SoonerCare provider update, spring 2014

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SoonerCare Provider Update
Spring 2014
Permanent
Rule Changes
This year’s changes to the Oklahoma Health Care Authority’s (OHCA) permanent rules were available for review and input through February 24. The rules include new regulations requested by the public, members, providers, other state agencies and OHCA staff and leadership. In addition, rules previously promulgated on an emergency basis were considered.
A Rule Impact Summary, including projected budget impacts, was furnished for each proposed rule. All text changes to the regulations were also highlighted in the postings.
The Medical Advisory Committee made its recommendations regarding all rules at its March 26 meeting.
Finally, the OHCA Board took action regarding the rules during its March 27 meeting (with the exception of WF #13-43, which was withdrawn from consideration due to a technical error). Following Board action, the rules were forwarded to the Legislature and Governor for action. If approved, most of the rules will take effect around July 1, 2014.
Among the new rules are changes regarding:
• Diabetic Testing Supplies — Policy is revised to clarify diabetic supplies are covered items when medically necessary according to the member’s diabetic classification (e.g., Type 1 insulin and non-insulin dependent and Type 2 insulin and non-insulin dependent and gestational diabetes). (Reference APA WF # 13-07)
• Long Acting Reversible Contraceptive Devices — Policy is amended to allow reimbursement for Long Acting Reversible Contraceptive (LARC) devices to hospitals outside of the Diagnosis Related Group (DRG) methodology. (Reference APA WF # 13-13)
• Tobacco Cessation Counseling — Tobacco cessation counseling policy is revised to include Maternal/Child Health Licensed Clinical Social Workers (LCSWs) with certification as a tobacco treatment specialists as qualified providers for cessation counseling services. (Reference APA WF # 13-17)
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