OHCA Policies and Rules
Section 40 | Eligible providers |
Section 40.1 | General information |
Section 40.2 | Definitions [REVOKED] |
Section 41 | Inpatient hospital coverage/limitations |
Section 41.1 | Acute inpatient psychiatric services |
Section 41.2 | Organ transplants |
Section 42 | Coverage for children [REVOKED] |
Section 42.1 | Outpatient hospital services |
Section 42.2 | Blood and blood fractions |
Section 42.3 | Chemotherapy and radiation therapy |
Section 42.4 | Clinic/treatment room services; urgent care |
Section 42.5 | Diagnostic testing therapeutic services |
Section 42.6 | Dialysis |
Section 42.7 | Emergency department (ED) care/services |
Section 42.8 | Hearing and speech therapy |
Section 42.9 | Infusions/injections |
Section 42.10 | Laboratory |
Section 42.11 | Observation/treatment |
Section 42.12 | Physical therapy |
Section 42.13 | Radiology |
Section 42.14 | Surgery and diagnostic services |
Section 42.15 | Outpatient hospital services for members infected with tuberculosis |
Section 42.16 | Related services |
Section 42.17 | Non-covered services |
Section 42.18 | Coverage for children |
Section 42.19 | 340B Drug Discount Program |
Section 42.20 | High-investment drugs - outpatient hospitals |
Section 43 | Vocational Rehabilitation coverage [REVOKED] |
Section 44 | Medicare eligible individuals |
Section 45 | Psychiatric hospitals - inpatient services for persons age 65 and over [REVOKED] |
Section 46 | Psychiatric hospitals and residential psychiatric treatment facilities - inpatient services for persons under age 21 [REVOKED] |
Section 47 | Reimbursement for inpatient hospital services |
Section 47.1 | Reimbursement for newborn screening services provided by the OSDH |
Section 47.2 | Disproportionate share hospitals (DSH) |
Section 47.3 | Indirect medical education (IME) adjustment |
Section 47.4 | Direct medical education payment adjustment |
Section 47.5 | Critical Access Hospitals |
Section 47.6 | High-investment drugs - inpatient hospitals |
Section 48 | Cost reports [REVOKED] |
Section 49 | Reporting suspected abuse |
Section 50 | Abortions |
Section 51 | Elective sterilizations |
Section 52 | Hysterectomies |
Section 53 | Newborn care |
Section 54 | Hospital rate appeals [REVOKED] |
Section 55 | Residential psychiatric treatment facility rate appeals [REVOKED] |
Section 56 | Utilization review |
Section 57 | Notice of denial |
Section 58 | Supplemental Hospital Offset Payment Program |
Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.