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Global Messages

2021 Global Messages

Date Posted Title Message
7/20/21 Public Health Emergency Extension

The US Dept. of Health and Human Services has extended the public health emergency for 90 days. The previous extension was set to expire on July 20, 2021. The public health emergency renewal is posted at: https://www.phe.gov/emergency/news/healthactions/phe/Pages/COVID-19July2021.aspx

What does this mean for SoonerCare providers and members?

  • Expanded use of telehealth services for most SoonerCare services.
  • OHCA and DHS will not terminate SoonerCare coverage for members during this time.
  • No cost sharing for testing or treatment of COVID-19 for SoonerCare members.
  • Some medicines may be prescribed for 90 days to reduce trips to the pharmacy.
7/20/21 Oklahoma Health IT Survey

Please take 5-10 minutes to complete the Oklahoma Health IT Survey!

Provider Types: 08, 09, 10, 16, 27, 31, 52

Click this Link to Participate: https://mslc.qualtrics.com/jfe/form/SV_8dEgUcc3XHW5Dp4

The Oklahoma Health Care Authority has identified you and your organization as important stakeholders for the Health Information Technology (Health IT) Environmental Scan which will help inform an update to the Oklahoma State Medicaid Health IT Plan (SMHP). We request your participation in a survey to better understand the current health care technology landscape, illustrate Oklahoma’s progress of electronic health record (EHR) adoption since the inception of the Promoting Interoperability (PI) program to today, and identify areas of opportunity to ensure continued progress towards statewide and national interoperability.

Results from the survey will be used to inform the state’s health IT strategy and future direction, which will be described in the final SMHP. Your responses will remain anonymous.

This survey is designed to collect information about:

  • Your current capabilities and plans related to EHR, health information exchange (HIE) and social determinants of health (SDOH).
  • Your barriers and concerns regarding EHR, HIE and SDOH.
  • Your experience with HIE organizations, such as Coordinated Care Health Network, MyHealth Access Network and OKSHINE.
  • Your experience with the Promoting Interoperability Program (if applicable).

Please follow this link to participate in the Oklahoma Health IT Survey: OK eScan Survey

Please feel free to forward this email as necessary to ensure the correct individuals have access to the survey link.

Thank you in advance for your assistance in participating in this survey. Should you have any questions, please contact Myers and Stauffer at OKHealthIT@MSLC.com.       

7/20/21 Reminder - Electronic Submissions for PASRR Level 1 (LTC-300R) Provider Types/Specialties: 03/030

Effective July 22, 2021, the electronic PASRR Level 1 (LTC-300R) will now allow providers to edit demographics, diagnoses, the Level 1 PASRR screening section and the consultation section. Providers will also have the ability to print the LTC – 300R.

Training for this provider group will occur during the months of July and August of 2021.

Register to attend the Electronic Submissions for PASRR Level 1 (LTC-300R) webinar on Wednesday, July 28, 2021 from 10 a.m. to 11:30 a.m.: https://okhca.zoom.us/webinar/register/WN__PD5IefcRGmNRQJBvRO_Yw 

Register to attend the Electronic Submissions for PASRR Level 1 (LTC-300R) webinar on Wednesday, August 4, 2021 from 2 p.m. to 3:30 p.m.: https://okhca.zoom.us/webinar/register/WN_de7BE43pRFeRvwVoQGYm0Q  
7/15/21 Soonercare Expansion Webinar Dates

Provider Types: All

OHCA has added more dates in July for provider training webinars titled SoonerCare Expansion: Healthy Adult Program.

These webinars will address the adult expansion population enrolled in the Healthy Adult Program, eligibility requirements, benefits and cost-sharing.

Recommended Audience: Contracted SoonerCare providers

Register to attend the SoonerCare Expansion: Healthy Adult Program webinar on:

Thursday, July 15, 2021 from 2 p.m. to 3:30 p.m.: 
https://okhca.zoom.us/webinar/register/WN_UBUH1I8HQbGhu937H5-MQg

Wednesday, July 21, 2021 from 2 p.m. to 3:30 p.m.: https://okhca.zoom.us/webinar/register/WN_ppERJTRPQquSftQ4unDs5g

Thursday, July 22, 2021 from 2 p.m. to 3:30 p.m.:
https://okhca.zoom.us/webinar/register/WN_S98hWfGHSQmRCVMFM-Ekyw

Tuesday, July 27, 2021 from 10:00 am – 11:30 a.m.:
https://okhca.zoom.us/webinar/register/WN_-ytyrOuYTvKufNjkfzgRcA

Thursday, July 29, 2021 from 2 p.m. to 3:30 p.m.:
https://okhca.zoom.us/webinar/register/WN_KcKGhlsrSU6gFs_I1RUYAg

After registering, you will receive a confirmation e-mail containing information about joining the webinar.
7/12/21 OHCA Training Survey Provider Types/Specialties: All

The Oklahoma Health Care Authority strives to provide effective trainings to contracted SoonerCare providers. To better understand the training needs of providers and their staff, OHCA requests and welcomes feedback from the provider network by completing a two minute survey which will expire after two weeks.

Thank you for your participation and passion to serve SoonerCare members.

Click here to complete the two minute survey: https://www.surveymonkey.com/r/XRNJFYS.
7/12/21 Electronic Submissions for PASRR Level 1(LTC-300R)

Provider Types/Specialties: 03/030

Effective July 22, 2021, the electronic PASRR Level 1 (LTC-300R) will now allow providers to edit demographics, diagnoses, the Level 1 PASRR screening section and the consultation section. Providers will also have the ability to print the LTC – 300R.

