MedicaidAdministrativeMedium impact
Provider Letter 2022-13: RE: Policy Revisions and Program Updates – Effective Sept. 12, 2022
Oklahoma SoonerCare·OK·Provider Letter
Effective date
Sep 12, 2022
We identified it
Jun 20, 2026
Summary
Oklahoma Health Care Authority (OHCA) implemented multiple SoonerCare policy changes effective September 12, 2022, including requiring procedure code modifiers for 340B drug identification on outpatient and hospital claims, eliminating copayments for pregnant women, and allowing RHC/FQHC patients to exceed four-visit monthly limits.
Action Required
Effective September 12, 2022: Billing teams must add procedure code modifiers to all outpatient and hospital claims to identify 340B drugs versus non-340B drugs when billing OHCA. Update billing systems to automatically remove copayments for pregnant women covered by SoonerCare. RHC/FQHC providers should update patient visit tracking systems to allow SoonerCare Choice members with PCMH designation to exceed the four-visit monthly limitation.