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The Oklahoma Health Care Authority (OHCA) seeks advice and consultation from medical professionals, professional and tribal organizations, and the general public in developing new or amended policies (e.g., administrative rules, state plan, waivers, etc.). The proposed policy page is designed to give all constituents an opportunity to review and make comments regarding upcoming changes.  

To make suggestions on rules not currently being considered for change, use the following links: 

•  A New Rule  
•  Amend A Rule  
•  Revoke A Rule  

To view or make comments on upcoming proposed policy, state plan, and/or waiver changes, please click the link of the change(s) below. All comments regarding proposed administrative rules will be considered during the rulemaking process and become a part of the official work folder. All rule changes are subject to the Oklahoma Administrative Procedures Act. 

Additional resources:

• Oklahoma Statutes
• Oklahoma Secretary of State Administrative Code
• Archived OHCA Proposed Policy Changes

Public Notices

2021

• 09/09/2021 Adult Expansion Alternative Benefit Plan (ABP) Benefits Update & Alternative Non-Pharmacological Treatments for Pain Management (UPDATED)
• 09/07/2021 Certified Community Behavioral Health PPS & Intensive Residential SUD Treatment for Adolescents 
• 07/22/2021 Adult Expansion Alternative Benefit Plan (ABP) Benefits Update & Alternative Non-Pharmacological Treatments for Pain Management (UPDATED) 
• 06/16/2021 Adult Expansion Alternative Benefit Plan (ABP) Service Delivery System and Dental Services Copayment  
• 06/09/2021 Nursing Facility Annual Rebasing of Rates 
• 05/25/2021 Adult Expansion Alternative Benefit Plan (ABP) Updates and Dental Services (UPDATED)   
• 05/04/2021 Medically Fragile Waiver Amendment 
• 05/04/2021 Adult Expansion Alternative Benefit Plan (ABP) Updates (UPDATED)   
• 05/04/2021 Reimbursement of Long-Acting Reversible Contraceptive (LARC) Devices in a Federally Qualified Health Center (FQHC) (UPDATED) 
• 03/23/2021 Adult Expansion Alternative Benefit Plan (ABP) Service Delivery System Update (UPDATED) 
• 01/04/2021 Enrollment of Certain Medicaid Members under the Demonstration and Implementation of SoonerSelect Managed Care Model 

2020    

• 12/29/2020 Residential Substance Use Disorder (SUD) Services Reimbursement for Tribal Providers 
• 12/28/2020 Rate Revisions for the Specialty, Standard, and Extended Psychiatric Residential Treatment Facilities (PRTFs) 
• 10/01/2020 Insure Oklahoma Phase Out Plan and Waiver Amendment 
• 09/25/2020 SUPPORT Act Medication-Assisted Treatment (MAT) 
• 09/17/2020 Insure Oklahoma Abbreviated Phase Out Plan and Waiver Amendment 
• 09/16/2020 Residential Substance Use Disorder (SUD) Services 
• 09/01/2020 Therapy Assistants (UPDATED) 
• 08/28/2020 Certified Community Behavioral Health (CCBH) Services Reimbursement (UPDATED) 
• 07/31/2020 Medicaid Adult Expansion 
• 07/10/2020 Durable Medical Equipment, Supplies, and Appliances Reimbursement Methodology (UPDATED)     
• 06/15/2020 Nursing Facility Rate Increases and Pay-for-Performance (PFP) Quality Metric Update 
• 05/01/2020 1115(a) Institution for Mental Disease (IMD) Waiver for Serious Mental Illness (SMI) and Substance Use Disorder (SUD) 
• 03/31/2020 Adding the Newly Eligible Adult Group to Patient Centered Medical Homes (PCMH) and Increasing Care Coordination Rate for PCMH American Indian/Alaskan Native Providers (1115 Waiver Amendment)   
• 03/19/2020 Healthy Adult Opportunity (HAO) Demonstration Waiver (SoonerCare 2.0) (UPDATED)    
• 03/04/2020  High-Investment Drugs 
• 02/21/2020 SoonerCare Coverage for Newly Eligible Adults  

