{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-5051.2","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-5051.2","heading":"Right to reimbursement for medical services -","body":"Assignment to Oklahoma Health Care Authority.\n\nA. Whenever the Oklahoma Health Care Authority pays for medical\n\nservices or renders medical services, for or on behalf of a person\n\nwho has been injured or suffered an illness or disease, the right of\n\nthe provider of the services to reimbursement shall be automatically\n\nassigned to the Oklahoma Health Care Authority, upon notice to the\n\ninsurer or other party obligated as a matter of law or agreement to\n\nreimburse the provider on behalf of the patient.\n\nB. Upon the assignment, the Authority, for purposes of the\n\nclaim for reimbursement, becomes a provider of medical services.\n\nC. The assignment of the right to reimbursement shall be\n\napplied and considered valid against any employer or insurer under\n\nthe Administrative Workers’ Compensation Act in this state.\n\nD. Each insurer, upon receiving a claim from the Oklahoma\n\nHealth Care Authority, shall accept the state’s right of recovery,\n\nto process and, if appropriate, pay the claim to the same extent\n\nthat the plan would have been liable if it had been billed at the\n\npoint of sale or by the original provider of services. The insurer\n\nshall not deny the Authority claims on the basis of the date of\n\nsubmission, the format of the claim, or for failure to present\n\nproper documentation of coverage at the point of sale.\n\nE. An insurer or third-party administrator, except a Medicare\n\nAdvantage plan, shall not deny the Authority claims solely on the\n\nbasis that a claimed item or service did not receive prior\n\nauthorization under the rules or coverage policies of the insurer or\n\nthird-party administrator. The insurer or third-party administrator\n\nshall accept an authorization provided by the Authority for an item\n\nor service covered under the state Medicaid program or under a home-\n\nand community-based services waiver for such individual as if such\n\nauthorization was made by the insurer or third-party administrator\n\nfor such item or service.\n\nF. If the Authority submits an inquiry regarding a claim to an\n\ninsurer or third-party administrator not later than three (3) years\n\nafter the date of provision of the claimed item or service, the\n\ninsurer or third-party administrator shall respond to the inquiry\n\nwithin sixty (60) days of receiving the inquiry.\n\nG. An insurer shall make appropriate payments to the Authority\n\nas long as the claim is submitted for consideration within three (3)\n\nyears from the date the service was furnished. Any action by the\n\nAuthority to enforce the payment of the claim shall be commenced\n\nwithin six (6) years of the submission of the claim by the\n\nAuthority.","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":"02626207adbb6bf7a4c63ea8d853d7b03051e6462243e22ea19a3108dd6af10a","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-5051.1","next":"us-ok/okla.-stat.-tit.-63-63-5051.3"},"notice":"GroundRules: Original legal text. Not legal advice."}