Title 36 — Title 36 — Insurance

entity — Default rate — Payment. A. A local governmental entity, or ambulance service provider operating on its behalf, may annually submit to the Insurance Department, in the form and manner prescribed by the Insurance Commissioner, the ambulance service rates set or approved, w…

reimbursement. Notwithstanding any provision of any individual or group policy, contract, plan or agreement of accident and/or health insurance or any provisions of a policy, contract, plan or agreement for hospital or medical service or indemnity, whenever such policy, contract,…

Penalty - Rules. A. Any policy, contract or agreement issued or renewed by an insurer, as defined in Section 6054 of Title 36 of the Oklahoma Statutes, or any contract or agreement issued or renewed for any preferred provider or other provider arrangement or managed care plan, wh…

A. Sections 6053 through 6057 of this title and Sections 6 through 9 of this act shall be known and may be cited as the “Health Care Freedom of Choice Act”. B. The provisions of the Health Care Freedom of Choice Act shall not apply to contracts executed with a preferred provider …

As used in the Health Care Freedom of Choice Act: 1. “Accident and health insurance policy” or “policy” means any policy, certificate, contract, agreement or other instrument that provides accident and health insurance, as defined in Section 703 of this title, to any person in th…

Freedom of choice - Exclusions - Compensation of practitioners - Decisions to authorize or deny emergency services. A. Under any accident and health insurance policy, hereafter renewed or issued for delivery from out of Oklahoma or in Oklahoma by any insurer and covering an Oklah…

Services and procedures covered under an accident and health insurance policy may be performed at any hospital, home care agency or ambulatory surgical center where a practitioner is authorized to practice, doctor's office or clinic, at the choice of the insured, or the insured's…

act. A. Any provision, exclusion or limitation in an accident and health insurance policy which: 1. Denies an insured, or the insured's parent or guardian if the insured is a minor, the free choice of any practitioner or the use of any hospital, home care agency or ambulatory sur…

Attorneys’ fees. A. In order to enforce the provisions of the Health Care Freedom of Choice Act, the Insurance Commissioner may conduct an examination of insurers’ and preferred provider organizations’ claims files pursuant to the procedure set forth in Section 1250.4 of this tit…

For any violation of the Health Care Freedom of Choice Act, the Insurance Commissioner may, after notice and opportunity hearing, subject an insurer or practitioner to an administrative penalty of not less than One Hundred Dollars ($100.00) nor more than Five Thousand Dollars ($5…

Any insurer or practitioner affected by an order of the Insurance Commissioner issued pursuant to the Health Care Freedom of Choice Act may seek judicial review of such order pursuant to Article II of the Administrative Procedures Act. Added by Laws 1999, c. 331, § 8, eff. Nov. 1…

The Insurance Commissioner shall promulgate rules for the implementation and administration of the Health Care Freedom of Choice Act. Added by Laws 1999, c. 331, § 9, eff. Nov. 1, 1999.

members – Meetings – Reimbursement of travel expenses – Recommendations and report. A. There is hereby created to continue until February 1, 2006, the Surgical Patient Choice Task Force. 1. The Task Force shall consist of ten (10) members. 2. Of the ten members: a. three shall be…

A. All individual and group health insurance policies providing coverage on an expense incurred, fixed, or capitated basis, and all individual and group insurance policies, certificates, service or indemnity type contracts issued by insurance companies, health maintenance organiz…

Noncustodial parents. A. Notwithstanding any other provision of law, an insurer shall not deny enrollment of a child under the health plan of the child's parent on the grounds that: 1. The child was born out of wedlock; 2. The child is not claimed as a dependent on the parent's f…

A. All individual and group health insurance policies providing coverage on an expense incurred, fixed, or capitated basis, and all individual and group insurance policies, certificates, service or indemnity type contracts issued by insurance companies, health maintenance organiz…

A. No person shall act as an insurer and no insurer shall transact insurance in Oklahoma except as authorized by a subsisting authority granted to it by the Insurance Commissioner, except as to such transactions as are expressly otherwise provided for in this Code. B. No such aut…

insurers - Requirements and procedures. A. 1. Any foreign or alien insurer which is organized under the laws of any other jurisdiction for the purpose of transacting insurance may become a domestic insurer by complying with all of the requirements of law relative to the organizat…

A. For the purposes of this section: 1. "Breast magnetic resonance imaging" means a diagnostic tool used to produce detailed pictures of the structure of the breast; 2. "Breast ultrasound" means a noninvasive, diagnostic imaging technique that uses high-frequency sound waves to p…

A. All individual and group health insurance policies providing coverage on an expense incurred basis, and all individual and group service or indemnity type contracts issued by a nonprofit corporation which provide coverage for a female forty-five (45) years of age or older in t…

As used in this act: 1. "Base period" means the period of coverage pursuant to the issuance or renewal of a health benefit plan that is required to provide benefits pursuant to the provisions of Section 6060.11 of this title; 2. "Health benefit plan" means any plan or arrangement…

A. 1. No health benefit plan shall deny coverage, refuse to issue or renew, cancel or otherwise terminate, restrict or exclude any person from any health benefit plan issued or renewed on or after November 1, 2010, on the basis of the applicant’s or insured’s status as a victim o…

