Library: Policy

317:30-5-42.15. Outpatient hospital services for members infected with tuberculosis

Issued 12-1-06

     Outpatient hospital services are covered for members infected with tuberculosis.  Coverage includes, but may not be limited to, outpatient hospital visits, laboratory work and x-rays.

• (1) Services to members infected with TB are not limited to the scope of the SoonerCare program; however, prior authorization is required for services that exceed the scope of coverage under SoonerCare.

• (2)  Drugs prescribed for the treatment of TB not in accordance with OAC 317:30-3-46 require prior authorization by the OHCA Pharmacy Helpdesk using form "Petition for TB Related Therapy."