{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6570.52","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6570.52","heading":"Adverse determinations to include alternative","body":"prescription drugs — Qualifications of reviewers.\n\nA utilization review entity shall ensure that all adverse\n\ndeterminations include alternative prescription drugs covered by the\n\nhealth plan's formulary and are made by a physician, pharmacist, or\n\nlicensed mental health professional. The physician, pharmacist, or\n\nlicensed mental health professional shall:\n\n1. Possess a current and valid nonrestricted license in any\n\nUnited States jurisdiction;\n\n2. Have the appropriate training, knowledge, or expertise to\n\napply appropriate clinical guidelines to the health care service\n\nbeing requested; and\n\n3. Make the adverse determination under the clinical direction\n\nprovided by the committee or board responsible for developing\n\npolicies for drug use, evaluating clinical appropriateness, and\n\nensuring effective drug use when reviewing prescription drug prior\n\nauthorizations to enrollees of Oklahoma. All such medical directors\n\nshall be physicians licensed in any United States jurisdiction.","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":"364c2ae9c77739a3bab9f8df139dbb0f1fa09412cc2f172c987328260993d6d3","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6570.51","next":"us-ok/okla.-stat.-tit.-36-36-6570.53"},"notice":"GroundRules: Original legal text. Not legal advice."}