§56-4002.3d. Selection of primary care provider by members.
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/ok/title-56-poor-persons/56-4002-3dA research copy — for the controlling text, always check the official state or federal source. Not legal advice.
A. Every Medicaid member enrolled in a contracted entity shall have the right to select his or her primary care provider and to change his or her primary care provider at any time, as long as the selected primary care provider is a participating provider. Any parent or guardian of a Medicaid member who is a minor child enrolled in a contracted entity shall have the right to select the primary care provider for the member's minor child and to change the primary care provider at any time, as long as the selected primary care provider is a participating provider.
B. If a member, or parent or guardian of a member who is a minor child, does not select a primary care provider, the contracted entity shall notify the member, parent, or guardian that he or she needs to select a primary care provider and shall send the member, parent, or guardian the name, contact information, employer, and any other applicable information as determined by the Oklahoma Health Care Authority of the three primary care providers nearest to the member's home address that are contracted with the contracted entity.
C. 1. If, after the contracted entity sends the information described in subsection B of this section, the member, parent, or guardian does not select a primary care provider within a time determined by the Authority, the contracted entity shall assign the member to a primary care provider in accordance with the process described in paragraph 2 of this subsection.
2. The Authority shall develop and implement a process for the assignment by contracted entities of Medicaid members who do not select a primary care provider to a primary care provider. The process shall prioritize existing patient-provider relationships and geographic proximity of the patient to the provider, and shall assign families to the same primary care provider to the extent possible. Added by Laws 2022, c. 395, § 6, eff. July 1, 2022.