June 2026
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OHCA has launched an AI virtual agent, SoonerGuide, to quickly assist SoonerCare members with questions about eligibility, income guidelines, programs and more. Available on the OHCA website and the SoonerCare helpline at 800-987-7767, SoonerGuide helps improve the member experience. SoonerGuide can communicate in English, Spanish and Vietnamese. |
As the transition of the electronic visit verification (EVV) system from Fiserv’s AuthentiCare to Acumen’s Direct Care Innovations (DCI) continues, providers are encouraged to begin preparing. Review current EVV practices, identify internal transition owners and evaluate whether you plan to use the state-sponsored DCI solution or a third-party EVV solution.
Upcoming town halls will provide additional transition updates, provider readiness guidance and opportunities to ask questions. The next town hall is scheduled for 2 p.m., Tuesday, June 23. Register in advance.
Recommended actions at this stage include:
- Review current EVV capture and correction practices.
- If you're a new provider who has recently learned about the EVV mandate, compare Acumen DCI with third-party EVV solutions to determine which option is best for you.
- If you're currently utilizing the state EVV aggregator or a third-party EVV vendor, review your workflows to identify any compliance or data gaps as the transition approaches.
- If considering a third-party EVV solution, begin vendor conversations regarding development, testing, cost, and timeline considerations.
- Identify those responsible for EVV operations, billing, compliance, training and vendor coordination. This will support onboarding, training and overall transition readiness.
Future EVV compliance will include billing through the DCI state aggregator for EVV-required services and ensuring visit data is verified, except in limited circumstances.
Questions related to EVV may be directed to EVV@okhca.org.
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As summer approaches and temperatures rise, providers should be aware of an important safety update for Transderm Scōp® (scopolamine transdermal system). The Food and Drug Administration (FDA) has expanded a previous warning about heat-related complications. This patch, indicated for the prevention of motion sickness and postoperative nausea and vomiting, may increase body temperature and reduce sweating.
Post-marketing reports describe hyperthermia, including serious outcomes such as hospitalization and death. Increased risk has been primarily observed in patients 17 and younger and 60 and older. The product is not FDA-approved for pediatric use. Symptoms usually occur within 72 hours, which is the normal dosing period of one patch.
Advise your patients to avoid wearing more than one patch at a time and to monitor for signs of overheating, including elevated temperature, reduced sweating, confusion or dizziness. Also have them avoid high ambient temperatures and external heat sources (e.g., heating pads), especially during warmer months. If symptoms develop, the patient should remove the patch immediately and seek medical attention.
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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Tooth decay is the most common disease among children. It's five times more common than asthma and seven times more common than hay fever. Fortunately, tooth decay is preventable. Studies have shown that topical fluoride varnish can reduce tooth decay by 30-35%. SoonerCare covers a twice-yearly fluoride varnish benefit for members 5 years old and younger with a primary care provider.
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June is Men’s Health Month, and health care providers play an important role in helping patients take steps toward better long-term health. Men are less likely to seek preventive care or talk openly about concerns like stress, anxiety or tobacco use, which can lead to delayed diagnoses and missed opportunities for support.
That’s why conversations started by providers matter. A simple question about tobacco use during intake, annual visits or follow-up appointments can encourage patients to think seriously about quitting. The Oklahoma Tobacco Helpline offers free resources and services that providers can use to help patients take the next step toward a tobacco-free life.
Tobacco use continues to increase the risk of serious health conditions affecting men, including heart disease, stroke, cancer and chronic lung disease. Many patients may understand the risks but still struggle to quit or feel unsure where to start. Provider encouragement can make a difference. Research shows when a health care provider talks to a patient about quitting tobacco, patients are more likely to consider a quit attempt.
Mental health is just as important as physical health, but many men avoid discussing concerns like stress, anxiety or depression. Tobacco use and mental health challenges are often connected, making it important for providers to create space for honest conversations about both.
