Okla. Stat. tit. 36, § 36-1219.6

restricting methods – Notice of fees.

A. As used in this section:

1. “Health maintenance organization” means an entity that is

organized for the purpose of providing or arranging health care,

which has been granted a certificate of authority by the Insurance

Commissioner as a health maintenance organization pursuant to the

Health Maintenance Organization Act of 2003;

2. “Credit card payment” means a type of electronic funds

transfer in which a health insurance plan or health insurer or its

contracted vendor issues a single-use series of numbers associated

with the payment of health care services performed by a health care

provider and chargeable to a predetermined dollar amount, whereby

the health care provider is responsible for processing the payment

by a credit card terminal or Internet portal. Such term shall

include virtual or online credit card payments, whereby no physical

Oklahoma Statutes - Title 36. Insurance Page 300

credit card is presented to the health care provider and the single-

use credit card expires upon payment processing;

3. “Electronic funds transfer payment” means a payment by any

method of electronic funds transfer other than through the Automated

Clearing House Network (ACH), as codified in 45 C.F.R., Sections

162.1601 and 162.1602;

4. “Health care provider” means any physician, dentist,

pharmacist, optometrist, psychologist, registered optician, licensed

professional counselor, physical therapist, chiropractor, hospital

or other entity or person that is licensed or otherwise authorized

in this state to furnish health care services;

5. “Health care provider agent” means a person or entity that

contracts with a health care provider establishing an agency

relationship to process bills for services provided by the health

care provider under the terms and conditions of a contract between

the agent and health care provider. Such contracts may permit the

agent to submit bills, request reconsideration and receive

reimbursement;

6. “Health care services” means the examination or treatment of

persons for the prevention of illness or the correction or treatment

of any physical or mental condition resulting from illness, injury

or other human physical problem and includes, but is not limited to:

a. hospital services which include the general and usual

services and care, supplies and equipment furnished by

hospitals,

b. medical services which include the general and usual

services and care rendered and administered by doctors

of medicine, doctors of dental surgery and doctors of

podiatry, and

c. other health care services which include appliances

and supplies; nursing care by a registered nurse or a

licensed practical nurse; care furnished by such other

licensed practitioners; institutional services

including the general and usual care, services,

supplies and equipment furnished by health care

institutions and agencies or entities other than

hospitals; physiotherapy; ambulance services; drugs

and medications; therapeutic services and equipment

including oxygen and the rental of oxygen equipment;

hospital beds; iron lungs; orthopedic services and

appliances including wheelchairs, trusses, braces,

crutches and prosthetic devices including artificial

limbs and eyes; and any other appliance, supply or

service related to health care;

7. “Health insurance plan” means any hospital or medical

insurance policy or certificate; qualified higher deductible health

plan; health maintenance organization subscriber contract; contract

Oklahoma Statutes - Title 36. Insurance Page 301

providing benefits for dental care whether such contract is pursuant

to a medical insurance policy or certificate; stand-alone dental

plan, health maintenance provider contract or managed health care

plan; and

8. “Health insurer” means any entity or person that issues

health insurance plans, as defined in this section.

B. Any health insurance plan issued, amended or renewed on or
e Page 301

providing benefits for dental care whether such contract is pursuant

to a medical insurance policy or certificate; stand-alone dental

plan, health maintenance provider contract or managed health care

plan; and

8. “Health insurer” means any entity or person that issues

health insurance plans, as defined in this section.

B. Any health insurance plan issued, amended or renewed on or

after January 1, 2020, between a health insurer or its contracted

vendor or a health maintenance organization and a health care

provider for the provision of health care services to a plan

enrollee shall not contain restrictions on methods of payment from

the health insurer or its vendor or the health maintenance

organization to the health care provider in which the only

acceptable payment method is a credit card payment.

C. If initiating or changing payments to a health care provider

using a credit card, a health insurance plan, health insurer or its

contracted vendor, or health maintenance organization shall:

1. Notify the health care provider of any fees associated with

a particular payment method; and

2. Advise the health care provider of the available methods of

payment and provide clear instructions on how to select a preferred

method of payment.

D. If initiating or changing payments to a health care provider

using electronic funds transfer payments, including virtual credit

card payments, a health insurance plan, health insurer or its

contracted vendor, or health maintenance organization shall:

1. Notify the health care provider of any fees that are

associated with a particular payment method; and

2. Advise the provider of the available methods of payment and

provide clear instructions to the health care provider as to how to

select an alternative payment method.

E. A health insurance plan, health insurer or its contracted

vendor, or health maintenance organization that initiates or changes

payments to a health care provider through the Automated Clearing

House Network, as codified in 45 C.F.R., Sections 162.1601 and

162.1602, shall not charge a fee solely to transmit the payment to a

health care provider unless the health care provider has consented

to the fee. A health care provider agent may charge reasonable fees

when transmitting an Automated Clearing House Network payment

related to transaction management, data management, portal services

and other value-added services in addition to the bank transmittal.

F. The provisions of this section shall not be waived by

contract, and any contractual clause in conflict with the provisions

of this section or that purport to waive any requirements of this

section are void.

G. Violations of this section shall be subject to enforcement

by the Insurance Commissioner.

Oklahoma Statutes - Title 36. Insurance Page 302