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December 2025
The holiday season brings joy, happy family memories and, sometimes, stress. For your patients who have quit or who are trying to quit tobacco, that added stress can be especially tough. Share these stress management strategies to help them stay tobacco-free:
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Plan ahead for triggers. Help your patients identify specific holiday situations that may make them want to use tobacco so they can be ready with coping mechanisms.
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Stay active. Finding time for movement can help your patients’ overall mental health. Even short walks can help with stress management.
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Set boundaries. Encourage your patients to set healthy boundaries. For example, ask family members to smoke outside or leave tobacco products in the car during celebrations.
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Connect. Remind patients that asking for help during difficult times shows strength, not weakness. Ask them to talk with family members about their struggles or connect with a coach from the Oklahoma Tobacco Helpline.
Free Quit Support Every Step of the Way
The Oklahoma Tobacco Helpline provides free quit services for every stage of the quitting journey. Support from coaches provides personalized strategies for every situation. Encouraging texts and emails offer small reminders and actionable tips to stay tobacco-free. Live online group sessions give your patients the space to talk with peers who understand that nicotine replacement therapy — patches, gum or lozenges — helps fight tough tobacco cravings.
Whether your patients are thinking about quitting or trying to stay tobacco free, the Helpline has free services that can help. Remember to stock up on free Helpline materials for your office, too, including products such as pens, brochures and prescription pads.
SoonerCare covers dozens of prenatal vitamins at no cost to female members, ages 10 to 50. Prenatal vitamins do not count toward monthly prescription limits, and many prenatal vitamins are available without prior authorization. SoonerCare also covers additional services for pregnant members in certain circumstances. While not listed on the 90-day Maintenance Drug List, several prenatal vitamin formulations are available for a 90-day supply without prior authorization.
If you have questions about a particular medication or other pharmacy benefit questions, please call the Pharmacy Help Desk associated with your patient’s health plan.
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Provider Files
Please update your OHCA 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 (ATN), received upon submitting your update on the OHCA provider portal, to ProviderEnrollment@okhca.org with "SoonerSelect update" and your ATN in the subject line.
Executive Order 2025-16
OHCA has paused the implementation of Executive Order 2025-16. See the provider letter issued on Nov. 12, 2025. Applications that were previously sent back due to the attestation are being revived. If you had an application sent back due to the attestation and need to confirm that it is being reviewed again, please email ProviderEnrollment@okhca.org.
Renewal Processing
Due to the high volume of renewals, processing is taking longer than usual. OHCA published a global message on Nov. 24, 2025, informing providers that renewals have been extended to providers through Jan. 31, 2026. This will allow processing time to ensure that providers are not affected.
Please ensure the contact information, including email address, is up to date for all individual and facility/group provider files so that important contract information will be received.
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This holiday season, give the gift of better health. There are many benefits to quitting smoking, including seeing health improve within minutes of quitting, saving money and improved taste and smell. Talk to your patients about SoonerCare’s robust tobacco cessation benefit, including free nicotine replacement therapy. Tobacco cessation products do not count toward a member's six-prescription per month limit. Learn more about the tobacco cessation benefit and share with your patients the timeline of how their bodies will start healing almost immediately after they've had their last cigarette:
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20 minutes: Blood pressure and pulse rate drop; body temperature rises toward normal.
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12 hours: Carbon monoxide and oxygen levels become normal.
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2 weeks to 3 months: Breathing and walking become easier; risk of heart attack decreases.
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1 to 9 months: Less coughing and shortness of breath; more energy.
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1 year: Risk of heart disease is cut in half.
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5 to 15 years: Risk of stroke is lowered to that of a non-smoker.
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10 years: Risk of lung cancer drops to half that of continuing smokers. Risk of cancer of the mouth, throat, bladder, kidney and pancreas decreases.
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15 years: Risk of heart disease and death is nearly the same as people who have never smoked.
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As the calendar year ends, the Oklahoma ABLE Tech Device Reutilization Program has additional durable medical equipment (DME) funding available through its partnership with three Area Agencies on Aging (AAAs). Funding is available on a first-come/first-served basis.
The Kiamichi Economic Development District of Oklahoma (KEDDO), Indian Nations Council of Governments (INCOG) and Central Oklahoma Economic Development District (COEDD) AAAs have partnered with ABLE Tech to provide Masonic Grant funds for residents of their respective counties. Through this partnership, ABLE Tech’s Device Reutilization Program assists qualified recipients in purchasing needed assistive technology (AT) and DME.
To qualify for these funds, patients must live in one of the specified counties, be 55 years of age or older, be of low to moderate income, and have a need for AT and DME to maintain an independent lifestyle. If patients no longer need the purchased equipment, items should be donated back to the Oklahoma ABLE Tech Device Reutilization Program for use by another individual.
Eligible Counties
COEDD: Hughes, Lincoln, Okfuskee, Pawnee, Payne, Pottawatomie and Seminole counties
INCOG: Tulsa, Creek and Osage counties
KEDDO: Choctaw, Haskell, Latimer, LeFLore, McCurtain, Pittsburg and Pushmataha counties
To apply for equipment, complete the Device Reutilization Program application and provide any required documentation. If the item patients are looking to acquire is not listed, use the "other" field when completing the application. Visit the Device Reutilization Program page to learn more.