Training for this provider group will occur during the months of July and August of 2021.

Register to attend the ‘Electronic Submissions for PASRR Level 1(LTC-300R)’ webinar on Tuesday, July 20, 2021 from 10 a.m. to 11:30 a.m.:
https://okhca.zoom.us/webinar/register/WN_wBK7xjI_TIqTXyWjvQQXIA

Register to attend the ‘Electronic Submissions for PASRR Level 1(LTC-300R)’ webinar on Wednesday, July 28, 2021 from 10 a.m. to 11:30 a.m.:
https://okhca.zoom.us/webinar/register/WN__PD5IefcRGmNRQJBvRO_Yw

Register to attend the ‘Electronic Submissions for PASRR Level 1(LTC-300R)’ webinar on Wednesday, August 4, 2021 from 2 p.m. to 3:30 p.m.:
https://okhca.zoom.us/webinar/register/WN_de7BE43pRFeRvwVoQGYm0Q

7/9/21     SoonerCare Adult Expansion Webinars

Provider Types: All

OHCA will be presenting two webinars in July titled “SoonerCare Expansion: Healthy Adult Program.”

These webinars will address the adult expansion population enrolled in the Healthy Adult Program, eligibility requirements, benefits and cost-sharing.

Recommended Audience: Contracted SoonerCare providers

Register to attend the “SoonerCare Expansion: Healthy Adult Program” webinar on Wednesday, July 14, 2021 from 2 p.m. to 3:30 p.m.:

https://okhca.zoom.us/webinar/register/WN_HBRLPdHER_25wfp3xDunWw

Register to attend the “SoonerCare Expansion: Healthy Adult Program” webinar on Thursday, July 15, 2021 from 2 p.m. to 3:30 p.m.:

https://okhca.zoom.us/webinar/register/WN_UBUH1I8HQbGhu937H5-MQg

After registering, you will receive a confirmation e-mail containing information about joining the webinar.    

7/8/21 Dental Updates and Changes webinar   OHCA will be presenting a webinar titled Dental Updates and Changes on Tuesday, July 27, 2021 from 2:00 p.m. to 3:30 p.m.

This class will provide information regarding the most recent changes and updates for Dental providers. The attendees will learn about contract renewal, PIN reset process, expanded dental benefits for adults, eligibility for the expansion population and changes for the prior authorization and claims processes.

Recommended Audience: All dental providers and staff

Register to attend the Dental Updates and Changes webinar on Tuesday, July 27, 2021 from 2:00 p.m. to 3:30 p.m.: https://okhca.zoom.us/webinar/register/WN_M6F024ENRJunGp_l-3RuUg

After registering, you will receive a confirmation e-mail containing information about joining the webinar.   
7/6/21 Dental Contracts Expiring

Provider Types: 27, 270-279

Dental contracts expire September 30, 2021 and can be renewed beginning July 15, 2021. To avoid any delay in reimbursement, we encourage dental providers to submit their renewals as soon as possible. Visit the provider training page at https://oklahoma.gov/ohca/providers/provider-training.html for a how-to video on Renewing your SoonerCare Contract. The video is towards the bottom of the page. 

If you have any questions, please contact provider enrollment at 800-522-0114, option 5, or email ProviderEnrollment@okhca.org.

The new contracts will include language asking providers to employ tobacco cessation best practices in partnership with the SoonerQuit program. Please email SoonerQuit@okhca.org for more information. 

7/6/21 Adult SoonerCare Eligibility Verification

Provider Types:  All

Members who are a part of SoonerCare expansion will have an active eligibility line that reads Expansion Healthy Adult Program (HAP).  These members’ benefits will be Title XIX benefits; however, the Title XIX line will not show as active.

For more information on the comparison of benefits, please visit: https://oklahoma.gov/ohca/individuals/mysoonercare/soonercare-benefits.html.

Expansion adults will fall into the category “SoonerCare Traditional: Adults 21 and Over”. 

7/6/21 EDEA Agreement

Provider Types: All

The Electronic Data Exchange Agreement (EDEA) with OHCA, Gainwell Technologies and Trading Partners, Billing Agents, Clearinghouses and Telecommunication Vendors(VANS) for Oklahoma Soonercare will be extended. The current EDEA expired on June 30, 2021, but OHCA has now extended the agreement to June 30, 2022. All current terms, conditions, transaction cost and requirements will remain the same during this period. If you have any questions or concerns, please contact our EDI department at 1-800-522-0114, option 2, 2.

OHCA and Gainwell will work together over this period to simplify and update the current document. We appreciate your services to our Providers and Members.

7/1/21 Expansion Adults

Provider Types: All

SoonerCare coverage for newly eligible expansion adults in the Healthy Adult Program begins July 1, 2021. The Healthy Adult Program is a fee-for-service payment model. Members will not be assigned a Patient Centered Medical Home (PCMH) and no SoonerCare referral is required at this time.

Services that currently require prior authorization will continue to require prior authorization for the Healthy Adult Program. Billing procedures for this population remains unchanged. Monthly cost sharing will apply for all non-exempt SoonerCare adult members. More information can be found at https://oklahoma.gov/ohca/about/medicaid-expansion/expansion.

For questions, please contact the OHCA Call Center at 1-800-522-0114, option 1.

