar levels and prevent complications. Benefits: 1 hour of individual training and 9 hours of group training in the first year; 2 hours of follow-up education each year after.
• Tobacco Cessation Counseling and Support: Counseling sessions with SoonerCare provider who will develop personalized quit plans, including nicotine replacement therapy (NRT) and medication options. Benefits: 8 sessions; coverage of all 6 FDA-approved NRT medications: gum, lozenges, patches, nasal spray, bupropion (Zyban) and varenicline (Chantix); Oklahoma Tobacco Helpline support (see article below).

Early intervention saves lives! Encourage your patients to take advantage of their benefits to reduce their risk of stroke and improve long-term health outcomes.

For more information, including technical assistance in implementing these benefits into your practice, patient eligibility and referral processes, contact SoonerQuit@okhca.org or watch the SoonerQuit Program SoonerCare Benefits Overview.

Pharmacy Questions

For questions about pharmacy benefits for SoonerCare members, contact the SoonerCare Pharmacy Help Desk at 405-522-6205, option 4, or toll-free at 800-522-0114, option 4.

For questions about pharmacy benefits for SoonerSelect members, contact the pharmacy help desk associated with your member’s health plan or email SoonerSelect@okhca.org.

Please update your Oklahoma Health Care Authority provider files to ensure all details, including new or missing locations and group member assignments, are accurate. If your update impacts services under SoonerSelect partners, email your application tracking number (received upon submitting your update on the OHCA provider portal) to ProviderEnrollment@okhca.org with "SoonerSelect update" and your application tracking number in the subject line.

OHCA is extending all ITU contracts that expired on March 31, 2025, to July 31, 2025. For the following provider types, 75-day renewals started April 16, and contracts expire June 30, 2025: CBSCC, CCARC, day treatment, outpatient behavioral health agency, partial hospitalization, paraprofessional, psychologist, school-based paraprofessional, schools — ESPDT.

Please be sure the contact information, including email address, is current for all individual and facility/group provider files so you can quickly receive important contract information.

Global Messages

Provider letter 2025-11 Informs SoonerSelect providers of how to appropriately utilize D1354 for the use of silver diamine fluoride (SDF). Provider Types: 27/270-279, 08/080 & 086

Provider Letter 2025-10 Informs providers that Liberty Dental Plan will implement changes related to claims processing for therapeutic pulpotomies, gross pulpal debridement and endodontic therapy for dates of services on or after April 1, 2025. Provider Types: 27/270-279, 08/080 & 086

Claim Inquiries

Direct inquiries to Provider Services at 800-522-0114 or ProviderServicesAdmins@okhca.org.

Member Inquiries

Direct member questions or concerns to Member Services at 800-987-7667.

Dental Prior Authorization Assistance

Provider inquiries may be made by emailing DentalServices@okhca.org. You can also call and leave a voicemail at 405-522-7401. For faster assistance, leave the prior authorization (PA) number or member ID for review. In addition, before rendering services, visit the provider portal to review your authorization on file to verify an approval, status or denial reason.

Member Eligibility

Please ensure your office staff is checking member eligibility on the day the member is in your office prior to performing any services. Also, note whether the member has a dental benefit plan. A prior authorization does not guarantee payment, and, if services are rendered for a member who does not have eligibility or prior approval, those services must be written off. The member will not be responsible.

Dental Page on the Public Website 

OHCA has a web page devoted to dental services. It contains links to policy, dental fee schedule, dental forms and other useful information such as an amendment tutorial. 

When should I start/from date my PA request when submitting a PA in the provider portal?

When submitting a PA request through the portal, you must enter a start/from date and an end date for your request. The start/from date entered on the PA must be a present date or a future date. Entering any historic date will automatically cancel your request, and it will not go to a reviewer for clinical review.

Present start/from date: This is the date you are submitting the PA request in the provider portal system. If the PA is approved upon review, services requested will be covered from this day onward. This is ideal, however, not always possible (see “future start/from date” below). Even in a situation when treatment won’t start until 1, 2 or 3 weeks from this submission date, the PA should be start/from dated with the submission date. The longer the gap between the PA submission date and the actual start/from date entered on the PA request, the higher the likelihood that the PA approval will be dependent upon the need for an up-to-date progress note to ascertain the need for the service relative to the start/from date entered. This is especially important to consider for PT/OT, where an evaluation or progress note completed within the past 30 days of the requested start/from date elaborating the member’s current status is necessary for a PA approval.

