OK SPA 24-0018 Coverage of Prescribed Drugs

The Oklahoma Health Care Authority will seek approval of a State Plan amendment to address special circumstances arising from drug shortages. The Food and Drug Administration (FDA) allows temporary importation of non-FDA approved drugs to mitigate the effects of shortages and to ensure continued access to medication.  For imported, medically necessary, drugs to be covered, a shortage must be identified by the FDA, or the American Society of Health-System Pharmacists (ASHP) and the imported drug must be authorized for import by the FDA. Imported drugs will be reimbursed according to existing payment methodology for covered outpatient drugs and will be subject to the same requirements and limitations, such as prior authorization.

Please view the draft SPA here: OK SPA #24-0018

Interested parties may submit feedback via the comment box.

Circulation Date: June 21, 2024

Tribal Consultation Period: June 21 – August 20, 2024

Comment Due Date: July 21, 2024

SPA Effective Date: August 1, 2024; Contingent upon CMS approval