Okla. Stat. tit. 63, § 63-2200.32
This is the official text of Okla. Stat. tit. 63, § 63-2200.32, part of Oklahoma’s Stat. tit. 63, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 63,." Browse the sections below, each linked to its official government source.
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Prohibited actions by health carriers
Official statutory text
A. For purposes of this section:
1. "Covered person" means a policyholder, subscriber, enrollee,
member or individual covered by a health benefit plan;
2. "Health benefit plan" means a policy, contract, certificate,
or agreement entered into, offered or issued by a health carrier to
provide, deliver, arrange for, pay for or reimburse any of the costs
of health care services. Health benefit plan shall not include a
plan providing coverage for excepted benefits and short term
policies that have a term of less than twelve (12) months; and
Oklahoma Statutes - Title 63. Public Health and Safety Page 1375
3. "Health carrier" means an entity subject to the insurance
laws and regulations of this state, or subject to the jurisdiction
of the Insurance Commissioner, that contracts or offers to contract
to provide, deliver, arrange for, pay for or reimburse any of the
costs of health care services including through a health benefit
plan as defined in this section, and shall include a sickness and
accident insurance company, a health maintenance organization, a
preferred provider organization or any similar entity, or any other
entity providing a plan of health insurance or health benefits.
B. A health carrier that provides coverage for anatomical
gifts, organ transplants or related treatment and services shall
not:
1. Deny coverage to a covered person solely on the basis of the
person's disability;
2. Deny to a patient eligibility, or continued eligibility, to
enroll or to renew coverage under the terms of the health benefit
plan, solely for the purpose of avoiding the requirements of this
section;
3. Penalize or otherwise reduce or limit the reimbursement of
an attending provider, or provide monetary or nonmonetary incentives
to an attending provider, to induce such provider to provide care to
an insured or enrollee in a manner inconsistent with this section;
or
4. Reduce or limit coverage benefits to a patient for the
medical services or other services related to organ transplantation
performed pursuant to this section as determined in consultation
with the attending physician and patient.
C. In the case of a health benefit plan maintained pursuant to
one or more collective bargaining agreements between employee
representatives and one or more employers, any plan amendment made
pursuant to a collective bargaining agreement relating to the plan
which amends the plan solely to conform to any requirement imposed
pursuant to this section shall not be treated as a termination of
the collective bargaining agreement.
D. Nothing in this section shall be construed to require a
health carrier to provide coverage for a medically inappropriate
organ transplant.
E. The Insurance Commissioner shall promulgate rules to
implement the provisions of this section.
1. "Covered person" means a policyholder, subscriber, enrollee,
member or individual covered by a health benefit plan;
2. "Health benefit plan" means a policy, contract, certificate,
or agreement entered into, offered or issued by a health carrier to
provide, deliver, arrange for, pay for or reimburse any of the costs
of health care services. Health benefit plan shall not include a
plan providing coverage for excepted benefits and short term
policies that have a term of less than twelve (12) months; and
Oklahoma Statutes - Title 63. Public Health and Safety Page 1375
3. "Health carrier" means an entity subject to the insurance
laws and regulations of this state, or subject to the jurisdiction
of the Insurance Commissioner, that contracts or offers to contract
to provide, deliver, arrange for, pay for or reimburse any of the
costs of health care services including through a health benefit
plan as defined in this section, and shall include a sickness and
accident insurance company, a health maintenance organization, a
preferred provider organization or any similar entity, or any other
entity providing a plan of health insurance or health benefits.
B. A health carrier that provides coverage for anatomical
gifts, organ transplants or related treatment and services shall
not:
1. Deny coverage to a covered person solely on the basis of the
person's disability;
2. Deny to a patient eligibility, or continued eligibility, to
enroll or to renew coverage under the terms of the health benefit
plan, solely for the purpose of avoiding the requirements of this
section;
3. Penalize or otherwise reduce or limit the reimbursement of
an attending provider, or provide monetary or nonmonetary incentives
to an attending provider, to induce such provider to provide care to
an insured or enrollee in a manner inconsistent with this section;
or
4. Reduce or limit coverage benefits to a patient for the
medical services or other services related to organ transplantation
performed pursuant to this section as determined in consultation
with the attending physician and patient.
C. In the case of a health benefit plan maintained pursuant to
one or more collective bargaining agreements between employee
representatives and one or more employers, any plan amendment made
pursuant to a collective bargaining agreement relating to the plan
which amends the plan solely to conform to any requirement imposed
pursuant to this section shall not be treated as a termination of
the collective bargaining agreement.
D. Nothing in this section shall be construed to require a
health carrier to provide coverage for a medically inappropriate
organ transplant.
E. The Insurance Commissioner shall promulgate rules to
implement the provisions of this section.
Status: in_force · Read it on the official government site
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