APA WF# 21-17 Dental Revisions
Please note, parts of this rule change were previously approved by the OHCA Board of Directors and the Governor and are currently in effect as emergency rules. Additional revisions have not yet been approved. Due to Oklahoma Statutes, these rules must be taken through the permanent rulemaking process.
The proposed revisions will update the current adult dental policy to outline new benefits for SoonerCare adults. Additional revisions will update the certification requirements for primary care physicians to provide fluoride varnish during a child-health screening. Furthermore, revisions will update the timeframe for dental prophylaxis from once every 184 days to once every six (6) months. Finally, language regarding coverage for periodontal maintenance will be added.
Please view the circulation document here: APA WF # 21-17 and submit feedback via the comment box below.
Circulation Date: 02/01/2022
Comment Due Date: 03/03/2022
Public Hearing: 03/08/2022
Medical Advisory Committee (MAC) Meeting: 03/10/2022
Board Meeting: 03/16/2022
Comments
Linda Jones:
Is the periodontal maintenance covered for adult soonercare patients at this time, because it does not show it is covered on the fee schedule.
OHCA Response:
Thank you for your comment. Currently, periodontal maintenance is not covered for adults. This rule is seeking to add coverage for this service. Ultimately, the rule must be approved by the OHCA Board, Oklahoma Legislature, and Oklahoma Governor. Once, the OHCA receives approval, further education and information will be sent out regarding the change.
Amy Carpenter:
I noticed that perio maintenance is indicated to become a covered service but will require authorization. Is this correct? Does this mean it will apply to adults and children?
OHCA Response:
Thank you for your comment. Yes, this proposed rule change is seeking to add coverage for this service for both children and adults, with appropriate prior authorization. Ultimately, the rule must be approved by the OHCA Board, Oklahoma Legislature, and Oklahoma Governor. Once, the OHCA receives approval, further education and information will be sent out regarding the change.