7/1/21 Adult Dental Benefits
Provider Types: 080, 270-278

Effective July 1, SoonerCare adults are eligible for additional dental benefits including dental cleanings, exams, X-rays, periodontal scalings, resin and amalgam restorations, and full and partial dentures. Please find a more comprehensive guide at the following website: https://oklahoma.gov/ohca/individuals/soonercare-dental.html.  
7/1/21 Healthy Adult Program Provider Types: All

Effective July 1, 2021, newly eligible expansion adults are in a new eligibility group called the Healthy Adult Program (HAP).

When checking eligibility on the OHCA secure provider portal for new adult SoonerCare members, Healthy Adult Program (HAP) will display as the program of eligibility.  In order to ensure coverage for services, use the Search Fee Schedule feature that is located under the Resources tab in the secure provider portal. 

For questions, please contact the OHCA Call Center at 1-800-522-0114, option 1.  
6/28/21 SFY2021 Cost Report Provider Types/Specialties: 03/030, 031, 034, 035

This is a reminder to LTC providers that all cost reports for the State Fiscal Year ending June 30, 2021, will be due on or before October 31, 2021.

You must report costs electronically via the OHCA Provider Portal, unless you are submitting a partial year Cost Report. However, if a change of ownership has occurred and you have an entire year of data available, the two partial reports must be combined and entered on the Provider Portal.

A new cost classification titled Oxygen Only has been added to the Drug and Medical Supply LTC Cost Reporting section of the provider portal. All LTC providers who need to report oxygen as an expense, must report that amount in the box titled “Oxygen Only”.

Thank you for the services you provide to SoonerCare members.  
6/23/21 Introduction to SoonerCare – Part 2 (Benefits and Programs) Provider Types: All

OHCA will be presenting a webinar titled Introduction to SoonerCare – Part 2 (Benefits and Programs) on Thursday, July 22 from 2:00 p.m. to 3:30 p.m.

This class is part two of a series titled Introduction to SoonerCare. Attendees will learn more about the various Oklahoma Medicaid member benefits and programs. Demonstrations will be provided on how these programs appear on the provider portal when conducting an eligibility search. It will provide an in-depth look at the eligibility process, qualifications and verification for Oklahoma Medicaid members. Claims and HMS third party liability discussions will not be included in this session.

Recommended Audience: New Oklahoma Medicaid providers and staff.

Register to attend the Introduction to SoonerCare Part 2 webinar here: Expired Link.https://okhca.zoom.us/webinar/register/WN_51JTkRAMT9WXE41OahAU2g

After registering, you will receive a confirmation e-mail containing information about joining the webinar.
6/15/21 Dental Updates & Changes webinar  

Provider Types: 27/270-278, 08/080

OHCA will be presenting a webinar titled ‘Dental Changes & Updates’ on Thursday, July 8, 2021 from 2:00 p.m. to 3:30 p.m.

This class will provide information regarding the most recent changes and updates for Dental providers. The attendees will learn about contract renewal, PIN reset process, expanded dental benefits for adults, eligibility for the expansion population and changes for the prior authorization and claims processes.

Recommended Audience: All dental providers and staff

Register to attend the ‘Dental Changes & Updates’ webinar on Thursday, July 8, 2021 from 2:00 p.m. to 3:30 p.m.: https://okhca.zoom.us/webinar/register/WN_l3q33sX3QCiP0IDPgjWsnA

After registering, you will receive a confirmation e-mail containing information about joining the webinar.

6/15/21 Introduction to SoonerCare – Part 1 (Eligibility & Verification)   Provider Types: All

OHCA will present a webinar titled "Introduction to SoonerCare – Part 1 (Eligibility & Verification)" on Thursday, July 15, 2021 from 2 p.m. to 3:30 p.m.

This class is part one of a multi-series of Introduction to SoonerCare. It will provide an in-depth look at the eligibility process, qualifications and verification for Oklahoma Medicaid members. Claims and HMS third party liability discussions will not be included in this session.

Recommended Audience: New Oklahoma Medicaid providers and staff.

Register to attend the Introduction to SoonerCare – Part 1 (Eligibility & Verification) webinar on Thursday, July 15, 2021 from 2 p.m. to 3:30 p.m.: https://okhca.zoom.us/webinar/register/WN_CoXN86OGQMCMBGLJpISCuA

After registering, you will receive a confirmation e-mail containing information about joining the webinar. 
6/14/21 2021 EHR Incentive Attestations
Provider Types/Specialties:  08, 09, 10, 16, 27, 31, 52

Providers may now submit their program year 2021 attestations!

Program year 2021 is the last year to participate in the program. As outlined in statute (https://www.federalregister.gov/d/2010-17207/p-3158), all incentive payments must be issued by Dec. 31, 2021; therefore, this will impact the typical attestation timeframe for program year 2021. Providers will have until Aug. 31, 2021 to submit their program year 2021 attestation to allow OHCA ample time to review the attestation and pay the incentive to the provider by the Dec. 31, 2021 deadline. No payments will be made after this date.

The reporting period will be any 90-day period between Jan. 1, 2021 and Aug. 31, 2021. Providers attest to a 90-day reporting period for both meaningful use and clinical quality measures, and all 2021 attestations must be submitted by Aug. 31, 2021.

