MedicaidCoverageMedium impact
Provider Letter 2021-07: OHCA Program Updates
Oklahoma SoonerCare·OK · Dentistry, OB-GYN, Family Medicine +1 more·Provider Letter
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Summary
Oklahoma Health Care Authority (OHCA) is implementing multiple Medicaid policy changes effective September 1, 2021, including updates to copayment refund requirements, bariatric surgery guidelines, dental procedures, obstetrical ultrasounds, and clinical trial coverage guidelines.
Action Required
By September 1, 2021: Billing teams must implement new refund procedures for over-collected copayments and amounts collected after family cost-sharing maximums are reached. Update dental billing to include caries risk assessment forms for crown prior authorizations and obtain written parental consent for minor services. Update obstetrical ultrasound billing to allow both abdominal and vaginal ultrasounds in first trimester when medically necessary. Review and update clinical trial billing procedures for routine care services.