Okla. Stat. tit. 63, § 63-2550.4

This is the official text of Okla. Stat. tit. 63, § 63-2550.4, 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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Nonformulary or prior-authorized drugs - Approval

Official statutory text

A. A managed care plan that has a closed formulary or that

requires prior authorization to obtain certain drugs shall approve

or disapprove a provider’s or a covered person’s request for a

nonformulary drug or a drug that requires prior authorization within

twenty-four (24) hours of receipt of such request.

B. If the managed care plan does not render a decision within

twenty-four (24) hours, the provider or covered person shall be

entitled to a seventy-two-hour supply of the drug. The managed care

plan shall then approve or disapprove the request for a nonformulary

Oklahoma Statutes - Title 63. Public Health and Safety Page 1402

drug or prior authorized drug within the additional seventy-two-hour

period.

C. Failure of the managed care plan to respond within the

subsequently allowed seventy-two-hour period shall be deemed as

approval of the request for the nonformulary drug or prior

authorized drug; provided, however, the approval shall be subject to

the terms of the managed care plan’s drug formulary; provided

further, the purchase of the approved drug shall be at no additional

cost to the covered person beyond what the covered person would

otherwise pay for a prescription pursuant to the managed care plan.

D. All providers and covered persons in a managed care plan

shall be provided with a copy of the plan’s drug prior authorization

process upon initial contracting or enrollment and at the time of

enactment of any subsequent changes to the process.

Status: in_force · Read it on the official government site

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