{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6592","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6592","heading":"Definitions","body":"For purposes of this act:\n\n1. \"Enrollee\" means an individual who is enrolled in a health\n\ncare plan, including covered dependents;\n\n2. \"Health care plan\" means any arrangement whereby any person\n\nundertakes to provide, arrange for, pay for, or reimburse any part\n\nof the costs of any health care services for an enrollee;\n\n3. \"Health care provider\" means a physician, hospital,\n\npharmaceutical company, pharmacy, pharmacist, laboratory, or other\n\nstate-licensed or state-recognized provider of health care services;\n\n4. \"Health insurance carrier\" means an insurance company that\n\nissues policies of accident and health insurance and is or should be\n\nlicensed to sell insurance in this state;\n\n5. \"Health maintenance organization\" means an organization\n\nwhich is or should be licensed by the State Department of Health\n\npursuant to Section 2501 et seq. of Title 63 of the Oklahoma\n\nStatutes;\n\n6. \"Managed care entity\" means any entity which is a health\n\ncare plan, health insurance carrier or health maintenance\n\norganization as defined in this section, but does not include an\n\nemployer that sponsors or participates in a health care plan or\n\npurchases coverage or assumes risk on behalf of or for the benefit\n\nof its employees or the employees of one or more subsidiaries or\n\naffiliates of the employer; and\n\n7. \"Medically necessary” means services or supplies provided by\n\na health care provider that are:\n\na. appropriate for the symptoms and diagnosis or\n\ntreatment of the enrollee’s condition, illness,\n\ndisease, or injury,\n\nb. in accordance with standards of good medical practice,\n\nc. not primarily for the convenience of the enrollee or\n\nthe enrollee’s health care provider, and\n\nd. the most appropriate supply or level of service that\n\ncan safely be provided to the enrollee.","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":"68970080d09c7ea0e275e51c66c676bbba5f0ad73803010a936d294337b59344","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6591","next":"us-ok/okla.-stat.-tit.-36-36-6593"},"notice":"GroundRules: Original legal text. Not legal advice."}