{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6803","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6803","heading":"Coverage of services – Requirements for insurers","body":"A. For services that a health care professional determines to\n\nbe appropriately provided by means of telemedicine, health care\n\nservice plans, disability insurer programs, workers' compensation\n\nprograms, or state Medicaid managed care program contracts issued,\n\namended, or renewed on or after January 1, 1998, shall not require\n\nperson-to-person contact between a health care professional and a\n\npatient.\n\nB. Subsection A of this section shall apply to health care\n\nservice plan contracts with the state Medicaid managed care program\n\nonly to the extent that both of the following apply:\n\n1. Telemedicine services are covered by, and reimbursed under,\n\nthe fee-for-service provisions of the state Medicaid managed care\n\nprogram; and\n\n2. State Medicaid managed care program contracts with health\n\ncare service plans are amended to add coverage of telemedicine\n\nservices and make any appropriate capitation rate adjustments.\n\nC. Any health benefit plan that is offered, issued or renewed\n\nin this state by an insurer on or after the effective date of this\n\nact shall provide coverage of health care services provided through\n\ntelemedicine, as provided in this section.\n\nD. An insurer shall not exclude a service for coverage solely\n\nbecause the service is provided through telemedicine and is not\n\nprovided through in-person consultation or contact between a health\n\ncare professional and a patient when such services are appropriately\n\nprovided through telemedicine. An insurer may limit coverage of\n\nservices provided by telehealth consistent with coding and clinical\n\nstandards recognized by the American Medical Association or the\n\nCenters for Medicare and Medicaid Services as covered if delivered\n\nby telehealth or telemedicine, except as agreed to by the insurer\n\nand provider.\n\nE. An insurer shall reimburse the treating health care\n\nprofessional or the consulting health care professional for the\n\ndiagnosis, consultation or treatment of the patient delivered\n\nthrough telemedicine services on the same basis and at least at the\n\nrate of reimbursement that the insurer is responsible for coverage\n\nfor the provision of the same, or substantially similar, services\n\nthrough in-person consultation or contact.\n\nF. An insurer shall not apply any deductible to telemedicine\n\nservices that accumulates separately from the deductible that\n\napplies in the aggregate to all items and services covered under the\n\nhealth benefit plan.\n\nG. Any copayment or coinsurance applied to telemedicine\n\nbenefits by an insurer shall not exceed the copayment or coinsurance\n\napplied to such benefits when provided through in-person\n\nconsultation or contact.\n\nH. An insurer shall not impose any annual or lifetime\n\ndurational limits or annual or lifetime dollar maximums for benefits\n\nor services provided through telemedicine that are not equally\n\nimposed upon all terms and services covered under the health benefit\n\nplan.\n\nI. An insurer shall not impose any type of utilization review\n\non benefits provided through telemedicine unless such type of\n\nutilization review is imposed when such benefits are provided\n\nthrough in-person consultation or contact. Any type of utilization\n\nreview that is imposed on benefits provided through telemedicine\n\nshall not occur with greater frequency or more stringent application\n\nthan such form of utilization review is imposed on such benefits\n\nprovided through in-person consultation or contact.\n\nJ. An insurer shall not restrict coverage of telemedicine\n\nbenefits or services to benefits or services provided by a\n\nparticular vendor, or other third party, or benefits or services\n\nprovided through a particular electronic communications technology\n\nplatform; provided, that nothing shall require an insurer to cover\n\nany electronic communications technology platform that does not\n\ncomply with applicable state and federal privacy laws.\ne of telemedicine\n\nbenefits or services to benefits or services provided by a\n\nparticular vendor, or other third party, or benefits or services\n\nprovided through a particular electronic communications technology\n\nplatform; provided, that nothing shall require an insurer to cover\n\nany electronic communications technology platform that does not\n\ncomply with applicable state and federal privacy laws.\n\nK. An insurer shall not place any restrictions on prescribing\n\nmedications through telemedicine that are more restrictive than what\n\nis required under applicable state and federal law.\n\nL. No later than January 1, 2023, the State Department of\n\nHealth shall request a report from the Statewide Health Information\n\nExchange that will provide the following data:\n\n1. The number of providers using telehealth, including the\n\nlocation, frequency and specific services for which telehealth is\n\nutilized; and\n\n2. The overall cost and cost savings associated with the\n\nutilization of telehealth services.","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":"27a7dfc598a5cb0ae9cb9d434f3a5b2154399a8578e977245e7ea78c7f83ecfe","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6802v2","next":"us-ok/okla.-stat.-tit.-36-36-6810"},"notice":"GroundRules: Original legal text. Not legal advice."}