Okla. Stat. tit. 36, § 36-1219.3
This is the official text of Okla. Stat. tit. 36, § 36-1219.3, part of Oklahoma’s Stat. tit. 36, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 36,." Browse the sections below, each linked to its official government source.
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Discounted reimbursement and disclosure of
Official statutory text
reimbursement terms prohibited.
A. An insurer or third-party administrator shall not reimburse
a health care provider on a discounted fee basis for covered
services that are provided to an insured unless:
1. The insurer or third-party administrator has contracted with
either:
a. the health care provider, or
b. a preferred provider organization which has contracted
with the health care provider;
2. The health care provider has agreed to provide health care
services under the terms of the contract; and
3. The insurer or third-party administrator has agreed to
provide coverage for those health care services under an accident
and health insurance policy.
B. A party to a preferred provider contract, including a
contract with a preferred provider organization, may not sell,
lease, or otherwise transfer information regarding the payment or
reimbursement terms of the contract without the express authority
and prior adequate notification of the other contracting parties.
A. An insurer or third-party administrator shall not reimburse
a health care provider on a discounted fee basis for covered
services that are provided to an insured unless:
1. The insurer or third-party administrator has contracted with
either:
a. the health care provider, or
b. a preferred provider organization which has contracted
with the health care provider;
2. The health care provider has agreed to provide health care
services under the terms of the contract; and
3. The insurer or third-party administrator has agreed to
provide coverage for those health care services under an accident
and health insurance policy.
B. A party to a preferred provider contract, including a
contract with a preferred provider organization, may not sell,
lease, or otherwise transfer information regarding the payment or
reimbursement terms of the contract without the express authority
and prior adequate notification of the other contracting parties.
Status: in_force · Read it on the official government site
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