APA WF# 21-20 Alternative Treatments for Pain Management
These rule changes were previously approved by the OHCA Board of Directors and the Governor and are currently in effect as emergency rules. Due to Oklahoma Statutes, these rules must be taken through the permanent rulemaking process.
The proposed revisions will establish coverage for chiropractor services and physical therapy services as a nonpharmacologic alternative for the treatment of spinal pain in SoonerCare adult members. The proposed additions will define provider participation and credentialing requirements, medical necessity, as well as coverage and service limitation guidelines. Furthermore, the proposed additions will state that reimbursement is established within the State Plan. Finally, revisions will involve minor cleanup to fix grammatical and formatting errors and add references to the new sections.
Please view the circulation document here: APA WF # 21-20 and submit feedback via the comment box below.
Circulation Date: 02/01/2022
Comment Due Date: 03/03/2022
Public Hearing: 03/08/2022
Board Meeting: 03/16/2022
Comments
Don Stover:
Does the adult soonercare coverage for independent PT services for non pharmacological pain management cover conditions affecting the cervical spine ( neck), thoracic spine ( mid back) , and lumbar spine (lower back)? Or only spinal pain affecting the lower back?
OHCA Response:
Thank you for your comment. These conditions are covered for independent PT services, under non-pharmacological pain management, for spinal pain only. For the full guidelines, please refer to https://oklahoma.gov/ohca/mau.