A. Subject to the limitations set forth in this section and Sections 6060.12 and 6060.13 of this title, any health benefit plan that is offered, issued, or renewed in this state on or after January 1, 2000, shall provide benefits for treatment of mental health and substance use d…

network behavioral health care providers. A. For the purposes of this act: 1. “Health benefit plan” means a health benefit plan as defined pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; 2. “Health care provider” or “provider” means a health care provider as defi…

behavioral health integration and psychiatric collaborative care models. A. For the purposes of this section: 1. “Behavioral health integration” means an approach to delivering mental health care that improves the ability for primary care providers to include mental and behaviora…

cost. 1. A health benefit plan that, at the end of its base period, experiences a greater than two percent (2%) increase in premium costs pursuant to providing benefits for treatment of mental health and substance use disorders shall be exempt from the provisions of Section 6060.…

report by Commissioner. A. The Insurance Commissioner shall analyze any direct incremental impact on premium costs pursuant to the requirements of Section 6060.11 of this title. The Commissioner shall submit a report of all preliminary data and findings to the Governor, the Presi…

This act shall be known and may be cited as the "Health Savings Account Act". Added by Laws 2005, c. 306, § 1, eff. Nov. 1, 2005.

As used in this act: 1. "Deductible" means the total deductible for an eligible individual and all the dependents of that eligible individual for a calendar year; 2. "Dependent" means the spouse or child of the eligible individual as defined in Section 152 of the Internal Revenue…

A. The provisions of this act shall also apply to taxpayers who are not receiving preferred federal tax treatment for a health savings account pursuant to Section 223 of the Internal Revenue Code. B. For taxable years beginning after 2005, a resident of Oklahoma or an employer sh…

The trustee or custodian shall utilize the funds held in a health savings account solely for the following purposes: 1. To pay the qualified medical expenses of the eligible individual or their dependents; or 2. To purchase a health coverage policy certificate, or contract, if th…

A. Notwithstanding paragraphs C, D, E, and F of this section, an eligible individual may withdraw money from their health savings account for any purpose other than a purpose described in Section 6060.17 of this title. B. If the eligible individual withdraws money for any purpose…

services. A. 1. Every health benefit plan issued or renewed on or after November 1, 1996, shall, subject to the terms of the policy contract or agreement, include coverage for the following equipment, supplies and related services for the treatment of Type I, Type II, and gestati…

A. All individual and group health insurance policies that provide medical and surgical benefits shall provide the same coverage and benefits to any individual under the age of eighteen (18) years who has been diagnosed with an autistic disorder as it would provide coverage and b…

disorder. A. For all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan shall provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals. No insurer shall termina…

spectrum disorder coverage. A. 1. A health benefit plan that, at the end of its base period, experiences a greater than one percent (1%) increase in premium costs pursuant to providing applied behavior analysis for treatment of autism spectrum disorders shall be exempt from the p…

A. Every health benefit plan issued, amended, renewed or delivered in this state on or after July 1, 1996, that provides maternity benefits shall provide for coverage of: 1. A minimum of forty-eight (48) hours of inpatient care at a hospital, or a birthing center licensed as a ho…

No insurer in this state shall refuse to insure, or refuse to continue to insure, or limit the amount, extent or kind of coverage available for life insurance, disability insurance or long-term care insurance to an individual, or charge an individual a different rate for the same…

A. Any health benefit plan, including the State and Education Employees Group Health Insurance plan, that is offered, issued or renewed in this state on or after January 1, 2005, that provides medical and surgical benefits shall provide coverage for routine annual obstetrical/gyn…

A. As used in this section: 1. “Contraceptive drugs” means all drugs approved by the United States Food and Drug Administration that are used to prevent pregnancy including but not limited to hormonal drugs administered orally, transdermally, and intravaginally; and 2. “Health be…

A. A health benefit plan delivered, issued for delivery or renewed in this state on or after January 1, 1998, that provides benefits for the dependents of an insured individual shall provide coverage for each child of the insured, from birth through the date the child is eighteen…

This act shall be known and may be cited as the "Oklahoma Right to Shop Act". Added by Laws 2022, c. 151, § 1.

As used in the Oklahoma Right to Shop Act: 1. "Allowed amount" means the contractually agreed-upon amount paid by a carrier to a health care entity participating in the network of the carrier; 2. "Comparable health care service" means any covered nonemergency health care service …

A. An insurance carrier may offer a shared savings incentive program to provide incentives to an enrollee when the enrollee obtains a comparable health care service that is covered by the carrier from providers that charge less than the average allowed amount paid by that carrier…

The Insurance Department shall promulgate necessary rules for the implementation of the Oklahoma Right to Shop Act. Added by Laws 2022, c. 151, § 4.

The Office of Management and Enterprise Services shall conduct an analysis no later than November 1, 2022, of the cost- effectiveness of implementing a shared savings incentive program, as defined in paragraph 6 of Section 2 of this act, for current enrollees of the Oklahoma Empl…

detention. A. No health benefit plan, including, but not limited to, the State and Education Employees Group Health Insurance Plan, that is offered, issued or renewed in the state on or after January 1, 2009, shall exclude otherwise allowable claims which occur in conjunction wit…

A. As used in this section: 1. “Health benefit plan” has the same meaning as provided by Section 6060.4 of Title 36 of the Oklahoma Statutes; and 2. “Medically necessary” means services or supplies provided by a health care provider that are: a. provided for the diagnosis of syph…

A. This section shall be known and may be cited as the "Oklahoma Breast Cancer Patient Protection Act". B. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 1998, that provides medical and surgical benefits with respect to the treatme…

As used in this section: 1. “Health benefit plan” means group hospital coverage, individual and group medical insurance coverage, a not-for-profit hospital or medical service or indemnity plan, a prepaid health plan, a health maintenance organization plan, a preferred provider or…