If you have any questions or concerns regarding this program, please contact the EHR incentive team at EHRIncentive@okhca.org or by phone at 405-522-7347. You can also visit us online at https://oklahoma.gov/ohca/about/office-of-public-information/oklahoma-electronic-health-record-incentive-program.html.
6/9/21 Electronic Dental Prior Authorizations & Dental Claims Effective July 1, Oklahoma Health Care Authority (OHCA) will transition to a fully electronic prior authorization (PA) and claims process. All dental claims and PAs, and any related documents, should be submitted electronically through the SoonerCare provider portal. Mailed PAs and claims will no longer be accepted. OHCA will no longer accept paper documents or diagnostic models. Radiographic and photographic images must also be submitted electronically. PA status notifications will continue to be available through the SoonerCare provider portal. The PA notification process for members will also remain the same.
6/8/21 SoonerCare Notification of Date of Service (NODOS) webinar Provider Types/Specialties:  01, 63

OHCA will present a webinar titled "SoonerCare Notification of Date of Service (NODOS)" on Wednesday, June 16 from 1 p.m. - 2:30 p.m.

This training will offer facility staff the opportunity to be educated on how NODOS works and notify OHCA of needed medical services for potential members.

Target audience:
Inpatient hospital facilities and inpatient crisis intervention facilities.

Register for the SoonerCare Notification of Date of Services webinar here: Expired Link.

After registering, you will receive a confirmation email containing information about joining the webinar.  
6/7/21 Update: SoonerSelect
Provider Types/Specialties: All

Due to Oklahoma Supreme Court decision 2021 OK 30, the Oklahoma Health Care Authority has paused implementation of SoonerSelect. Please continue to monitor our website for updates.
6/1/21 Telehealth ends for Physical Therapy Effective immediately and per the Oklahoma Board of Medical Licensure and Supervision, the use of telehealth in physical therapy has ended. The Governor’s Executive Order, which allowed physical therapy to utilize telehealth during the pandemic, ended May 4, 2021.
5/21/21 Pfizer BioNtech Covid-19 Vaccine Expanded Coverage Provider Types: All

In keeping with the FDA emergency use authorization and CDC Advisory Committee on Immunization Practices (ACIP) approval, OHCA has expanded coverage for Pfizer BioNtech Covid-19 vaccine and administration to include ages 12 to 15, effective 5/10/2021.

The Pfizer BioNtech Covid-19 vaccine code 91300 and administration codes 0001A and 0002A are now covered by SoonerCare for ages 12 and older.

If you have any questions, please call the OHCA provider helpline at 800-522-0114.  
5/11/21 SoonerSelect (Dental) Reminder: OHCA will be presenting a SoonerSelect Dental webinar on Thursday, May 13 from 10 a.m. – 11:30 a.m.

This class provides an overview of the upcoming Dental Benefit Plan (DBP) changes. Topics include transition of managed care, member populations affected by the transition, contracting with a DBP, requirements of the MCOs/DBPs and responsibilities of OHCA.

Recommended audience: All SoonerCare dental providers.

Register to attend the SoonerSelect Dental Basics class on Thursday, May 13: Expired Link.

The webinar registration requires manual approval. Once approved, you will receive a confirmation email containing information about joining the webinar.   
5/5/21 SoonerSelect Basics Webinars
OHCA will be presenting webinars titled SoonerSelect Basics during May and June 2021. Additional training dates will be posted at a later time.

The classes are provider type specific and will provide an overview of the upcoming Managed Care Organization (MCO) changes. Topics include transition to managed care, member populations affected by the transition, contracting with an MCO, requirements of the MCOs and responsibilities of OHCA.

Note: The webinar registration requires manual approval. Once approved, you will receive a confirmation email containing information about joining the webinar.

Select the registration link below to attend the webinar session for your provider type:

Hospital Providers:
Tuesday, May 18 from 10 a.m. – 11:30 a.m.
Expired Link.

Physicians and Physician Groups:

Thursday, May 20 from 2 p.m. – 3:30 p.m.
Expired Link.

Behavioral Health:
Tuesday, May 25 from 10 a.m. – 11:30 a.m.
Expired Link.

Occupation, Physical and Speech/Language Pathology:
Thursday, May 27 from 10 a.m. – 11:30 a.m.
Expired Link.

Durable Medical Equipment (DME):
Tuesday, June 1 from 1 p.m. – 2:30 p.m.
Expired Link.

Pharmacy: 
Thursday, June 3 from 10 a.m. – 11:30 a.m.
Expired Link.
5/2/21 SoonerSelect (Dental)

OHCA will be presenting webinars titled "SoonerSelect Dental Basics" on Tuesday, May 11 from 2 p.m. to 3:30 p.m. and Thursday, May 13 from 10 a.m. to 11:30 a.m.

This class provides an overview of the upcoming Dental Benefit Plan (DBP) changes. Topics include transition of managed care, member populations affected by the transition, contracting with a DBP, requirements of the MCO/DBPs and responsibilities of OHCA.

Recommended Audience:
All SoonerCare Dental providers

Register to attend the ‘SoonerSelect Dental Basics’ class on Tuesday, May 11:
Expired Link.

Register to attend the ‘SoonerSelect Dental Basics’ class on Thursday, May 13:
Expired Link.

The webinar registration requires manual approval. Once approved, you will receive a confirmation email containing information about joining the webinar.

4/30/21 Prior Authorizations Virtual Town Hall OHCA will host town hall meetings throughout the state and virtually to answer provider and stakeholder questions about our new managed care program, SoonerSelect. Please complete the below registration form if you plan to attend this virtual-only town hall about prior authorizations.

Register to attend here: https://oklahoma.gov/ohca/townhall/prior-authorizations

Look for a link to join the webinar after completing the registration form. The meeting will be recorded, and a replay will be available at a later date.

