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Coronavirus/COVID-19 (en Español)

If you need a COVID-19 test, please contact your local county health department to schedule a free test. There are 80 testing locations throughout the state. 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.

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.


What is OHCA doing for SoonerCare members?

The Oklahoma Health Care Authority is taking measures to ensure that 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.

  • 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 Jan. 31, 2021, for most SoonerCare reimbursable services.
      
  • OHCA will assess the status of the Coronavirus pandemic at the end of January to determine if the expansion should be continued.

In addition, OHCA submitted an 1135 waiver to the Center for Medicare & Medicaid Services allowing for the following flexibilities during this emergency period: 

  • 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 and/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 at www.okhca.org/rx.

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 October 2, HHS renewed the national Public Health Emergency. It was scheduled to end on Oct. 23, 2020, but it has been extended to Jan. 21, 2021. The PHE renewal is posted at https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-2Oct2020.aspx.

What members need to know about coronavirus

Below are the CDC guidelines regarding coronavirus.

How it spreads:

  • There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
      
  • The best way to prevent illness is to avoid being exposed to the virus.
     
  • The virus is thought to spread primarily from person-to-person.
    • From person to person who are in close contact with one another (within about six feet).
    • Through respiratory droplets produced when an infected person coughs or sneezes. 
     
  • These droplets can land in the mouths or noses of people who are nearby or can possibly be inhaled into the lungs. They may also land on solid surfaces and can be picked up by others touching those surfaces then touching their faces.
       

 

Protect yourself:

  • Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place or after blowing your nose, coughing or sneezing.
      
  • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry. 
      
  • Avoid touching your eyes, nose and mouth with unwashed hands.
      
  • Avoid close contact with people who are sick.
      
  • Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
      

 Protect others:

  • Stay home if you are sick, except to get medical care. Learn what to do if you are sick.
      
  • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
      
  • Throw used tissues in the trash.
      
  • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
      
  • If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a health care provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. Learn what to do if you are sick.
      
  • If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers and medical professionals.
      
  • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets and sinks.

Who is at higher risk?

Early data shows some people are at higher risk of getting very sick from the virus. This includes:

  • Adults 65 years old and above.
  •  People who have serious chronic medical conditions such as:
    • Heart disease
    • Diabetes
    • Lung disease

For more information, please call the OSDH coronavirus hotline at 877-215-8336 or visit www.coronavirus.health.ok.gov.

Providers should refer to the Global Messages page on the OHCA website as well as messages within the provider portal.

Providers can apply for HHS relief fund

The U.S. Department of Health & Human Services plans to distribute $15 billion in CARES Act relief payments to eligible Medicaid and CHIP providers. Providers must apply to be considered for the funds. Even those who are unsure if they are eligible are encouraged to apply. Click here to learn more.

Medicaid and CHIP providers who missed the deadline to apply for CARES Act relief fund payments during the first general distribution will have another opportunity. The U.S. Department of Health & Human Services is planning another opportunity to apply for a provider relief payment equivalent to 2% of total net patient revenue. The timeline has not been released, and HHS is still reserving funds for the payments. HHS will provide guidance when the portal reopens at a future date.

Providers who want to learn about the process and relief payments can participate in an HHS webinar at 3 p.m. this Wednesday. Click here to reguster: https://protect-us.mimecast.com/s/SnerCERBAoH3OXJNuNkZ86?domain=webex.webcasts.com

Resources

Provider Webinars

Some of the information in the recorded sessions may have changed since the live session. For the most up to date information regarding changes to reimbursement during the emergency period, please visit www.okhca.org/globals. 

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