Okla. Stat. tit. 36, § 36-6570.8: Time frame in which prior authorization may not be
Where this section sits in the code
- OK Code
- Title 36
altered — Contracted payment rate requirement and exceptions.
A. A health benefit plan may not revoke, limit, condition, or
restrict a prior authorization if care is provided within forty-five
(45) business days from the date the health care provider received
the prior authorization unless the enrollee was no longer eligible
for care on the day care was provided.
B. A health benefit plan must pay a contracted health care
provider at the contracted payment rate for a health care service
provided by the health care provider per a prior authorization,
unless:
1. The health care provider knowingly and materially
misrepresented the health care service in the prior authorization
request with the specific intent to deceive and obtain an unlawful
payment from a utilization review entity;
2. The health care service was no longer a covered benefit on
the day it was provided;
3. The health care provider was no longer contracted with the
patient's health benefit plan on the date the care was provided;
4. The health care provider failed to meet the utilization
review entity's timely filing requirements; or
5. The patient was no longer eligible for health care coverage
on the day the care was provided.
Collected 2026-09-14T18:32:36Z. Source file · JSON