Okla. Stat. tit. 63 § 5026.1

Current through Laws 2024, c. 453.

Section 5026.1 - Annual review of all medications and forms of treatment for sickle cell disease

A. The Oklahoma Health Care Authority shall conduct an annual review of all medications and forms of treatment for sickle cell disease and services for enrollees with a diagnosis of sickle cell disease. The purpose of the annual review is to determine if the available covered medications, treatments, and services are adequate to meet the needs of enrollees with a diagnosis of sickle cell disease, and whether the Authority should seek to add or recommend additional medications, treatments, or services.

B. The review shall include, but not be limited to:

1. The extent to which healthcare transitional programs covered under the state Medicaid program prepare, transfer, and integrate emerging adults into the adult care setting from a pediatric setting;

2. The extent to which emergency department providers are adequately trained and otherwise prepared to treat and manage sickle cell patients presenting with vaso-occlusive crises including but not limited to the extent to which providers follow clinically validated algorithms and protocols regarding such treatment and management;

3. The extent to which sickle cell patients covered under the state Medicaid program are entitled to receive the same standard of care when referred or transferred to an out-of-state facility, and the extent to which the state reimburses such patients for reasonable interstate travel costs; and

4. Any additional areas identified by the Authority that impact the care and treatment of individuals in this state living with sickle cell disease or sickle cell trait.

C. When conducting the annual review required by this section, the Authority shall solicit and consider input from the general public, with specific emphasis on seeking input from persons or groups with knowledge and experience in the area of sickle cell disease treatment.

D. To the extent practicable, the Authority shall utilize the Oklahoma State Health Information Network and Exchange created under Section 1-133 of Title 63 of the Oklahoma Statutes to collect information for the purpose of implementing this section.

E. On or before January 15, 2023, and on or before January 15 each year thereafter, the Authority shall submit a report to the President Pro Tempore of the Senate and the Speaker of the House of Representatives for distribution to the appropriate subject matter committees that details the Authority's findings from the annual review required by this section and any recommendations to the Legislature based upon those findings. The Authority shall publish the annual report required by this subsection to its website in a manner accessible by the general public.

Okla. Stat. tit. 63, § 5026.1

Added by Laws 2022 , c. 162, s. 1, eff. 11/1/2022.