{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-1219.6","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-1219.6","heading":"Methods of payments to providers – Prohibition on","body":"restricting methods – Notice of fees.\n\nA. As used in this section:\n\n1. “Health maintenance organization” means an entity that is\n\norganized for the purpose of providing or arranging health care,\n\nwhich has been granted a certificate of authority by the Insurance\n\nCommissioner as a health maintenance organization pursuant to the\n\nHealth Maintenance Organization Act of 2003;\n\n2. “Credit card payment” means a type of electronic funds\n\ntransfer in which a health insurance plan or health insurer or its\n\ncontracted vendor issues a single-use series of numbers associated\n\nwith the payment of health care services performed by a health care\n\nprovider and chargeable to a predetermined dollar amount, whereby\n\nthe health care provider is responsible for processing the payment\n\nby a credit card terminal or Internet portal. Such term shall\n\ninclude virtual or online credit card payments, whereby no physical\n\ncredit card is presented to the health care provider and the single-\n\nuse credit card expires upon payment processing;\n\n3. “Electronic funds transfer payment” means a payment by any\n\nmethod of electronic funds transfer other than through the Automated\n\nClearing House Network (ACH), as codified in 45 C.F.R., Sections\n\n162.1601 and 162.1602;\n\n4. “Health care provider” means any physician, dentist,\n\npharmacist, optometrist, psychologist, registered optician, licensed\n\nprofessional counselor, physical therapist, chiropractor, hospital\n\nor other entity or person that is licensed or otherwise authorized\n\nin this state to furnish health care services;\n\n5. “Health care provider agent” means a person or entity that\n\ncontracts with a health care provider establishing an agency\n\nrelationship to process bills for services provided by the health\n\ncare provider under the terms and conditions of a contract between\n\nthe agent and health care provider. Such contracts may permit the\n\nagent to submit bills, request reconsideration and receive\n\nreimbursement;\n\n6. “Health care services” means the examination or treatment of\n\npersons for the prevention of illness or the correction or treatment\n\nof any physical or mental condition resulting from illness, injury\n\nor other human physical problem and includes, but is not limited to:\n\na. hospital services which include the general and usual\n\nservices and care, supplies and equipment furnished by\n\nhospitals,\n\nb. medical services which include the general and usual\n\nservices and care rendered and administered by doctors\n\nof medicine, doctors of dental surgery and doctors of\n\npodiatry, and\n\nc. other health care services which include appliances\n\nand supplies; nursing care by a registered nurse or a\n\nlicensed practical nurse; care furnished by such other\n\nlicensed practitioners; institutional services\n\nincluding the general and usual care, services,\n\nsupplies and equipment furnished by health care\n\ninstitutions and agencies or entities other than\n\nhospitals; physiotherapy; ambulance services; drugs\n\nand medications; therapeutic services and equipment\n\nincluding oxygen and the rental of oxygen equipment;\n\nhospital beds; iron lungs; orthopedic services and\n\nappliances including wheelchairs, trusses, braces,\n\ncrutches and prosthetic devices including artificial\n\nlimbs and eyes; and any other appliance, supply or\n\nservice related to health care;\n\n7. “Health insurance plan” means any hospital or medical\n\ninsurance policy or certificate; qualified higher deductible health\n\nplan; health maintenance organization subscriber contract; contract\n\nproviding benefits for dental care whether such contract is pursuant\n\nto a medical insurance policy or certificate; stand-alone dental\n\nplan, health maintenance provider contract or managed health care\n\nplan; and\n\n8. “Health insurer” means any entity or person that issues\n\nhealth insurance plans, as defined in this section.\n\nB. Any health insurance plan issued, amended or renewed on or\ne Page 301\n\nproviding benefits for dental care whether such contract is pursuant\n\nto a medical insurance policy or certificate; stand-alone dental\n\nplan, health maintenance provider contract or managed health care\n\nplan; and\n\n8. “Health insurer” means any entity or person that issues\n\nhealth insurance plans, as defined in this section.\n\nB. Any health insurance plan issued, amended or renewed on or\n\nafter January 1, 2020, between a health insurer or its contracted\n\nvendor or a health maintenance organization and a health care\n\nprovider for the provision of health care services to a plan\n\nenrollee shall not contain restrictions on methods of payment from\n\nthe health insurer or its vendor or the health maintenance\n\norganization to the health care provider in which the only\n\nacceptable payment method is a credit card payment.\n\nC. If initiating or changing payments to a health care provider\n\nusing a credit card, a health insurance plan, health insurer or its\n\ncontracted vendor, or health maintenance organization shall:\n\n1. Notify the health care provider of any fees associated with\n\na particular payment method; and\n\n2. Advise the health care provider of the available methods of\n\npayment and provide clear instructions on how to select a preferred\n\nmethod of payment.\n\nD. If initiating or changing payments to a health care provider\n\nusing electronic funds transfer payments, including virtual credit\n\ncard payments, a health insurance plan, health insurer or its\n\ncontracted vendor, or health maintenance organization shall:\n\n1. Notify the health care provider of any fees that are\n\nassociated with a particular payment method; and\n\n2. Advise the provider of the available methods of payment and\n\nprovide clear instructions to the health care provider as to how to\n\nselect an alternative payment method.\n\nE. A health insurance plan, health insurer or its contracted\n\nvendor, or health maintenance organization that initiates or changes\n\npayments to a health care provider through the Automated Clearing\n\nHouse Network, as codified in 45 C.F.R., Sections 162.1601 and\n\n162.1602, shall not charge a fee solely to transmit the payment to a\n\nhealth care provider unless the health care provider has consented\n\nto the fee. A health care provider agent may charge reasonable fees\n\nwhen transmitting an Automated Clearing House Network payment\n\nrelated to transaction management, data management, portal services\n\nand other value-added services in addition to the bank transmittal.\n\nF. The provisions of this section shall not be waived by\n\ncontract, and any contractual clause in conflict with the provisions\n\nof this section or that purport to waive any requirements of this\n\nsection are void.\n\nG. Violations of this section shall be subject to enforcement\n\nby the Insurance Commissioner.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"3850c8911f8b0a08ea986c09f9252d9173993c77f42481d7175d3abf7c66d7c6","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-1219.5","next":"us-ok/okla.-stat.-tit.-36-36-122"},"notice":"GroundRules: Original legal text. Not legal advice."}