The Oklahoma Tobacco Helpline offers free services for eligible Oklahomans ready to quit tobacco, including:
- Free patches, gum or lozenges (plus extra benefits for SoonerCare members)
- One-on-one support from trained coaches
- Text and email encouragement
- 24/7 online resources
- Free materials and referral resources for providers and health systems
Using electronic health record prompts and support from rooming technicians can help make tobacco screenings and referrals a more consistent part of patient care. Learn more.
Don't forget to order free materials like pens, brochures and prescription pads for your office at OKhelpline.com/order.
Do you have patients between 50 and 80? Are they a current or former smoker within the past 15 years? Do they smoke or have they smoked at least a pack a day for 20 years or more? If they answer yes to the above, SoonerCare offers a low-dose lung cancer screening benefit for members who meet qualifying criteria. Remember to talk to your patients today about this potentially life-saving scan.
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Oklahoma ABLE Tech operates its Device Reutilization Program through a formal partnership with OHCA, as established in Oklahoma Statutes Title 56. Under this law, OHCA is required to develop and implement a durable medical equipment (DME) retrieval program that:
- Retrieves DME purchased with Medicaid (SoonerCare) funds from members who no longer need the equipment.
- Donates that equipment to community-based programs, such as ABLE Tech, for refurbishment and redistribution.
- Ensures valuable medical equipment is reused rather than wasted — benefiting other Oklahomans who are disabled or elderly.
Through this partnership, Oklahoma ABLE Tech sanitizes, repairs and reassigns donated equipment at no cost to recipients, with priority given to SoonerCare members.
If you previously received equipment from ABLE Tech and would like information about donating it back to the program, contact ABLE Tech at atreuse@okstate.edu or 405-967-6010. To learn more about the program, visit ABLE Tech’s Device Reutilization Program page.
What should a prescription for therapy services submitted with any PA request include?
All PT/OT and SLP services requiring prior authorization must include a prescription for the requested specialty. The submitted prescription must include:
- Member’s name and date of birth.
- Referring provider’s name, credentials, signature and date of signature. A digital signature is acceptable.
- The profession(s) toward which the prescription is directed.
- Direction such as “eval and treat as necessary” or indicate parameters (e.g., 2 times a week for 8 weeks).
- All applicable diagnoses for the skilled service(s) requested.
For all therapies, evaluations should be performed within 90 days of the signed date on the prescription for services. Treatment can be requested for up to 1 year from the signed date on the prescription unless parameters are indicated to follow.
Any subsequent authorization request for PT and OT submitted within the year of an evaluation can include the referring provider’s signature on the required progress note or re-evaluation being submitted in place of a prescription.
The OHCA SC-10 Referral Form is an available option that providers can use as a prescription. However, any other form of a referral is also acceptable if the above criteria are met.
Can I make a change to a PA that has been approved?
Any PA in approved status can be altered through the amendment process to best meet the member's and provider’s needs. Criteria for amendment submissions are listed for SLP and PT/OT. Amendments seeking to add additional coverage to an approved PA should be submitted within the active authorization period with appropriate documentation. They should not be submitted retroactively.
The HCA-60 amendment form provided with any amendment submission must reflect the absolute change on the PA. As an example, if a PA was originally approved for line item A for CPT code 97530 for 48 units, and the provider wants to add 12 more units of coverage to this PA, then the HCA-60 amendment form must reflect a total of 60 units in this “unit change” amendment.
The HCA-60 amendment form may reflect multiple changes if the professional documentation supports them. In the example above, the provider may also need to extend the PA's end date to use 12 more units. In that case, both “date change” and “unit change” must be marked on the HCA-60 amendment form, and the form must reflect the needed timeline and units for the PA in its entirety.
The HCA-60 form also provides an option to change the provider ID associated with the PA. This type of amendment is only possible when there are no claims tied to the old provider ID. In most cases, if claims exist under the old provider ID, a new change-of-provider PA submission should be made, with all document requirements met.
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