Date and Time
Wednesday, May 5  3:30 - 4:00 PM

Location
Online webinar via Zoom.  
4/22/21 Important Dates
Provider Types/Specialties:  All

Medicaid Expansion - July 1, 2021:
Oklahomans voted to expand SoonerCare eligibility to adults ages 19-64 whose income is 138% of the federal poverty level or lower. This equates to an estimated annual income of $17,796 for an individual or $36,588 for a family of four. Members may begin to enroll in Medicaid expansion on June 1, 2021.

SoonerSelect - Oct. 1, 2021: SoonerSelect goes in effect on October 1. How does this impact medical and dental providers who see SoonerCare members? Medical and dental providers must contract with at least one of the plans to continue serving SoonerCare members (excluding those included in our aged/blind/disabled population, home and community-based waiver members, dual eligible populations and TEFRA children).
4/19/21 School-Based Contract Renewal
Provider Types/Specialties: 12/120, 126

School-based contracts and school-based paraprofessional contracts that expire on June 30, 2021 may now be renewed via the OHCA secure provider portal. Visit the provider training page at https://oklahoma.gov/ohca/providers/provider-training.html for a how-to video on Renewing your SoonerCare Contract.  
4/20/21 Dental Prior Authorization Documentation Provider Types/Specialties: 27/270-278, 08/080

Effective immediately, all required documentation must be submitted at time of prior authorization request. Prior authorizations submitted without the required documentation will be cancelled due to insufficient documentation for comprehensive review and will no longer be electronically returned to the provider for attachment of required documentation.
4/19/21 Public Health Emergency Extension

The US Department of Health and Human Services has extended the public health emergency for 90 days.

The previous extension was set to expire on April 21, 2021.

The public health emergency renewal is posted at: https://www.phe.gov/emergency/news/healthactions/phe/Pages/COVID-15April2021.aspx.

What does this mean for SoonerCare providers and members?

  • Expanded use of telehealth services for most SoonerCare services.

  • OHCA and DHS will not terminate SoonerCare coverage for members during this time.

  • No cost sharing for testing or treatment of COVID-19 for SoonerCare members.

  • Some medicines may be prescribed for 90-days to reduce trips to the pharmacy.
4/13/21 Managed Care (SoonerSelect) What you need to know about managed care (SoonerSelect)

OHCA is transitioning to a managed care delivery service model in partnership with four medical plan organizations and three dental plan organizations. The following SoonerCare populations will be asked to choose from one of the four health plans:  children (including foster children), low-income parents, pregnant women, and adults ages 19 – 64 (expansion population). American Indian/Alaska Native members are considered voluntary and will have the option to opt-in to a managed care plan.

When will SoonerSelect go into effect? Oct. 1, 2021

How does this impact providers who see SoonerCare members?  Providers who serve our members that will be transitioning into managed care will need to contract with our partner plans in order to continue serving those members. Members will be able to choose which plan they will join.

How can I learn more? Visit https://oklahoma.gov/ohca/about/soonerselect.html for more information on SoonerSelect.

SoonerSelect Town Halls
OHCA is hosting town hall meetings throughout the state to answer provider and stakeholder questions about our new managed care program, SoonerSelect. All town halls have in-person and virtual attendance options. To stay up-to-date on the latest information regarding Town Halls, visit: https://oklahoma.gov/ohca/townhall.
4/12/21 Kingfisher and Oklahoma City Town Hall Global Message OHCA will host town hall meetings throughout the state to answer provider and stakeholder questions about our new managed care program, SoonerSelect. Please complete the below registration form if you plan to attend — either virtually or in-person — the town halls in Kingfisher or Oklahoma City. The meeting will be recorded, and a replay will be available at a later date.

Register to attend here: https://oklahoma.gov/ohca/townhall.html   

Date and Time
Kingfisher:
Thursday, April 15
10:00 - 11:00 AM

Oklahoma City:
Monday, April 19
10:00 – 11:30 AM

Location
Kingfisher:
Kingfisher County Fairgrounds
Exhibit Building
300 South 13th St.
Kingfisher, OK 73750

Oklahoma City:
OKC MetroTech - South Bryant Campus
4901 South Bryant Ave.
Oklahoma City, OK 73129  
4/7/21 Unlocking Implicit Bias Training    

Provider Types/Specialties:  All

The Oklahoma Health Care Authority and the Oklahoma Department of Mental Health and Substance Abuse Services are providing Unlocking Implicit Bias Training for medical professionals on April 26, 2021 from 2-3 p.m. and April 27, 2021 from 12 - 1p.m. The link to register can be found on the provider training page at https://oklahoma.gov/ohca/providers/provider-training.

4/5/21 Poteau Town Hall

OHCA will host town hall meetings throughout the state to answer provider and stakeholder questions about our new managed care program, SoonerSelect. Please complete the below registration form if you plan to attend — either virtually or in-person — the town hall in Poteau. The meeting will be recorded, and a replay will be available at a later date. 

Date and Time
Wednesday, April 7
1:00 - 2:00 PM

Location
Kiamichi Technology Seminar Center
1509 S McKenna St
Poteau, OK 74953
4/1/21 OSDH Seeking Providers for COVID-19 Vaccine Administration The Oklahoma State Department of Health is seeking interested providers to administer the COVID-19 vaccine to eligible Oklahomans. Any facility, organization, or health care provider licensed to possess vaccine, administer vaccine, or provide vaccination services in Oklahoma is eligible to enroll.

Visit https://oklahoma.gov/covid19/providers/provider-enrollment-process.html for information and to enroll.  
4/1/21 Insure Oklahoma Population Changes   Oklahoma’s Medicaid program, SoonerCare, currently covers only children, pregnant women, elderly adults and disabled individuals.

