{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-5011.1","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-5011.1","heading":"State-purchased health care benefits – Optometrists to","body":"be permitted to provide vision care or medical diagnosis and\n\ntreatment of the eye.\n\nA. All state-purchased and state-subsidized health care benefit\n\nplans, including but not limited to Medicaid, which offer services\n\nfor vision care or medical diagnosis and treatment for the eye shall\n\nallow optometrists to be providers of those services. Such state-\n\npurchased and state-subsidized health care benefit plans shall also\n\nrequire equal payment for the same services provided by an\n\noptometrist if the services are within the scope of practice of\n\noptometry.\n\nB. With respect to optometric services, any state-purchased and\n\nstate-subsidized health care benefit plan, including but not limited\n\nto Medicaid, which uses a gatekeeper or equivalent for referrals for\n\nservices for vision care or for medical diagnosis and treatment of\n\nthe eye, shall require such covered services be provided on a\n\nreferral basis within the medical group or network at the request of\n\nan enrollee who has a condition requiring vision care or medical\n\ndiagnosis and treatment of the eye if:\n\n1. A referral is necessitated in the judgment of the primary\n\ncare physician; and\n\n2. Treatment for the condition falls within the licensed scope\n\nof practice of an optometrist.\n\nC. All state-purchased and state-subsidized health care benefit\n\nplans shall have a defined set of standards and procedures for\n\nselecting providers, including specialists, to serve enrollees. The\n\nstandards and procedures shall be drafted in such a manner that they\n\nare applicable to all categories of providers and shall be utilized\n\nby the health plan in a manner that is without bias for or\n\ndiscrimination against a particular category or categories of\n\nproviders.\n\nD. No health care benefit plan specified by this section shall\n\nrequire a provider to have hospital privileges if hospital\n\nprivileges are not usual and customary for the services the provider\n\nprovides.\n\nE. Nothing in this section shall be construed to:\n\n1. Prohibit any state-purchased and state-subsidized health\n\ncare benefit plan which offers services for vision care or medical\n\ndiagnosis and treatment for the eye from determining the adequacy of\n\nthe size of its network;\n\n2. Prohibit an optometrist from agreeing to a fee schedule;\n\n3. Limit, expand, or otherwise affect the scope of practice of\n\noptometry; or\n\n4. Alter, repeal, modify or affect the laws of this state\n\nexcept where such laws are in conflict or are inconsistent with the\n\nexpress provisions of this section.\n\nF. Existing state-purchased and state-subsidized health care\n\nbenefit plans shall comply with the requirements of this section\n\nupon issuance or renewal on or after the effective date of this act.","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":"586ae9ef861dc2789c8afc374842b3e3be2716ddabc84ac02ca515b13d5c63a8","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-5010","next":"us-ok/okla.-stat.-tit.-63-63-5012"},"notice":"GroundRules: Original legal text. Not legal advice."}