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Code · Oklahoma · Title 36 — Insurance

§36-6556. Health insurance plans - Certification or contract with

118 words·~1 min read·/ok/title-36-insurance/36-6556·

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certified private review agent - Exceptions.
Every health insurance plan which proposes to administer a health benefits program that provides for the coverage of hospital and/or medical benefits and the utilization review of those benefits shall:
1. Be certified in accordance with the Hospital and Medical Services Utilization Review Act; or
2. Contract with a private review agent who is certified in accordance with the Hospital and Medical Services Utilization Review Act.
The provisions of this section shall not apply to insurance companies and not-for-profit hospital services and medical indemnity plans, licensed by the Commissioner to transact insurance in this state, that perform in-house utilization review. Added by Laws 1991, c. 294, § 6, eff. Nov. 1, 1991.
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