On June 30, 2020, the Oklahoma Medicaid Expansion Initiative, State Question 802, passed to expand Medicaid eligibility to adults ages 19-64 whose income is 138% (133% with a 5% disregard) of the federal poverty level or lower. This equates to an estimated annual income of $17,796 for an individual or $36,588 for a family of four.

As OHCA prepares for the expanded adult Medicaid population, the current Insure Oklahoma premium assistance program will be modified due to population changes. There are two Insure Oklahoma programs, Individual Plan (IP) and Employer Sponsored Insurance (ESI).

As Oklahoma adds the expansion adult population, the ESI program will be revised to cover individuals with qualifying income from 138% to 200% of the federal poverty level starting July 1, 2021. Insure Oklahoma will continue to accept applications from small businesses who want to join the premium subsidy program. The IP members will be moved into the new expansion population.

Approximately 21,000 of the currently enrolled IP and ESI members will become covered as expansion adults. As adults who are 19 through 64 years old with lower income levels are moved to expansion adult coverage, they will not pay a premium for coverage in SoonerCare.
3/30/21 Duncan Town Hall

OHCA will host town hall meetings throughout the state to answer provider and stakeholder questions about our new managed care program, SoonerSelect. Please complete the below registration form if you plan to attend — either virtually or in-person — the town hall in Duncan. The meeting will be recorded, and a replay will be available at a later date.

Date and Time
Thursday, April 1
2:30 - 3:30 PM 

Location
Red River Technology Center
3300 W Bois D'Arc Ave
Duncan, OK 73533
3/26/2021 Medical Authorization Using InterQual® Webinar OHCA will be presenting a webinar titled: ‘Medical Authorization Using InterQual®’ on Thursday, April 29 at 2PM.

This class covers the prior authorization (PA) submission for InterQual®-related procedures and provides resolutions to common errors within the InterQual® review. PAs related to behavioral health, dental, DME, Therapy (OT/PT/ST), pharmacy and waivers are not included. Note: This webinar will not include Managed Care Organization (MCO) changes or Medicaid Expansion. For more information about MCOs or Medicaid expansion, visit our home page and click on one of the banners toward the center of the page.

Recommended Audience: Providers who submit PAs related to surgeries, procedures and high tech imaging.

Register to attend the ‘Medical Authorization Using InterQual®’ on Thursday, April 29 at 2PM: Expired Link.

After registering, you will receive a confirmation email containing information about joining the webinar.
3/22/2021 SoonerSelect Town Halls
Provider Types: All

Attention Providers: Save-the-date for one of our town hall meetings to discuss the transition to managed Medicaid. Our experts will be on hand to answer all your questions, as will representatives from our chosen medical and dental partners.

Please register for the event as COVID-19 guidelines will be enforced at each facility. A virtual option will be provided if you are unable to attend in-person. If you don't see your location listed, please check back as we are scheduling more locations.

https://oklahoma.gov/ohca/townhall.html
3/19/2021 Portal Access Form
Provider Types: All

The Provider/Administrator Portal Access Form has been updated. This form should only be utilized by providers and provider portal administrators to obtain a temporary password, reset challenge questions, receive a new PIN letter, or receive a user ID. The new version can be viewed and utilized from the following link: https://oklahoma.gov/ohca/providers/claim-tools/claim-tools.html, including an instructional video to assist in completing the document.

Providers/Administrators should complete the form electronically and send to the Provider Internet Helpdesk upon completion. Faxing the document is no longer allowed. The new document will go into effect immediately and beginning May 1, 2021 the old form will no longer be accepted. Please allow a minimum of 48 hours for completion of these requests.
3/15/2021 SoonerCare Provider and Stakeholder SoonerSelect Survey The Oklahoma Health Care Authority, in partnership with managed care organizations, will transition to a new health care model through SoonerSelect.

We understand our providers and stakeholders have many questions about managed care. OHCA will send out a survey to providers, and the survey responses will help us to create informational materials to answer your questions.

We have created a Survey for Providers and Stakeholders that will help us create informational materials to answer your questions. Please click on the link above and take a few minutes to submit your survey responses.

OHCA will host town hall meetings throughout the state in late March and April to answer provider and stakeholder questions. For more information about upcoming town halls, visit www.oklahoma.gov/ohca/townhall.  
3/12/2021 Dental Prior Authorizations Provider Types: Provider Types 08 (080 & 086) and 27 (271-275)

This class will provide a current look at covered dental services requiring a prior authorization, the documents required for each submission, and how to submit a prior authorization on the SoonerCare Provider Portal. Note: This webinar will not include dental Managed Care Organization (MCO) changes or Medicaid Expansion. For more information, click on the banner from the homepage.

Recommended Audience:Dentists, Orthodontists, Administrative Staff

Register to attend the ‘Dental Prior Authorizations’ on Wednesday, April 7 at 2PM: Expired Link.

After registering, you will receive a confirmation email containing information about joining the webinar.
3/9/2021 Hospital Contracts Expiring
Provider Types: 01 - Hospitals

Hospital contracts expire on March 31, 2021. To avoid any delay in reimbursement, we encourage hospitals to submit their renewals as soon as possible.

If you have any questions, please contact provider enrollment at 800-522-0114, option 5, or email ProviderEnrollment@okhca.org.
3/3/2021 COVID-19 Monoclonal Antibodies

Provider types: All

OHCA has opened coverage for the following COVID-19 monoclonal antibodies and administration when used in accordance with the emergency use authorization from the FDA. Monoclonal antibody infusion is reimbursable when provided in a hospital outpatient department or physician’s office experienced in infusion services. Due to the risk of anaphylaxis, treatment should only be administered in settings where health care providers have immediate access to medications to treat a severe infusion reaction and the ability to activate the emergency medical system as needed.

