{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-313b","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-313B","heading":"Prior authorization forms for prescription drug benefits","body":"A. As used in this section:\n\n1. a. \"Health benefit plan\" means a plan that:\n\n(1) provides benefits for medical or surgical\n\nexpenses incurred as a result of a health\n\ncondition, accident, or sickness, and\n\n(2) is offered by any insurance company, group\n\nhospital service corporation, the State and\n\nEducation Employees Group Insurance Board, or a\n\nhealth maintenance organization that delivers or\n\nissues for delivery an individual, group,\n\nblanket, or franchise insurance policy or\n\ninsurance agreement, a group hospital service\n\ncontract, or an evidence of coverage, or, to the\n\nextent permitted by the Employee Retirement\n\nIncome Security Act of 1974, 29 U.S.C., Section\n\n1001 et seq., by a multiple employer welfare\n\narrangement as defined in Section 3 of the\n\nEmployee Retirement Income Security Act of 1974,\n\nor any other analogous benefit arrangement,\n\nwhether the payment is fixed or by indemnity.\n\nb. \"Health benefit plan\" shall not include:\n\n(1) a plan that provides coverage:\n\n(a) only for a specified disease or diseases or\n\nunder an individual limited benefit policy,\n\n(b) only for accidental death or dismemberment,\n\n(c) for dental or vision care,\n\n(d) a hospital confinement indemnity policy,\n\n(e) disability income insurance or a combination\n\nof accident-only and disability income\n\ninsurance, or\n\n(f) as a supplement to liability insurance,\n\n(2) a Medicare supplemental policy as defined by\n\nSection 1882(g)(1) of the Social Security Act (42\n\nU.S.C., Section 1395ss),\n\n(3) workers' compensation insurance coverage,\n\n(4) medical payment insurance issued as part of a\n\nmotor vehicle insurance policy,\n\n(5) a long-term care policy, including a nursing home\n\nfixed indemnity policy, unless a determination is\n\nmade that the policy provides benefit coverage so\n\ncomprehensive that the policy meets the\n\ndefinition of a health benefit plan, or\n\n(6) short-term health insurance issued on a\n\nnonrenewable basis with a duration of six (6)\n\nmonths or less; and\n\n2. \"Prior authorization\" means a utilization management\n\ncriterion utilized to seek permission or waiver of a drug to be\n\ncovered under a health prior authorization.\n\nB. Notwithstanding any other provision of law to the contrary,\n\nin order to establish uniformity in the submission of prior\n\nauthorization forms, on or after January 1, 2015, a health benefit\n\nplan shall utilize prior authorization forms for obtaining any prior\n\nauthorization for prescription drug benefits. A form shall not\n\nexceed three pages in length, excluding any instructions or guiding\n\ndocumentation and a health benefit plan may customize the content of\n\nthe form specific to the prescription drug for which the prior\n\nauthorization is being requested. A health benefit plan may make\n\nthe form accessible through multiple computer operating systems.\n\nAdditionally, upon request, the health benefit plan shall make a\n\ncopy of the form available to the Insurance Commissioner.","path":["OK Code","Title 63"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"3eb23b8e706add6dea750d9dec52ee532b5565c76dd0e758768e2c4dc17727c1","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-313a","next":"us-ok/okla.-stat.-tit.-63-63-3141.1"},"notice":"GroundRules: Original legal text. Not legal advice."}