Okla. Stat. tit. 36, § 36-6570.5
This is the official text of Okla. Stat. tit. 36, § 36-6570.5, 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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Prior Authorization Application Programming Interface
Official statutory text
requirement.
A. For plan years beginning on or after January 1, 2027, a
health benefit plan must implement and maintain a Prior
Authorization Application Programming Interface (API), as described
in 45 C.F.R. Part 156.
B. By July 1, 2027, health care providers must have electronic
health records or practice management systems that are compatible
with the API.
C. As of the effective date of this act, a utilization review
entity must provide health care providers with the following
opportunities for communication during the prior authorization
process:
1. Make staff available at least eight (8) hours a day during
normal business hours for inbound telephone calls regarding prior
authorization issues;
2. Allow staff to receive inbound communication regarding prior
authorization issues after normal business hours; and
3. Provide a treating provider with the opportunity to discuss
a prior authorization denial with an appropriate reviewer.
A. For plan years beginning on or after January 1, 2027, a
health benefit plan must implement and maintain a Prior
Authorization Application Programming Interface (API), as described
in 45 C.F.R. Part 156.
B. By July 1, 2027, health care providers must have electronic
health records or practice management systems that are compatible
with the API.
C. As of the effective date of this act, a utilization review
entity must provide health care providers with the following
opportunities for communication during the prior authorization
process:
1. Make staff available at least eight (8) hours a day during
normal business hours for inbound telephone calls regarding prior
authorization issues;
2. Allow staff to receive inbound communication regarding prior
authorization issues after normal business hours; and
3. Provide a treating provider with the opportunity to discuss
a prior authorization denial with an appropriate reviewer.
Status: in_force · Read it on the official government site
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