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What is required in my SLP PA submission?
Depending on the period of the request (initial vs. subsequent/continuation), documentation requirements may change. Additionally, situations such as a transfer-back (returning to OHCA from SoonerSelect), change of provider (services to be delivered under a different provider ID), TEFRA (retroactive eligibility being granted), or amendments involve their own specific requirements. Please feel free to print out and use the table below as a guide when submitting a PA request on the PA Portal. Next month’s newsletter will include a table for PT/OT.
| Submission Type |
Documentation Requirements |
Limitations |
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SLP Evaluation Request
CPT: 92521, 92522, 92523, 92524, 92607/92608, 92610
Modifier: GN
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1. HCA-61 form
2. Rx for services
3. Referring provider visit note
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2. Request cannot exceed a timeline of 90 days from the signed date on the Rx.
3. This visit note needs to be from within the past 12 months.
Only one evaluation can be approved per year per member. Members are allowed up to 12 lifetime units of 92610 without a PA.
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SLP Treatment Request
CPT: 92507, 92508, 92526, 92609, 92630, 92633
Modifier: GN
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1. HCA-61 form
2. SC-15 Parental Consent form or clinic’s own equivalent
3. Evaluation note completed within the past year
4. Progress note – if request is to continue services within the year of above evaluation
5. Rx for services
6. Any request for CPT 92526 cannot exceed six months in duration
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2. Request cannot exceed one year from parental consent.
3. Request cannot exceed one year from the date of the SLP evaluation.
4. Progress notes for subsequent/continuation requests need to be recently completed, followed by a timely submission.
5. Request cannot exceed one year from the signed date on the Rx.
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| SLP Transfer-Back Request |
1. HCA-61 form
2. SC-15 Parental Consent form or clinic’s own equivalent
3. Evaluation note completed within the past year
4. Progress note – if request is to continue services within the year of above evaluation
5. Rx for services
6. SoonerSelect contracted entity approval letter
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1-6. All transfer-back PA requests will be approved upon meeting documentation requirements for a period of up to 90 days, or the original end date of the SoonerSelect contracted entity approval letter, whichever period is shorter. The request end date must also be reduced based on the year timeline of the SLP evaluation, parental consent form and Rx for services. The SoonerSelect contracted entity approval letter must be sufficiently detailed to allow a retro-start-date.
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| SLP Change of Provider Request |
1. HCA-61 form
2. SC-15 Parental Consent form or clinic’s own equivalent
3. Evaluation note completed within the past year at the old clinic
4. Progress note – if a recent one exists but not necessary for approval
5. Rx for services
6. SC-16 Change of Provider form
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2. Request cannot exceed one year from parental consent.
3. The evaluation completed by the old clinic within the past year is always needed.
4. If a period of six months has passed since the evaluation by the old clinic, then the new clinic can request a new evaluation.
5. Request cannot exceed one year from Rx.
6. It is the new clinic's responsibility to ensure that the family has communicated the provider change with the old clinic. If not, please ensure that the old clinic is aware that care will now continue at your location. This form is required for both SLP evaluation and treatment requests.
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| SLP TEFRA Request |
1. HCA-61 form
2. SC-15 Parental Consent form (if available)
3. Evaluation note completed within the past year
4. Rx for services
5. TEFRA award letter granting retroactive eligibility
6. A current progress note
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1. Need to reflect the historic start date and the future end date and account for the entirety of services.
2. Consent from does not need to be an OHCA-specific form.
3. The evaluation that was performed before the historic start date.
4. Rx needs to be signed/dated before the historic start date.
5. Submission should occur in a timely fashion once the family provides the clinic with a copy of this letter.
6. A current progress note is necessary if services are to be not only retroactive, but also to seek coverage for the future.
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| SLP Amendments (submitted to existing PAs) |
1. HCA-60 Amendment form
2. A current progress note may be required on a case-by-case review basis if the request seeks additional coverage: extending timeline, adding units, adding line items or changing CPT codes.
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1. This form must indicate the absolute change that is needed. Check boxes for all applicable changes being sought.
2. Requests for additional coverage must be submitted within the authorization timeline. A new PA request must be submitted after the authorization timeline.
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AAC/SGD Request – submitted by an OHCA-Contracted DME Provider
HCPCS: E2500, E2502, E2504, E2506, E2508, E2510, E2511, E2512, E2599
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1. The SLP’s AAC/SGD Evaluation
2. Rx for services – being DME-specific
3. InterQual Summary Sheet
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1. Must be detailed with trialing of at least three devices before a final recommendation.
3. During submission, the provider is routed to InterQual to answer questions ascertaining the device needed. This summary sheet will be rendered by the system.
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Chief Executive Officer
Clay Bullard
OHCA Board of Directors
Marc Nuttle, Chairman
Norman, OK
Alex Yaffe, Vice Chairman
Oklahoma City, OK
Tanya Case
Duncan, OK
John Christ
Oklahoma City, OK
Kevin Corbett
Edmond, OK
Jeffrey Cruzan, M.D.
Oklahoma City, OK
Clark Jolley
Edmond, OK
Kim Leland
Norman, OK
Phillip Kennedy
Lawton, OK
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.
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