{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6050.3","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6050.3","heading":"Minimum reimbursement rate set by local governmental","body":"entity — Default rate — Payment.\n\nA. A local governmental entity, or ambulance service provider\n\noperating on its behalf, may annually submit to the Insurance\n\nDepartment, in the form and manner prescribed by the Insurance\n\nCommissioner, the ambulance service rates set or approved, whether\n\nin contract or ordinance, by the local governmental entity.\n\nB. By January 1, 2026, the Department shall establish and\n\nmaintain on its public website a database listing all submitted\n\nrates.\n\nC. The minimum allowable reimbursement rate under any health\n\ncare benefit plan issued by a health care insurer to an out-of-\n\nnetwork ambulance service provider for providing covered ambulance\n\nservices shall be the rates set or approved, whether in contract or\n\nordinance on May 1, 2025, submitted by a local governmental entity\n\nin the jurisdiction in which the covered ambulance services\n\noriginate, or ambulance service provider operating on its behalf, as\n\nprovided in subsection A of this section, if the local governmental\n\nentity has submitted such rates.\n\nD. In absence of the rates provided in subsection A of this\n\nsection, the rate shall be the lesser of:\n\n1. Three hundred twenty-five percent (325%) of the current\n\npublished rate for ambulance services as established by the Centers\n\nfor Medicare and Medicaid Services under Title XVIII of the Social\n\nSecurity Act for the same services provided in the same geographic\n\narea; or\n\n2. The ambulance service provider’s billed charges.\n\nE. Payment made in compliance with this section shall be\n\nconsidered payment in full for the covered ambulance services\n\nprovided, except for any copayment, coinsurance, deductible, and\n\nother cost-sharing feature amounts required to be paid by the\n\nenrollee. An ambulance service provider is prohibited from billing\n\nthe enrollee for any additional amounts for the paid covered\n\nambulance services in excess of what the health care insurer pays.\n\nF. All copayments, coinsurance, deductible, and other cost-\n\nsharing feature amounts applicable to amounts calculated in\n\naccordance with subsection A of this section shall not exceed the\n\nin-network copayment, coinsurance, deductible, and other cost-\n\nsharing features for the covered ambulance services received by the\n\nenrollee.\n\nG. In administering and paying claims, a health care insurer\n\nshall comply with Section 1219 of this title.\n\nH. The Department shall review the data from the database and\n\nsubmit a report by January 1, 2027, to the Governor, the President\n\nPro Tempore of the Oklahoma State Senate, and the Speaker of the\n\nOklahoma House of Representatives. The rates provided for in\n\nsubsections C and D of this section shall cease to remain in effect\n\nunless the rates are modified by the Oklahoma Legislature prior to\n\nDecember 31, 2027.","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":"3c00f798e43c39287e9f27d50b7d6d317da8334677893924b63f630c2d2d74bd","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6050.2","next":"us-ok/okla.-stat.-tit.-36-36-6051"},"notice":"GroundRules: Original legal text. Not legal advice."}