Future start/from date: In some cases, a clinic may choose to start a PA in the near future because an existing PA is ending soon. There should always be a 24-hour period between the end date of an existing/old PA and the start/from date of a new PA request. For example: if the present date (today) of the submission is June 1, 2025, and a clinic has an existing PA that will end on June 7, 2025, then it is valid to enter a start/from date of June 8, 2025, with the appropriate documentation for the submission. A start/from date of June 7, 2025, would conflict with the existing/old PA end dated and the request would be canceled. Please submit timely PAs with appropriate start/from dates to ensure continuity of care.

Retro/historic start/from date: A PA request should not be submitted with a historic start/from date. The provider portal system will always automatically cancel the request. Retro-dating of services for PT/OT and SLP is approved when TEFRA or transfer-back PA requirements are met. Such requests must be present start/from dated. The HCA-61 form should reflect the “true” timeline to alert the clinical reviewer of the need to start/from date of the service in the past. Clinics should include a brief remark on this form alerting reviewers of the retro/historic start date.

When should I end date my PA request?

Most therapy requests can extend up to a year if there are no limitations with the documents provided. The parental consent form or Rx for services provided is valid for 1 year from the date of the parent's or referring provider's signature, whichever is earlier. For example, if the parental consent form was signed on July 1, 2025, and the Rx for services was signed on June 13, 2025, then the PA request end date cannot be later than June 13, 2026.

For SLP services, evaluations should occur yearly. As such, the end date of an SLP treatment request cannot be more than one year from the previously completed evaluation. In the example above, if the previous SLP evaluation was performed on May 30, 2025, then the treatment PA request would need an end date of May 30, 2026, or earlier, despite the dates on both the parental consent form and Rx for services.

For transfer-back PA requests, submissions must consider the above factors and the SoonerSelect contracted entity (CE) approval letter that is provided. Transfer-back PAs cannot be approved for longer than 90 days with an end date no later than the original end date on the SoonerSelect CE approval letter. The HCA-61 form provided must account for this timeline limitation on submissions. For example, if a member transferred back to traditional SoonerCare on May 1, 2025, and the SoonerSelect CE approval letter shows an approval from Jan. 1, 2025 to Sept. 30, 2025, then the transfer-back request cannot be longer than 90 days and the HCA-61 form being submitted should reflect a timeline of May 1, 2025 to July 1, 2025, with CPT code units matching this timeline.

If the provided SoonerSelect CE approval letter instead has a timeline of Jan. 1, 2025 to June 15, 2025, then the transfer-back PA submission should be May 1, 2025 to June 15, 2025. These dates must be reflected on the HCA-61 form.

The HCA-61 form provided is to specify the needed coverage for services. However, submissions in the provider portal system should still reflect present start/from dating and future end dating.

Stetson, a young child who receives SoonerStart services, received a specialized stroller through the Oklahoma ABLE Tech Device Reutilization Program. Stetson has a seizure disorder and developmental delays, and his mom wanted a stroller that would raise her son higher. They were able to meet his support needs with a stroller called a Zippie.

The Zippie is a specialized stroller with features like a quick-folding frame and versatile seating and positioning. It's equipped with adjustable head supports, upper body supports and positioning straps to ensure the user is secure. The seat can easily face the caregiver or let the child face outward to interact with their environment. The Zippie is a great example of early intervention equipment that allows for adjustments as the user grows.

Stetson’s mom says Stetson is so happy in his stroller, and they use it all the time. The stroller has made it easier for Stetson to go outside his home, and easier for his mom as a caregiver because they can adjust how high he sits.

Oklahoma ABLE Tech, through a collaboration with SoonerStart, provides kids aged 0-3 with services to help them live more independently. To learn more about the devices and equipment available through the Device Reutilization Program, visit the ABLE Tech website.