Okla. Stat. tit. 36, § 36-6974
This is the official text of Okla. Stat. tit. 36, § 36-6974, 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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Credentials — Reimbursement and requirements for
Official statutory text
physicians and optometrists — Subcontracts.
A. 1. No agreement between an insurer or a prepaid vision plan
and a vision care provider shall require that a provider participate
with or be credentialed by any specific prepaid vision plan as a
condition for participation in the health care network of the
insurer to provide covered services to its enrollees.
2. In the event that a vision care provider is credentialed by
an insurer or vision care plan organization, no insurer or vision
care plan organization shall construe re-credentialing as re-
contracting with a vision care provider. All contracts shall be
distinct and separate documents from any credentialing materials.
B. Any insurer issuing or renewing a health benefit plan or
prepaid vision plan which provides coverage for services rendered by
a duly licensed physician or osteopath that are within the scope of
practice of a duly licensed optometrist shall provide the same
reimbursement for services to optometrists as allowed for those
services rendered by physicians or osteopaths.
C. No insurer or prepaid vision plan organization shall require
an optometrist to meet terms and conditions that are not required of
a physician or osteopath as a condition for participation in its
provider network for the provision of services that are within the
scope of practice of an optometrist.
D. If a vision care provider enters into any subcontract
agreement with another provider to provide his or her licensed
health care services to the enrollee, dependent of the enrollee, or
an enrollee of a managed care plan where the subcontracted provider
will bill the managed care plan or enrollee directly for the
subcontracted services, the subcontract agreement shall meet all
requirements of this act.
A. 1. No agreement between an insurer or a prepaid vision plan
and a vision care provider shall require that a provider participate
with or be credentialed by any specific prepaid vision plan as a
condition for participation in the health care network of the
insurer to provide covered services to its enrollees.
2. In the event that a vision care provider is credentialed by
an insurer or vision care plan organization, no insurer or vision
care plan organization shall construe re-credentialing as re-
contracting with a vision care provider. All contracts shall be
distinct and separate documents from any credentialing materials.
B. Any insurer issuing or renewing a health benefit plan or
prepaid vision plan which provides coverage for services rendered by
a duly licensed physician or osteopath that are within the scope of
practice of a duly licensed optometrist shall provide the same
reimbursement for services to optometrists as allowed for those
services rendered by physicians or osteopaths.
C. No insurer or prepaid vision plan organization shall require
an optometrist to meet terms and conditions that are not required of
a physician or osteopath as a condition for participation in its
provider network for the provision of services that are within the
scope of practice of an optometrist.
D. If a vision care provider enters into any subcontract
agreement with another provider to provide his or her licensed
health care services to the enrollee, dependent of the enrollee, or
an enrollee of a managed care plan where the subcontracted provider
will bill the managed care plan or enrollee directly for the
subcontracted services, the subcontract agreement shall meet all
requirements of this act.
Status: in_force · Read it on the official government site
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