APA WF # 26-01 Removal of Physician Visit Limit Caps

The proposed policy changes are being promulgated as Emergency and Permanent Rules.

The Oklahoma Health Care Authority proposes revising policy to eliminate existing limits on physician visits for adults, allowing members to receive medically necessary services. This change is intended to improve access to primary and preventive care and ensure members can receive timely outpatient treatment. In addition, the rule includes non-substantive clean-up to align existing abortion-related language with other sections of policy and ensure consistency with state law. These edits do not change coverage requirements.

Please view the draft regulatory text here and submit feedback via the comment box.

Pursuant to 75 O.S. §303(D), a rule impact statement will be posted here beginning December 30, 2025. Individuals may also request a copy using the comment box, and the statement will be provided on December 30, 2025.

Proposed Policy Timeline

Circulation Date: 12/15/2025

Medical Advisory Committee: 1/8/2026

Comment Due Date: 1/15/2026

Public Hearing: 1/15/2026

Board Meeting: 1/21/2026

After you submit your comment, you should be re-directed to a confirmation page. If you are not, please submit your comment through e-mail to federal.authorities@okhca.org.

Please note that all comments must be reviewed and approved prior to posting. Approved comments will be posted Monday through Friday between the hours of 7:30 a.m. – 4 p.m. Any comments received after 4 p.m. will be posted on the following business day.

Jeff:

Having limits in place for physician visits in the post acute, skilled wnd long term care phase of heath and medicine is hindering best possible outcomes of patients in need of care and removing a cap on visits would greatly enhance  not only patient outcomes but patient and provider relationships. 

Kristi: 

I round in nursing home settings and also acute care settings. Removing the cap for physician visits in the post acute care and long term care phase of patient care would be nothing but extremely beneficial to patient health and outcomes! 

Eddie: 

I am a nursing home operator in Oklahoma and support APA WF # 26-01 Removal of Physician Visit Limit Caps.

Rodolfo:

I appreciate the Oklahoma Health Care Authority’s proposal to remove physician visit limits. This change will make it easier for SoonerCare members to see their doctors when they truly need care, without worrying about arbitrary caps that can delay treatment. Removing these limits supports better health outcomes, continuity of care, and peace of mind for patients and families across Oklahoma. Thank you to Oklahoma Health Care Authority for putting patient needs first and improving access to medically necessary care.

Christel: 

As a nurse caring for SoonerCare patients, I strongly support the Oklahoma Health Care Authority’s proposal to remove physician visit limits. In daily practice, I see how visit caps can delay care, interrupt treatment plans, and create unnecessary stress for patients and families. Removing these limits allows care teams to focus on what truly matters—timely, appropriate, and medically necessary care—rather than administrative barriers. Thank you to Oklahoma Health Care Authority for listening to frontline healthcare professionals and prioritizing patient access.

Johanna: 

I support this change to improve healthcare access in Oklahoma. 

Mehran: 

No caps