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MedicaidPrior AuthMedium impact

Provider Letter 2022-22: PA Changes

Oklahoma SoonerCare·OK·Provider Letter
Effective date
Oct 24, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

SoonerCare (Oklahoma Medicaid) is experiencing significant delays in pharmacy prior authorization decisions due to increased membership volume. PA decisions will now take closer to the full 24-hour allowable timeframe, and providers must stop using Cover My Meds and complete all PA forms entirely to avoid rejections.

Action Required

Action needed
Immediately: Stop using Cover My Meds for SoonerCare pharmacy PA submissions - use only OHCA forms from oklahoma.gov/ohca/rxforms. Ensure all PA forms are completed entirely before submission to avoid rejections. Update EHR/EMR systems to interface with SoonerCare tier information by contacting your vendor. Train staff to expect PA decisions closer to 24-hour mark and not to resubmit before then.