Okla. Stat. tit. 36, § 36-6555
This is the official text of Okla. Stat. tit. 36, § 36-6555, 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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Rules - Forms - Issuance of certificate - Reporting
Official statutory text
requirements - Confidentiality.
A. The Insurance Commissioner may promulgate and adopt rules to
implement the provisions of this section.
B. The Commissioner shall develop standardized forms for
registration, performing and implementing certification requirements
pursuant to the Hospital and Medical Services Utilization Review
Act.
C. The Commissioner shall issue a certificate to an applicant
that has met all the requirements of the Hospital and Medical
Services Utilization Review Act and applicable rules.
D. The Commissioner may establish reporting requirements to:
1. Evaluate, based upon the information furnished pursuant to
the provisions of this act, the effectiveness of private review
agents; and
2. Determine if the utilization review programs are in
compliance with the provisions of the Hospital and Medical Services
Utilization Review Act and applicable rules.
E. Any information required by the Commissioner with respect to
customers, patients or utilization review procedures of a private
review agent shall be held in confidence and shall not be disclosed
to the public. However, a patient or a person with financial
responsibility for a patient's bill shall be entitled to information
and documents relating to them and their claim.
F. A certificate issued pursuant to the Hospital and Medical
Services Utilization Review Act is not transferable.
G. No individual conducting utilization review shall be
required to be certified if such utilization review is performed
within the scope of such person's employment with an entity already
certified pursuant to the Hospital and Medical Services Review Act.
Oklahoma Statutes - Title 36. Insurance Page 1301
A. The Insurance Commissioner may promulgate and adopt rules to
implement the provisions of this section.
B. The Commissioner shall develop standardized forms for
registration, performing and implementing certification requirements
pursuant to the Hospital and Medical Services Utilization Review
Act.
C. The Commissioner shall issue a certificate to an applicant
that has met all the requirements of the Hospital and Medical
Services Utilization Review Act and applicable rules.
D. The Commissioner may establish reporting requirements to:
1. Evaluate, based upon the information furnished pursuant to
the provisions of this act, the effectiveness of private review
agents; and
2. Determine if the utilization review programs are in
compliance with the provisions of the Hospital and Medical Services
Utilization Review Act and applicable rules.
E. Any information required by the Commissioner with respect to
customers, patients or utilization review procedures of a private
review agent shall be held in confidence and shall not be disclosed
to the public. However, a patient or a person with financial
responsibility for a patient's bill shall be entitled to information
and documents relating to them and their claim.
F. A certificate issued pursuant to the Hospital and Medical
Services Utilization Review Act is not transferable.
G. No individual conducting utilization review shall be
required to be certified if such utilization review is performed
within the scope of such person's employment with an entity already
certified pursuant to the Hospital and Medical Services Review Act.
Oklahoma Statutes - Title 36. Insurance Page 1301
Status: in_force · Read it on the official government site
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