Oklahoma
LLC
Website link to register:
https://www.sos.ok.gov/business
Naming conventions
PLLC names must be distinguishable from other entities and indicate the professional service. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLC applies to medical professionals.
Licensing Requirements
Proof of licensure is required from the Oklahoma State Board of Medical Licensure and Supervision. Proof of malpractice insurance required. Additional certifications for surgical practices may be needed.
Required documentation for medical practices
Articles of Organization, Oregon Health Authority Permits, Professional Licenses, Malpractice Insurance
Filing Fee: $100
Annual/Biennial Fee: $25
Additional Notes: Annual report due on LLC anniversary date.
Medicaid
Program Name: SoonerCare
Official Website: http://okhca.org
Legislation: Oklahoma passed SB 560 in 2017, defining DPC agreements as not being insurance and exempting them from state insurance laws.
Private Contracting
Explicitly permitted; DPC agreements are recognized and not subject to state insurance laws.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is required.
Medicaid Program
Oklahoma Medicaid, known as SoonerCare, provides health coverage to eligible low-income residents.
Notification Requirements
Notification required if Medicaid patients are not accepted.
Provider Enrollment Requirements
Providers must enroll with SoonerCare to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
"Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot serve as Medicaid PCPs unless fully enrolled.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Exemptions may apply under managed care frameworks.
Billing Clarity
Cannot bill Medicaid patients for covered services unless clearly agreed upon.
CMS Guidance
CMS supports streamlined enrollment for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state programs focused on expanding access to primary care.
State-Specific Notes
Collaboration opportunities exist with Oklahoma Medicaid Managed Care Organizations for DPC integration.
Dispensing Medication
Board of Pharmacy Official Link: https://www.ok.gov/pharmacy/
State Licensing
Physicians must register with the Oklahoma Board of Pharmacy and Medical Board to dispense controlled substances.
Scope of Practice
Dispensing is allowed within the physician’s scope of practice; controlled substances require strict compliance.
Inventory Management
Secure storage and accurate inventory tracking are mandatory for all dispensed medications.
Record-Keeping
Records must comply with Oklahoma state and federal HIPAA regulations.
Dispensing Standards
Labels must include patient name, prescribing physician, and dosage as per Oklahoma standards.
Controlled Substances
DEA registration and mandatory reporting to Oklahoma’s PMP are required for controlled substances.
Billing and Reimbursement
Billing practices must comply with Oklahoma-specific laws and federal anti-kickback statutes.
Federal Compliance
Adherence to FDA, DEA, and OSHA standards is mandatory for dispensing medications.
State Pharmacy Laws
Physicians must comply with Oklahoma Board of Pharmacy laws for dispensing controlled substances.
Patient Consent
Patient consent is required prior to dispensing medications.
Insurance and Liability
Liability insurance must cover risks associated with dispensing activities.
Training Requirements
Continuing education for compliance with Oklahoma controlled substances laws is recommended.
Audits and Inspections
Inspections are conducted by the Oklahoma Board of Pharmacy, with penalties for non-compliance.