{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6553","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6553","heading":"Private review agents - Certification required -","body":"Exemptions.\n\nA. A private review agent who approves or denies payment or who\n\nrecommends approval or denial of payment for hospital or medical\n\nservices or whose review results in approval or denial of payment\n\nfor hospital or medical services on a case-by-case basis shall not\n\nconduct utilization review in this state unless the Insurance\n\nCommissioner has granted the private review agent a certificate.\n\nB. Except as provided in Section 9 of this act, the Hospital\n\nand Medical Services Utilization Review Act shall not apply to any\n\ninsurance company or not-for-profit hospital service and medical\n\nindemnity plan licensed by the Commissioner to transact insurance in\n\nthis state. If the insurer contracts outside the company for any or\n\nall utilization review services, the entity with whom the insurance\n\ncompany contracts shall be subject to all of the provisions of the\n\nHospital and Medical Services Utilization Review Act.\n\nC. The State and Education Employees Group Insurance Board\n\nshall be exempt from the provisions of the Hospital and Medical\n\nServices Utilization Review Act and regulated accordingly as\n\nprovided for in the State and Education Employees Group Insurance\n\nAct. In addition, the Board shall comply with the provisions of\n\nSection 17 of this act. If the State and Education Employees Group\n\nInsurance Board contracts for utilization review services instead of\n\nhaving utilization review services be performed by employees of the\n\nBoard, the entity with whom the Board contracts shall be subject to\n\nall of the provisions of the Hospital and Medical Services\n\nUtilization Review Act.","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":"983745ab67537799bb250e9ded3ce25d7722ceca7d0c3defcf96f31331db9977","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6552","next":"us-ok/okla.-stat.-tit.-36-36-6554"},"notice":"GroundRules: Original legal text. Not legal advice."}