Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 18 - GENETIC COUNSELORS
Section 317:30-5-221 - Coverage

Universal Citation: OK Admin Code 317:30-5-221

Current through Vol. 42, No. 1, September 16, 2024

(a) Genetic counseling services are covered for SoonerCare members who meet the criteria for receiving medically necessary genetic testing as set forth in 317:30-5-2(a)(1)(FF) and for pregnant/postpartum SoonerCare members as set forth in this section. Services for pregnant/postpartum SoonerCare members must be referred by a provider involved in the provision of obstetric or pediatric care. Members are eligible for genetic counseling during pregnancy which includes twelve (12) months postpartum. Reasons for genetic counseling include but are not limited to the following:

(1) Advanced maternal age;

(2) Abnormal maternal serum first or second screening;

(3) Previous child or current fetus/infant with an abnormality;

(4) Consanguinity/incest;

(5) Parent is a known carrier or has a family history of a genetic condition;

(6) Parent was exposed to a known or suspected reproductive hazard;

(7) Previous fetal demise, stillbirth, or neonatal death involving known/suspected abnormalities;

(8) History of recurrent pregnancy loss; or

(9) Parent(s) are in an ethnic or racial group associated with an increased risk for specific genetic conditions.

(b) These services may be provided in an office or outpatient setting.

Added at 25 Ok Reg 428, eff 11-1-07 (emergency); Added at 25 Ok Reg 1161, eff 5-25-08 ; Amended at 27 Ok Reg 294, eff 11-3-09 (emergency); Amended at 27 Ok Reg 1439, eff 6-11-10 ; Amended at 30 Ok Reg 1143, eff 7-1-13

Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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