Okla. Stat. tit. 63, § 63-2550.3
This is the official text of Okla. Stat. tit. 63, § 63-2550.3, 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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Termination of participating providers – Procedures and
Official statutory text
conditions.
A. Every managed care plan shall establish procedures
governing termination of a participating provider who is terminated
for reasons other than cause. The procedures shall include
assurance of continued coverage of services, at the contract terms
and price by a terminated provider for up to ninety (90) calendar
days from the date of notice to the covered person, for a covered
person who:
1. Has a degenerative and disabling condition or disease;
2. Has entered the third trimester of pregnancy. Additional
coverage of services by the terminated provider shall continue
through at least six (6) weeks of postpartum evaluation; or
3. Is terminally ill.
Oklahoma Statutes - Title 63. Public Health and Safety Page 1401
B. 1. If a participating provider voluntarily chooses to
discontinue participation as a network provider in a managed care
plan, the managed care plan shall permit a covered person to
continue an ongoing course of treatment with the disaffiliated
provider during a transitional period:
a. of up to ninety (90) days from the date of notice to
the managed care plan of the provider’s disaffiliation
from the managed care plan’s network, or
b. that includes delivery and postpartum care if the
covered person has entered the third trimester of
pregnancy at the time of the provider’s
disaffiliation.
2. If a provider voluntarily chooses to discontinue
participation as a network provider participating in a managed care
plan, such provider shall give at least a ninety-day notice of the
disaffiliation to the managed care plan. The managed care plan
shall immediately notify the disaffiliated provider’s patients of
that fact.
3. Notwithstanding the provisions of paragraph 1 of this
subsection, continuing care shall be authorized by the managed care
plan during the transitional period only if the disaffiliated
provider agrees to:
a. continue to accept reimbursement from the managed
care plan at the rates applicable prior to the start
of the transitional period as payment in full,
b. adhere to the managed care plan’s quality assurance
requirements and to provide to the managed care plan
necessary medical information related to such care,
and
c. otherwise adhere to the managed care plan’s policies
and procedures, including, but not limited to,
policies and procedures regarding referrals, and
obtaining preauthorization and treatment plan
approval from the managed care plan.
A. Every managed care plan shall establish procedures
governing termination of a participating provider who is terminated
for reasons other than cause. The procedures shall include
assurance of continued coverage of services, at the contract terms
and price by a terminated provider for up to ninety (90) calendar
days from the date of notice to the covered person, for a covered
person who:
1. Has a degenerative and disabling condition or disease;
2. Has entered the third trimester of pregnancy. Additional
coverage of services by the terminated provider shall continue
through at least six (6) weeks of postpartum evaluation; or
3. Is terminally ill.
Oklahoma Statutes - Title 63. Public Health and Safety Page 1401
B. 1. If a participating provider voluntarily chooses to
discontinue participation as a network provider in a managed care
plan, the managed care plan shall permit a covered person to
continue an ongoing course of treatment with the disaffiliated
provider during a transitional period:
a. of up to ninety (90) days from the date of notice to
the managed care plan of the provider’s disaffiliation
from the managed care plan’s network, or
b. that includes delivery and postpartum care if the
covered person has entered the third trimester of
pregnancy at the time of the provider’s
disaffiliation.
2. If a provider voluntarily chooses to discontinue
participation as a network provider participating in a managed care
plan, such provider shall give at least a ninety-day notice of the
disaffiliation to the managed care plan. The managed care plan
shall immediately notify the disaffiliated provider’s patients of
that fact.
3. Notwithstanding the provisions of paragraph 1 of this
subsection, continuing care shall be authorized by the managed care
plan during the transitional period only if the disaffiliated
provider agrees to:
a. continue to accept reimbursement from the managed
care plan at the rates applicable prior to the start
of the transitional period as payment in full,
b. adhere to the managed care plan’s quality assurance
requirements and to provide to the managed care plan
necessary medical information related to such care,
and
c. otherwise adhere to the managed care plan’s policies
and procedures, including, but not limited to,
policies and procedures regarding referrals, and
obtaining preauthorization and treatment plan
approval from the managed care plan.
Status: in_force · Read it on the official government site
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