Okla. Stat. tit. 56, § 56-4006
This is the official text of Okla. Stat. tit. 56, § 56-4006, part of Oklahoma’s Stat. tit. 56, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 56,." Browse the sections below, each linked to its official government source.
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Mental health and substance use disorder coverage —
Official statutory text
Parity analysis.
A. For Medicaid managed care plans, the Oklahoma Health Care
Authority shall ensure that the insurers, health plans, and managed
care plans comply with federal and state laws, rules, and
regulations applicable to coverage for mental health or substance
use disorder services.
B. Contracts with Medicaid managed care plans must require
entities to conduct regular parity compliance analysis that contain
the information described in 42 U.S.C., Section 300gg–26(a)(8)(i-v)
for each nonquantitative treatment limitation imposed on mental
health or substance use disorder benefits in any classification of
care.
C. Contracts with Medicaid managed care plans must include
language requiring managed care plans and entities to conduct parity
analysis described in subsection B of this section for a
nonquantitative treatment limitation whenever as-written or in-
operation changes or amendments are made to that nonquantitative
treatment limitation, including prior authorization requirements.
D. State Medicaid programs and Children's Health Insurance
Programs (CHIP) must review and compile the analysis from all
managed care, CHIP, and alternative benefit plans to ensure
compliance and address any noncompliance through a standardized
process to mitigate findings of noncompliance.
E. The Oklahoma Health Care Authority shall develop a
standardized process for receiving, investigating, substantiating,
and resolving parity complaints.
F. The Oklahoma Health Care Authority shall make public the
surveys, financial analysis, managed care contract audits, de-
identified substantiated parity complaints, and parity reports
prepared by the managed care entities and plans and the reports they
submit to document parity compliance.
G. The Oklahoma Health Care Authority shall also make public
any parity analysis, summary, or report submitted to the Centers for
Medicare and Medicaid Services regarding the Oklahoma Medicaid
managed care program within thirty (30) days of the state's
submission of these reports to the Centers for Medicare and Medicaid
Services.
A. For Medicaid managed care plans, the Oklahoma Health Care
Authority shall ensure that the insurers, health plans, and managed
care plans comply with federal and state laws, rules, and
regulations applicable to coverage for mental health or substance
use disorder services.
B. Contracts with Medicaid managed care plans must require
entities to conduct regular parity compliance analysis that contain
the information described in 42 U.S.C., Section 300gg–26(a)(8)(i-v)
for each nonquantitative treatment limitation imposed on mental
health or substance use disorder benefits in any classification of
care.
C. Contracts with Medicaid managed care plans must include
language requiring managed care plans and entities to conduct parity
analysis described in subsection B of this section for a
nonquantitative treatment limitation whenever as-written or in-
operation changes or amendments are made to that nonquantitative
treatment limitation, including prior authorization requirements.
D. State Medicaid programs and Children's Health Insurance
Programs (CHIP) must review and compile the analysis from all
managed care, CHIP, and alternative benefit plans to ensure
compliance and address any noncompliance through a standardized
process to mitigate findings of noncompliance.
E. The Oklahoma Health Care Authority shall develop a
standardized process for receiving, investigating, substantiating,
and resolving parity complaints.
F. The Oklahoma Health Care Authority shall make public the
surveys, financial analysis, managed care contract audits, de-
identified substantiated parity complaints, and parity reports
prepared by the managed care entities and plans and the reports they
submit to document parity compliance.
G. The Oklahoma Health Care Authority shall also make public
any parity analysis, summary, or report submitted to the Centers for
Medicare and Medicaid Services regarding the Oklahoma Medicaid
managed care program within thirty (30) days of the state's
submission of these reports to the Centers for Medicare and Medicaid
Services.
Status: in_force · Read it on the official government site
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