Okla. Stat. tit. 63, § 63-5051.2
This is the official text of Okla. Stat. tit. 63, § 63-5051.2, 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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Right to reimbursement for medical services -
Official statutory text
Assignment to Oklahoma Health Care Authority.
A. Whenever the Oklahoma Health Care Authority pays for medical
services or renders medical services, for or on behalf of a person
who has been injured or suffered an illness or disease, the right of
the provider of the services to reimbursement shall be automatically
assigned to the Oklahoma Health Care Authority, upon notice to the
insurer or other party obligated as a matter of law or agreement to
reimburse the provider on behalf of the patient.
B. Upon the assignment, the Authority, for purposes of the
claim for reimbursement, becomes a provider of medical services.
C. The assignment of the right to reimbursement shall be
applied and considered valid against any employer or insurer under
the Administrative Workers’ Compensation Act in this state.
D. Each insurer, upon receiving a claim from the Oklahoma
Health Care Authority, shall accept the state’s right of recovery,
to process and, if appropriate, pay the claim to the same extent
that the plan would have been liable if it had been billed at the
point of sale or by the original provider of services. The insurer
shall not deny the Authority claims on the basis of the date of
submission, the format of the claim, or for failure to present
proper documentation of coverage at the point of sale.
E. An insurer or third-party administrator, except a Medicare
Advantage plan, shall not deny the Authority claims solely on the
basis that a claimed item or service did not receive prior
authorization under the rules or coverage policies of the insurer or
third-party administrator. The insurer or third-party administrator
shall accept an authorization provided by the Authority for an item
or service covered under the state Medicaid program or under a home-
and community-based services waiver for such individual as if such
authorization was made by the insurer or third-party administrator
for such item or service.
F. If the Authority submits an inquiry regarding a claim to an
insurer or third-party administrator not later than three (3) years
after the date of provision of the claimed item or service, the
insurer or third-party administrator shall respond to the inquiry
within sixty (60) days of receiving the inquiry.
G. An insurer shall make appropriate payments to the Authority
as long as the claim is submitted for consideration within three (3)
Oklahoma Statutes - Title 63. Public Health and Safety Page 1744
years from the date the service was furnished. Any action by the
Authority to enforce the payment of the claim shall be commenced
within six (6) years of the submission of the claim by the
Authority.
A. Whenever the Oklahoma Health Care Authority pays for medical
services or renders medical services, for or on behalf of a person
who has been injured or suffered an illness or disease, the right of
the provider of the services to reimbursement shall be automatically
assigned to the Oklahoma Health Care Authority, upon notice to the
insurer or other party obligated as a matter of law or agreement to
reimburse the provider on behalf of the patient.
B. Upon the assignment, the Authority, for purposes of the
claim for reimbursement, becomes a provider of medical services.
C. The assignment of the right to reimbursement shall be
applied and considered valid against any employer or insurer under
the Administrative Workers’ Compensation Act in this state.
D. Each insurer, upon receiving a claim from the Oklahoma
Health Care Authority, shall accept the state’s right of recovery,
to process and, if appropriate, pay the claim to the same extent
that the plan would have been liable if it had been billed at the
point of sale or by the original provider of services. The insurer
shall not deny the Authority claims on the basis of the date of
submission, the format of the claim, or for failure to present
proper documentation of coverage at the point of sale.
E. An insurer or third-party administrator, except a Medicare
Advantage plan, shall not deny the Authority claims solely on the
basis that a claimed item or service did not receive prior
authorization under the rules or coverage policies of the insurer or
third-party administrator. The insurer or third-party administrator
shall accept an authorization provided by the Authority for an item
or service covered under the state Medicaid program or under a home-
and community-based services waiver for such individual as if such
authorization was made by the insurer or third-party administrator
for such item or service.
F. If the Authority submits an inquiry regarding a claim to an
insurer or third-party administrator not later than three (3) years
after the date of provision of the claimed item or service, the
insurer or third-party administrator shall respond to the inquiry
within sixty (60) days of receiving the inquiry.
G. An insurer shall make appropriate payments to the Authority
as long as the claim is submitted for consideration within three (3)
Oklahoma Statutes - Title 63. Public Health and Safety Page 1744
years from the date the service was furnished. Any action by the
Authority to enforce the payment of the claim shall be commenced
within six (6) years of the submission of the claim by the
Authority.
Status: in_force · Read it on the official government site
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