Naloxone dispensing via pharmacist standing order
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Defines pharmacist authority, requirements, eligible recipients, formulations, and dispensing instructions for naloxone under a statewide standing order for SoonerCare members in Oklahoma.
No material clinical or coverage changes in this revision.
Coverage Criteria
Covered when dispensed under standing order
Covered when ALL of the following are met
Products dispensed under the statewide standing order must be FDA-approved and also covered by SoonerCare to be included in the standing order. Over-the-counter naloxone products may be covered when they meet these same guidelines; naloxone products that are not FDA-approved or not covered by SoonerCare are not included under this standing order.
Initial Administration and Dispensing
Initial administration
Initial dispensing and administration guidance
Quantity Limits
Coding
| No codes listed |
Provider Actions & Pharmacy Responsibilities
No physician visit required
No physician visit or prior authorization is required. Pharmacists practicing in a contracted, Oklahoma‑licensed pharmacy may initiate a prescription, dispense naloxone under the statewide standing order, and be reimbursed for the dispensed product.
Pharmacy obligations
When dispensing naloxone under the standing order, pharmacists must comply with all Oklahoma State Board of Pharmacy requirements and provide patient counseling and additional overdose‑education resources (for example, OSDH materials linked in the standing order).
- Provide patient counseling at dispensing.
- Provide additional resources on drug overdose and naloxone use (OSDH links noted in standing order).
Standing order retention and prescriber designation
The pharmacy must keep a copy of the standing order on site and must designate the prescriber named in the standing order as the designated physician for prescriptions issued under the order.
- Maintain a copy of the standing order at the pharmacy.
- Designate the prescriber as the designated physician pursuant to the standing order.
Noncompliance risk
Failure to follow Oklahoma State Board of Pharmacy rules for prescription orders, labeling, recordkeeping, and counseling when dispensing under the standing order could jeopardize lawful dispensing and reimbursement.
- Noncompliance with prescription order, labeling, recordkeeping, or counseling requirements risks penalties or denial of reimbursement.
Definitions
Site of Care
Pharmacist must practice in an Oklahoma-licensed pharmacy located in Oklahoma
Pharmacists may only initiate prescriptions and dispense naloxone under the standing order if they are practicing in an Oklahoma-licensed pharmacy located in Oklahoma.
- Pharmacist must maintain a current active license
- Pharmacy must be located in Oklahoma and be Oklahoma-licensed
Background
Naloxone is an opioid antagonist used to reverse suspected opioid overdose. Rapid administration via intranasal spray or injectable routes is critical, with injectables supplied with appropriate administration supplies. Recipients must receive basic patient education including overdose risk factors, recognition of overdose, response steps, proper naloxone use, and the need for comprehensive substance abuse treatment. The standing order became effective May 1, 2023.
Revision History
Statewide naloxone standing order became effective (standing order signed, authorizing pharmacists to prescribe and dispense listed FDA‑approved naloxone products under the order).
OHCA issued HealthChoice Oklahoma notice (OHCA 2023-15) announcing SoonerCare coverage of naloxone products and the pharmacist standing order allowing initiation of prescriptions and reimbursement without a physician visit.
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