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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.