Okla. Stat. tit. 36, § 36-6553: Private review agents - Certification required -

Exemptions.

A. A private review agent who approves or denies payment or who

recommends approval or denial of payment for hospital or medical

services or whose review results in approval or denial of payment

for hospital or medical services on a case-by-case basis shall not

conduct utilization review in this state unless the Insurance

Commissioner has granted the private review agent a certificate.

B. Except as provided in Section 9 of this act, the Hospital

and Medical Services Utilization Review Act shall not apply to any

insurance company or not-for-profit hospital service and medical

indemnity plan licensed by the Commissioner to transact insurance in

this state. If the insurer contracts outside the company for any or

all utilization review services, the entity with whom the insurance

company contracts shall be subject to all of the provisions of the

Hospital and Medical Services Utilization Review Act.

C. The State and Education Employees Group Insurance Board

shall be exempt from the provisions of the Hospital and Medical

Services Utilization Review Act and regulated accordingly as

provided for in the State and Education Employees Group Insurance

Act. In addition, the Board shall comply with the provisions of

Section 17 of this act. If the State and Education Employees Group

Insurance Board contracts for utilization review services instead of

having utilization review services be performed by employees of the

Board, the entity with whom the Board contracts shall be subject to

all of the provisions of the Hospital and Medical Services

Utilization Review Act.