  • Q0239 – Injection, bamlanivimab, 700 mg (Eli Lilly) (effective date 11/09/2020)
  • M0239 – Intravenous infusion, bamlanivimab-includes infusion and post administrative monitoring (Eli Lilly) (effective date 11/09/2020)
  • Q0243 – Injection, casirivimab and imdevimab, 2400 mg (Regeneron) (effective date 11/20/2020)
  • M0243 – Intravenous infusion, casirivimab and imdevimab includes infusion and post administrative monitoring (Regeneron) (effective date 11/20/2020)
  • Q0245 – Injection, bamlanivimab and etesevimab, 2100 mg (Eli Lilly) (effective date 2/9/2021)
  • M0245 – Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring (Eli Lilly) (effective date 2/9/2021)

If you have any questions, please call the OHCA provider helpline at 800-522-0114.

3/2/2021 Covid-19 related Private Duty Nursing (PDN) Overtime claims subject to timely filing Provider Types/Specialties: 05, 16, 50, 51, 163

As previously announced in a 5/29/2020 global message, effective March 1, 2020 and for the duration of the COVID-19 public health emergency, private duty nursing (PDN) providers may submit claims to receive a higher rate of pay for PDN hours that result in overtime rate of pay for nursing staff. Only PDN services for persons with tracheostomies or who are ventilator dependent are qualified for the overtime payment.

Please be advised that these overtime claims are subject to standard timely filing rules.The initial claim to receive the regular rate of pay for PDN services must be filed within 6 months of the date of service, and the subsequent overtime claims for qualified private duty nursing care must be submitted within one year of the date of service.

Full instructions for overtime claim submissions are contained in the 5/29/2020 global message titled “Private Duty Nursing Overtime Rate, COVID-19 related.”

Questions may be directed to Carolyn Reconnu-Shoffner, Director, Population Care Management, at 405-522-7630, or Kim Downing, Care Management Supervisor, at 405-857-2364.
3/1/2021 COVID-19 Vaccine Coverage Update

Provider Types: All

OHCA has opened coverage for the following COVID-19 vaccines and administration when used in accordance with the emergency use authorization (EUA) from the FDA:

91300 – Pfizer BioNtech COVID-19 vaccine (effective date 12/11/2020)

  • 0001A – Pfizer BioNtech COVID-19 vaccine administration – first dose
  • 0002A – Pfizer BioNtech COVID-19 vaccine administration – second dose

91301 – Moderna COVID-19 vaccine (effective date 12/18/2020)

  • 0011A – Moderna COVID-19 vaccine administration – first dose
  • 0012A – Moderna COVID-19 vaccine administration – second dose

91303 – Janssen (Johnson & Johnson) COVID-19 vaccine (effective date 2/28/2021)

  • 0031A – Janssen (Johnson & Johnson) COVID-19 vaccine administration – single dose

OHCA is still awaiting approval from CMS for pharmacies to administer the vaccine and be reimbursed.

2/25/2021 Introduction to SoonerCare - Part Three
Provider Types: All

OHCA will be presenting a webinar titled “Introduction to SoonerCare – Part Three (Coverage & Exclusions)” on Thursday, March 25 at 2 p.m.

This class is part three of a series titled “Introduction to SoonerCare”. Attendees will learn more about the services available with basic Medicaid coverage for both adults and children, as well as exclusions and limitations. Coverage for waiver programs, including Advantage and Home and Community Based Waiver Services, will not be part of this webinar.

Recommended Audience: New Oklahoma Medicaid providers and staff.

Register to attend the “Introduction to SoonerCare – Part Three (Coverage & Exclusions)” webinar on Thursday, March 25 at 2 p.m. using the link below.

Expired Link.

After registering, you will receive a confirmation email containing information about joining the webinar.
2/23/2021 Nursing Facility Pay for Performance (PFP) Payment Update Provider Types/Specialties: 03/30, 35

SFY2021 Third Quarter PFP payment will be made on Feb. 24, 2021.

We thank you for your continued service to SoonerCare members.
2/23/2021 Introduction to SoonerCare - Part Two
Provider Types: All

OHCA will be presenting a webinar titled Introduction to SoonerCare – Part Two (Programs) on Thursday, March 11, 2021 at 2 p.m.

This class is part two of a series titled Introduction to SoonerCare. Attendees will learn more about the various Oklahoma Medicaid member benefits and programs. Demonstrations will be provided on how these plans appear on the provider portal when conducting an eligibility search.

Recommended Audience: New Oklahoma Medicaid providers and staff.

Register to attend the Introduction to SoonerCare – Part Two (Programs) webinar on March 11, 2021 at 2 p.m.

Expired Link.

After registering, you will receive a confirmation email containing information about joining the webinar.
2/2/2021 Electronic Submissions for PASRR Level I and Level II

Provider Types/Specialties: 03/030

Effective March 1, 2021, the Oklahoma Healthcare Authority (OHCA) will only be accepting electronic submissions for PASRR Level I (LTC-300R) and Level II. It will be the responsibility of the nursing facility or provider to submit the Level I and Level II in a timely manner. Phone calls to OHCA Psych/ID analysts should be reserved for questions such as, but not limited to, 30 day exempted hospital discharges that are about to lapse and require a Level II PASRR, seven-day emergency PASRR requests, PASRR policy, questions about quarantine due to COVID-19 and Level I corrections.

