Okla. Stat. tit. 36, § 36-6554
This is the official text of Okla. Stat. tit. 36, § 36-6554, 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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Exemptions - Review of patients eligible under Social
Official statutory text
Security - In-house utilization review.
Oklahoma Statutes - Title 36. Insurance Page 1300
A. The Insurance Commissioner shall waive the requirements of
the Hospital and Medical Services Utilization Review Act for the
activities of a private review agent in connection with a contract
with the federal or state government for utilization review of
patients eligible for hospital and medical services under the Social
Security Act.
B. No certificate is required for those private review agents
conducting general in-house utilization review for hospitals, home
health agencies, preferred provider organizations, or other managed
care entities, clinics, private offices or any other health facility
or entity, so long as the review does not result in the approval or
denial of payment for hospital or medical services for a particular
case. Such general in-house utilization review shall be exempt from
all provisions of the Hospital and Medical Services Utilization
Review Act.
Oklahoma Statutes - Title 36. Insurance Page 1300
A. The Insurance Commissioner shall waive the requirements of
the Hospital and Medical Services Utilization Review Act for the
activities of a private review agent in connection with a contract
with the federal or state government for utilization review of
patients eligible for hospital and medical services under the Social
Security Act.
B. No certificate is required for those private review agents
conducting general in-house utilization review for hospitals, home
health agencies, preferred provider organizations, or other managed
care entities, clinics, private offices or any other health facility
or entity, so long as the review does not result in the approval or
denial of payment for hospital or medical services for a particular
case. Such general in-house utilization review shall be exempt from
all provisions of the Hospital and Medical Services Utilization
Review Act.
Status: in_force · Read it on the official government site
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