  2019 

•  11/08/2019 Diabetes Self-Management Training (DSMT) Services   
•  09/24/2019 Disproportionate Share Hospitals
•  09/17/2019 Provider Rate Increase, Nursing Facility Rate Increase, and Nursing Facility Pay-for-Performance Program   
•  08/29/2019 Inpatient Psychiatric Add-on Specialty and Intensive Treatment Family Care (ITFC)  
•  07/24/2019 Out-of-State Services
•  06/28/2019  Payment to State-owned Psychiatric Residential Treatment Facilities (PRTFs)
•  06/26/2019  Nursing Facility Rebasing; Applied Behavioral Analysis (ABA) Services and Reimbursement; Therapeutic Foster Care (TFC) Rate Increase; Developmental Disabilities Services (DDS) and ADvantage Waiver/State Plan Personal Care Services Rate Increases  
•  05/15/2019  Rural Health Clinics Reimbursement, Enhanced Payment for State University Employed or Contracted Physicians, Maternal Depression Screenings, Residential Behavior Management Services (RBMS) Rates  
•  03/27/2019 Partial Hospitalization Program (PHP) Services, Certified Community Behavioral Health Clinic (CCBHC)Services, and Deductible and Coinsurance for Crossover Claims (UPDATED) 
•  03/07/2019 Partial Hospitalization Program (PHP) Services, Certified Community Behavioral Health Clinic (CCBHC) Services, and Deductible and Coinsurance for Crossover Claims  
•  03/07/2019 Health Access Network (HAN) 1115(a) Demonstration Waiver Amendment 

 2018  

•  12/21/2018  Supplemental Hospital Offset Payment Program Cost-to-Charge Ratio Calculation Update for Critical Access Hospitals   
•  10/01/2018 1115(a) Demonstration Health Management Program Waiver Amendment   
•  09/07/2018 Provider Rate Increases, LTC Facilities Rate Increases, and Miller Trust 
•  09/07/2018 Supplemental Reimbursement for Ground Ambulance Transportation Providers
•  09/06/2018 State Plan Skilled Nursing Rate Increase
•  07/03/2018 1115(a) SoonerCare Choice Community Engagement Requirements Waiver Amendment 
•  06/28/2018 Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) Licensed Behavioral Health Practitioner and Licensure Candidate in an Outpatient Behavioral Health Clinic Rate Increase  
• 06/15/2018  Vaccine Rate Methodology, Nursing Facilities Rate Changes, Department of Mental Health & Substance Abuse Services (ODMHSAS) Rate Increases, & Oklahoma Department of Human Services (DHS) Rate Increases   
• 04/11/2018 Nursing Facilities Supplemental Payment Program

2017

• 12/27/2017 Nursing Facilities Supplemental Payment Program and Outpatient Hospital Dental and ENT Rates  
• 09/07/2017 Private Duty Nursing Rate Change  
• 06/26/2017 Long-term Care Facilities Rebasing & Miller Trust
• 02/07/2017 Nursing Facilities Supplemental Payment Program
• 01/05/2017 Insure Oklahoma Waiting Period for Dependent Children with Creditable Coverage and Language Update; Incontinence Supplies Sole Source 1915(b)(4) Waiver Request; Over-the-Counter Products Update; & Public Assistance Reporting Information System (PARIS)

2016

•  12/30/2016 Supplemental Drug Rebate & Investigational Drugs
•  12/23/2016 Statewide Transition Plan
•  12/02/2016 Nursing Facilities Supplemental Payment Program
•  11/02/2016 Pharmacy Covered Outpatient Drugs
•  09/19/2016 Supplemental Hospital Offset Payment Program; DRG Relative Weights
•  07/21/2016 Reversal of Three Percent Cut for Certain OHCA Provider/Services, Rate Revision for Behavioral Health Assessments performed in Outpatient Behavioral Health Agencies    
• 06/17/2016 Quality of Care Fee Increases for Long-Term Care Facilities, Miller Trust Monthly Income Eligibility Requirements, Unbundling of OB services methodology change and Eyeglass Materials Payment Methodology Change  

Policy Change Blog

Click on a policy change blog post below to view more information and add your input.

• OK SPA 21-0041 Certified Community Behavioral Health (CCBH) Reimbursement
• OK SPA 21-0042 Intensive Residential Substance Use Disorder (SUD) Treatment for Adolescents
• APA WF 21-22 Title XXI Dental Revisions for Pregnant Women

Disclaimer: Oklahoma Health Care Authority (OHCA) policy comment section will be reviewed and considered under the current policy rule change. Personal information should not be shared/or submitted in the comment section. This comment section is reserved for proposed policy rule changes. Any approved comments on a proposed policy change will be available for public view on this site.