SoonerCare Will Honor a SoonerSelect Prior Auth for 90 Days After a Member Moves

OHCA Letter 2026-20 sets a 90-day clock, a 30-day clock if the child already switched plans, and a trap for services the plan never authorized.

The Oklahoma Health Care Authority issued Provider Letter 2026-20 on October 27 to tell providers how authorizations travel when a member moves between a SoonerSelect plan and SoonerCare fee-for-service. The letter doesn’t name ABA. It governs any service that needed prior authorization, and ABA does.

Three scenarios, three clocks

SoonerSelect to SoonerCare. SoonerCare “will honor previously authorized services that have received a medical necessity determination by the SoonerSelect CE for up to 90 days without requiring a new medical necessity determination.” (“CE” is the contracted entity, meaning the plan.) You still have to submit prior authorization information to SoonerCare, with the plan’s approval letter for that specific service.

Plan to plan to SoonerCare. If the member is inside an active 90-day transition-of-care authorization from one SoonerSelect plan to another and then moves to SoonerCare in that window, OHCA honors the plan authorization for up to 30 days.

Complex changes. SoonerCare reviews these case by case, and the timeframe “will vary.”

In the first two scenarios there is one trap. If the plan required no prior authorization, or never made a medical necessity determination for that service code, SoonerCare “will not issue a transition of care PA” but will make its own medical necessity determination. Nothing carries over, because nothing existed.

Where this bites ABA

An ABA authorization usually runs several months and is built on a specific hour request per code. The letter gives you a clock, 90 days or 30, and a document to produce, the plan’s approval letter. It does not say that SoonerCare will authorize the same hours afterward, only that it won’t reopen medical necessity during the window. Plan your reassessment inside that window.

OHCA’s helpline for questions is 800-522-0114.

What you must know or do

  • Billing leads: For every Oklahoma client on a SoonerSelect plan, store the plan’s approval letter with the authorization number and date, not just the portal screenshot. If the child moves to SoonerCare, that letter is what OHCA asks for.
  • Clinical directors: The day you learn of a coverage change, put a date 90 days out (30 if the child had already changed plans) on the calendar and schedule the reassessment and new SoonerCare request before it.
  • Intake: Check on your open authorizations where the plan never required prior authorization. Those children get no carried-over approval and a fresh determination.