Proposed Policy Changes

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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 view or make comments on upcoming proposed policy changes please click the Feedback Form in each Work Folder box. 

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.

Please use the feedback forms below in the applicable proposed change box to give feedback on the proposed policy change.

 

 

 

proposed_rule_changes-01 

 

Use the links below to make suggestions on rules not currently being considered for change.

 

 Proposed Policy, State Plan, and/or Rate Changes 

  Circulated
Date
  
 

  Proposed Change Work Folder   

  Description of Change   

  OHCA Comment
Due Date
  
 

  OHCA Public Hearing/MAC/Board
Dates & Agendas
  
 

06/16/2015 

APA WF# 15-10  

Feedback Form 

 Long-Term Care Rule Changes - Long-term care eligibility rules are clarified to be consistent with 42 U.S. Code § 1396p. Changes include increasing home equity maximum amount to $500,000 plus the increase by the annual percentage increase in the urban component of the consumer price index, and allowing the individual to decrease this equity interest through the use of a reverse mortgage or home equity loan. The term "relative" is removed from the home exemption rules for members who fail to return back home from a long-term care institution. The term "assets" is changed to also include annuities purchased by, or on behalf of, an annuitant seeking long-term care services. 

07/16/2015

MAC: 7/16/2015

Board: 08/12/2015

06/16/2015

APA WF# 15-01 

Feedback Form  

Adult dental coverage for organ transplant clearance — The proposed policy revisions add coverage for medically necessary dental services for adult SoonerCare members needing dental clearance for organ transplant approval.  

07/16/2015

MAC: 7/16/2015

Board: 08/12/2015

Provider Letter 

   Circulated
Date
   

   Proposed Changes  

   Description of Change   

  OHCA Comment
Due Date
   

06/12/2015

Provider Letter OHCA 2015-08  

 Feedback Form 

Provider letter 2015-08 serves to update providers on Cardiology Services; Radiation Therapy; Joint Surgeries; Pain Management; Spine Surgeries, Effective August 1, 2015. Please submit all comments by close of business, July 12, 2015. Thank you for your participation in the process. 

07/12/2015

06/30/2015

Provider Letter OHCA 2015-11

Feedback Form 

OHCA is proposing to require prior authorization (PA) for more than 10 units of CPT code 88271, a molecular cytogenetics code used to bill each DNA probe, effective August 1, 2015.  Please submit all comments by close of business, July 30, 2015 via the feedback form link. Thank you for your participation in the process. 

07/30/2015

 1115 Waivers 

   Circulated
Date
  
 

  Proposed Change 

  Description of Change   

 OHCA Comment
Due Date
  
 

 Proposed Submittal Date 

06/12/2015 

Insure Oklahoma Sponsor's Choice Option   

Feedback Form 

The 1115 demonstration waiver and corresponding agency rules will be amended to reflect a third Insure Oklahoma option. The Insure Oklahoma Choice program will establish coverage for sponsoring organizations, eligible populations including dependent spouses and children, qualifying benefit plans, cost sharing and expenditure authorities. The evaluation design will be modified to incorporate the Insure Oklahoma Choice program as well.  

07/17/2015 

07/20/2015 

Home and Community-Based Services (HCBS) Waivers  


 Care Coordination Model    

   Circulated
Date
   

   Proposed Changes  

   Description of Change   

  OHCA Comment
Due Date
   

 06/24/2015

 RFI Care Coordination Model   

 Feedback Form 

Pursuant to House Bill 1566 passed by the Oklahoma Legislature in 2015, it is the intent of the Oklahoma Health Care Authority (OHCA) to issue a Request for Proposal (RFP) for care coordination model(s) for the Aged, Blind and Disabled (ABD) populations. To comply with the direction of the bill, the OHCA is soliciting information and input from a wide variety of stakeholders including but not limited to SoonerCare members, advocates, providers, health care systems, and the general public through a Request for Information (RFI) process, for the development and requirements of the RFP.  Please submit all comments by the close of business July 24, 2015. Thank you for your participation in the process.

 07/24/2015 


  SoonerCare Choice (SC) Waivers 

 

Circulated
Date
 

Waiver Application/Amendment 

 Waiver Program 

OHCA Comment
Due Date
 

Proposed Submittal Date 

 State Plan Amendment (SPA) 

Circulated
Date
 

Proposed
Change
 

Description of Change 

OHCA Comment
Due Date
 

Proposed Submittal Date 

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.