Library: Policy

317:30-5-210.2. Coverage for children

Revised 9-12-22

(a) Coverage. Medical supplies, equipment, and appliances are covered for children.

(b) Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services. EPSDT services, supplies, or equipment that are determined to be medically necessary for a child, and which are included within the categories of mandatory and optional services in Section 1905(a) of Title XIX, are covered regardless of whether such services, supplies, or equipment are listed as covered in the Oklahoma Medicaid State Plan.

(c) Medical necessity. Federal regulations require the Oklahoma Health Care Authority (OHCA) to make the determination as to whether the service is medically necessary and do not require the provision of any items or services that the State determines are not safe and effective or that are considered experimental. For more information regarding clinical trials, see Oklahoma Administrative Code 317:30-3-57.1.