Please contact the OHCA internet help desk at 800-522-0114, select option 1 for provider, enter your provider number, select option 2 for the internet helpdesk and then notify them that you have experienced a technical issue while submitting your PASRR Level I (LTC300R) electronic form. For questions concerning the PASRR Level II electronic submission form, please contact the behavioral health unit at 405-522-7597, select option 1 for provider, option 6 for prior authorizations and option 2 to reach inpatient behavioral health. The PASRR Level II electronic form is located at https://oklahoma.gov/ohca/providers/types/behavioral-health-and-substance-abuse-services/behavioral-health-and-substance-abuse-services.html, under templates/forms.

Please note: Your provider number was given to you upon contracting with OHCA. Please contact your business office to obtain a copy of this if you do not have it. After you select option 1 for provider, please be sure to listen to the recording completely as it will tell you how to enter the alphabetical letter at the end of your provider number.

1/26/2021 Introduction to SoonerCare - Part One
Provider Types: All

OHCA will be presenting a webinar titled: Introduction to SoonerCare – Part One (Medicaid Eligibility & Verification) on Thursday, Feb. 25 at 2 p.m.

This class is part one of a multi-series of Introduction to SoonerCare. It will provide an in-depth look at the eligibility process, qualifications and verification for Oklahoma Medicaid members. Claims and HMS third party liability discussions will not be included in this session.

Recommended Audience: New Oklahoma Medicaid providers and staff.

Register to attend the Introduction to SoonerCare – Part One (Medicaid Eligibility & Verification) webinar on Thursday, Feb. 25 at 2 p.m.: Expired Link.

After registering, you will receive a confirmation email containing information about joining the webinar.
1/21/2021 Anterior and Posterior Root Canal Prior Authorizations

Provider Types / Specialties: 270-275, 080

According to OHCA policy OAC 317:30-5-696(J)iii, prior authorization is required for members who have a treatment plan requiring more than two (2) anterior and/or any posterior root canals.  Two (2) or fewer anterior and/or posterior root canals within a twelve month period, will not require prior authorization. 

1/20/21 Hospital Addendum for Psych and Rehab Units

Numeric Provider Types:  01

Numeric Provider Specialties: 

Global Message Body: Hospital providers who wish to bill for services provided in a psychiatric or rehabilitation unit must do so using a separate provider number by completing an addendum to their hospital contract. The addendum to hospital contracts for psych and rehab units can now be accessed online at https://oklahoma.gov/ohca/providers/provider-enrollment.html.

1/19/20
Therapy Assistant Enrollment PV Specialties: 087, 120, 126, 145, 170, 171, 173, 174, 175, 179, 182

In regard to provider letter 2021-02, therapy assistants may now enroll at https://oklahoma.gov/ohca/providers/provider-enrollment.html. The agency has extended the deadline to April 1, 2021 for all enrollments to be submitted. During this time, billing under the licensed therapist is still permitted if needed.

If you have any questions, please call the OHCA provider helpline at 800-522-0114.

1/15/21 Public Health Emergency Extension

The US Dept. of Health and Human Services has extended the public health emergency through April 21, 2021. 

The public health emergency renewal is posted at: https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-07Jan2021.aspx.

What does this mean for SoonerCare providers and members?

  • Expanded use of telehealth services through April 30, 2021 for most SoonerCare services.
  • OHCA and DHS will not terminate SoonerCare coverage for members during this time.
  • No cost sharing for testing or treatment of COVID-19 for SoonerCare members.
  • Some medicines may be prescribed for 90 days to reduce trips to the pharmacy.
1/12/21 Provider Letter 2021-02

PV Specialties: 087, 120, 126, 145, 170, 171, 173, 174, 175, 179, 182

Provider letter 2021-02 informs providers about the reimbursement for the coverage of services that are rendered by physical therapy, occupational therapy, speech-language pathology therapy assistants and speech-language pathology clinical fellows. Please post all comments by close of business Monday, Feb. 8, 2021, via the Oklahoma Health Care Authority policy change blog. Thank you.

1/12/21 Provider Letter 2021-01

PV Specialties: 634

Provider letter 2021-01 informs providers about coverage for adults in a psychiatric hospital. Please post all comments by close of business Monday, Feb. 8, 2021, via the Oklahoma Health Care Authority policy change blog. Thank you.

1/5/21 ADA Dental Claim Submission
Provider Types: 08, 27
Specialty Types: 086, 270-279

OHCA will be presenting a webinar titled ADA Dental Claim Submission on Thursday, February 4 at 2 p.m.

This class will provide an in-depth look at the electronic ADA dental claims submission on the secure provider portal. Attendees will learn more about the policy and procedures of submitting Medicaid primary and Medicaid secondary claims. General coding for services will not be addressed in this presentation.

Recommended Audience: Billing staff who submit ADA dental claims.

Register to attend the ADA Dental Claim Submission on February 4 at 2 p.m.
Click Here to Register

After registering, you will receive a confirmation email containing information about joining the webinar.
1/4/21 C-Section Rate Letters
Provider Types: 01, 08, 31, 52
 
The year-end C-section rate letters for state fiscal year 2020 are now available through the OHCA Provider Portal. As a reminder, these C-section letters are now only available electronically. 
 
If you need help to retrieve your letters, please call 800-522-0114. 
 
You may also view the C-section rate release schedule on the OHCA webpage at www.okhca.org/c-section.

Thank you.
Hospital Addendum for Psych and Rehab Units
Last Modified on Jul 22, 2021