Skip to main content

Coronavirus/COVID-19

What is the coronavirus disease?

Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus. The first case in the U.S. was identified in a Washington state man on Jan. 21, 2020.

COVID-19 Testing 

If you need a COVID-19 test, please contact your SoonerCare provider.

If you are tested for COVID-19 somewhere other than a county health department or your SoonerCare provider, please check to be sure they are a contracted SoonerCare provider to avoid being charged a fee. 


COVID-19 Vaccines 

Register to receive your COVID-19 vaccine at https://vaccinate.oklahoma.gov/ or call 211.


What is OHCA doing for SoonerCare members?

The Oklahoma Health Care Authority is taking measures to ensure all SoonerCare members continue to have access to needed services during the COVID-19 pandemic. OHCA is focused on doing everything we can to ensure employee and member safety.   
  
If you believe you have been exposed to coronavirus, please immediately contact your primary health care provider. SoonerCare will fully cover COVID-19 testing for any SoonerCare patient who meets the standards for testing.

  • OHCA is allowing expanded use of telehealth through Oct. 31, 2021, for most SoonerCare reimbursable services. Testing and treatment services related to COVID-19 diagnoses will not have co-pays for SoonerCare members. 

  • OHCA is allowing expanded use of telehealth through Apr. 30, 2021, for most SoonerCare reimbursable services. 

  • OHCA will assess the status of the coronavirus pandemic at the end of October to determine if the expansion should be continued.

  • The use of telephonic services (non face-to-face) may be utilized in instances when a SoonerCare member does not have access to telehealth equipment, the service is necessary to the health and safety of the member, and the service can safely and effectively be provided over the telephone. 

  • Waiving certain provider enrollment requirements such as provider enrollment fees and background checks. 

  • Flexibility allowing providers to receive payments for services provided to affected SoonerCare members in alternative physical settings, such as mobile testing sites, temporary shelters or facilities. 

  • Authority to remove or modify prior authorization requirements for accessing covered state plan or waiver benefits during the emergency period. OHCA will only implement this flexibility if it loses the ability to virtually review/approve PAs. 

  • Postponing processing of recertification for members during the emergency declaration to ensure uninterrupted coverage. 

  • Increased maintenance prescriptions available with a 90-day supply to ensure members have adequate essential medications available without repeated trips to the pharmacy.

SoonerCare members’ pharmacy needs:

The OHCA pharmacy department has also taken additional steps to ensure SoonerCare members receive their medications. OHCA has relaxed some edits and restrictions for vulnerable populations to assist during this crisis. 
  
OHCA also encourages the use of 90-day supplies for certain maintenance medications. These maintenance medications will process for a 90-day supply without an override. A complete list of our current maintenance medications that will process for a 90-day supply can be found on our website here.

Due to the emergency declaration, we have temporarily expanded the maintenance drug list. The following categories listed below will process for a 90-day supply until the emergency declaration has expired.

  • Asthma medications (excluding albuterol inhalers)

  • Anticoagulant/platelet aggregator inhibitors 

  • HIV medications

  • Immunosuppressant medications for transplant 

  • Inhaled antibiotics

  • Pulmonary arterial hypertension medications 

*Please note not all medications in each of the categories listed above can be processed for a 90-day supply.

Due to limited supply, albuterol inhalers are currently limited to a 30-day supply. OHCA has removed prior authorization requirements for all brand and generic albuterol inhalers. 

Effective immediately, new prescriptions for chloroquine and hydroxychloroquine will require a prior authorization to ensure appropriate use and to comply with Gov. J Kevin Stitt’s executive order. 

Members currently stabilized on these medications for rheumatoid arthritis or systemic lupus erythematosus will be grandfathered, and their claims will process with an auto-PA. The executive order requires prescribers include a written diagnosis on the prescription, limits prescriptions to no more than a 14-day supply unless the patient was previously established on the medication before the executive order; and prohibits refills without a new prescription.

The pharmacy help desk is available during normal business hours to assist with other issues which may arise during this time of crisis. Contact the pharmacy helpdesk at 800-522-0114, option 4.

Federal legislation supports states' Medicaid programs:

President Donald Trump signed the Families First Coronavirus Response Act on March 18, 2020. The law provides flexibilities and support for Medicaid agencies across the country to prevent beneficiaries, including SoonerCare members, from experiencing interruptions in coverage.

It enables a number of the changes listed above that support members’ coverage during this national health emergency. The act also increases the federal match by 6.2 percentage points. The result is increased federal funding for SoonerCare and the coverage it provides its members.

Read House Resolution 6201 in its entirety: https://www.congress.gov/bill/116th-congress/house-bill/6201.

On January 7, HHS renewed the national Public Health Emergency. It was scheduled to end on Jan. 21, 2021, but it has been extended to Oct. 31, 2021. The PHE renewal is posted at https://www.phe.gov/emergency/news/healthactions/phe/Pages/COVID-19July2021.aspx.