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OHCA Policies and Rules

OHCA Policies and Rules Main Page

317:30-5-349. Program eligibility and covered services

[Issued 09-01-26]

(a) SoonerCare members, both children and adults, are eligible for services when medically necessary.

(b) A member must be reasonably believed to be experiencing a behavioral health crisis as evidenced by extreme emotional distress that includes, but is not limited to, an acute episode of mental illness and/or suicidal thoughts and/or behavior that may occur with substance use and other disorders.

(c) Secure behavioral health transportation may be provided when medically necessary for the purposes delineated in OAC 317:30-5-348(a), including:

(1) Transportation to hospitals and other appropriate behavioral health facilities;

(2) Facility-to-facility transports, provided that the member has been assessed as meeting criteria for emergency detention prior to transport; and

(3) Court-ordered transport for the purpose of evaluation and/or treatment.

(d) Members must be transported to the nearest appropriate facility.

(e) Out-of-state transports are allowable when medically necessary and may require prior approval or authorization by ODMHSAS.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.