{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6554","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6554","heading":"Exemptions - Review of patients eligible under Social","body":"Security - In-house utilization review.\n\nA. The Insurance Commissioner shall waive the requirements of\n\nthe Hospital and Medical Services Utilization Review Act for the\n\nactivities of a private review agent in connection with a contract\n\nwith the federal or state government for utilization review of\n\npatients eligible for hospital and medical services under the Social\n\nSecurity Act.\n\nB. No certificate is required for those private review agents\n\nconducting general in-house utilization review for hospitals, home\n\nhealth agencies, preferred provider organizations, or other managed\n\ncare entities, clinics, private offices or any other health facility\n\nor entity, so long as the review does not result in the approval or\n\ndenial of payment for hospital or medical services for a particular\n\ncase. Such general in-house utilization review shall be exempt from\n\nall provisions of the Hospital and Medical Services Utilization\n\nReview 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":"447b7c3b3c0fcb2ca93c66d83b076152b8b6e52e0e4b8068eb7e5f846f397331","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6553","next":"us-ok/okla.-stat.-tit.-36-36-6555"},"notice":"GroundRules: Original legal text. Not legal advice."}