{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6991","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6991","heading":"Prohibiting refusal of coverage for durable medical","body":"equipment.\n\nA. As used in this section:\n\n1. “Durable medical equipment” means equipment as defined\n\npursuant to Section 375.2 of Title 59 of the Oklahoma Statutes;\n\n2. “Health benefit plan” means a health benefit plan as defined\n\npursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes, but\n\nshall not include any health benefit plan offered by a contracted\n\nentity as defined in Section 4002.2 of Title 56 of the Oklahoma\n\nStatutes that provides coverage to members of the state Medicaid\n\nprogram;\n\n3. “Health care provider” means a provider as defined pursuant\n\nto Section 6571 of Title 36 of the Oklahoma Statutes;\n\n4. “Health maintenance organization” or “HMO” means a health\n\nmaintenance organization as defined pursuant to Section 6902 of\n\nTitle 36 of the Oklahoma Statutes, but shall not include any health\n\nbenefit plan offered by a contracted entity as defined in Section\n\n4002.2 of Title 56 of the Oklahoma Statutes that provides coverage\n\nto members of the state Medicaid program; and\n\n5. “Preferred provider organization” or “PPO” means a preferred\n\nprovider organization as defined pursuant to Section 6054 of Title\n\n36 of the Oklahoma Statutes.\n\nB. No health benefit plan, HMO, PPO, or other provider network\n\nauthorized to administer health care coverage in this state shall\n\nrefuse coverage to an insured for durable medical equipment and\n\nsupplies as prescribed by a health care provider, regardless of\n\nwhether they are in-network or out-of-network, unless there is an\n\nOklahoma-licensed in-network provider within a fifteen-mile radius\n\nof the patient’s home address that can provide in-person evaluation\n\nfor durable medical equipment, supplies, and related services.\n\nC. If a health care provider deems it necessary that an insured\n\nreceive covered durable medical equipment or supplies within twenty-\n\nfour (24) hours, the insured shall not be subject to drop-shipped\n\norders and may seek such equipment and supplies from any health care\n\nprovider who can provide the necessary services and supplies within\n\nthe requested time frame.\n\nD. When an insured utilizes an out-of-network health care\n\nprovider, as described in subsection B of this section, the out-of-\n\nnetwork provider shall be reimbursed at the same rate and benefit\n\nlevel for the provided services as an in-network provider for the\n\nhealth benefit plan, HMO, PPO, or other provider network authorized\n\nto administer health care coverage in this state.","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":"0c6a4fe0ff6e02339f8a96de34a4644042155ca4e96731794936d479fc10cc9f","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6985","next":"us-ok/okla.-stat.-tit.-36-36-7001"},"notice":"GroundRules: Original legal text. Not legal advice."}