{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-5051.5","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-5051.5","heading":"Data files comparisons - File systems maintained by","body":"insurers - Exchange of information with Authority.\n\nA. 1. On or after November 1, 2003, any entity that provides\n\nhealth insurance in this state including, but not limited to, a\n\nlicensed insurance company, not-for-profit hospital service, medical\n\nindemnity corporation, managed care organization, self-insured plan,\n\npharmacy benefit manager or other party that is, by statute,\n\ncontract, or agreement, legally responsible for payment of a claim\n\nfor a health care item or service is hereby required to compare data\n\nfrom its files with data in files provided to the entity by the\n\nOklahoma Health Care Authority and accept the Authority’s right of\n\nrecovery and the assignment of rights and not charge the Authority\n\nor any of its authorized agents any fees for the processing of\n\nclaims or eligibility requests. Data files requested by or provided\n\nto the Authority shall provide the Authority with eligibility and\n\ncoverage information that will enable the Authority to determine the\n\nexistence of third party coverage for Medicaid recipients and the\n\nnecessary information to determine during what period Medicaid\n\nrecipients may be or may have been covered by the health insurer and\n\nthe nature of the coverage that is or was provided, including the\n\nname, address, and identifying number of the plan.\n\n2. The insurer shall transmit to the Authority, in a manner\n\nprescribed by the Centers for Medicare and Medicaid Services or as\n\nagreed between insurer and the Authority, an electronic file of all\n\nidentified subscribers or policyholders, or their dependents, for\n\nwhom there is data corresponding to the information contained in\n\nsubsection C of this section.\n\nB. 1. An insurer shall comply with a request under the\n\nprovisions of this subsection no later than sixty (60) days after\n\nthe date of transmission by the Authority and shall only be required\n\nto provide the Authority with the information required by subsection\n\nC of this section.\n\n2. The Authority may make such request for data from an insurer\n\nno more than once every six (6) months, as determined by the date of\n\nthe Authority’s original request.\n\nC. Each insurer shall maintain a file system containing the\n\nname, address, group policy number, coverage type, social security\n\nnumber, and date of birth of each subscriber or policyholder, and\n\neach dependent of the subscriber or policyholder covered by the\n\ninsurer, including policy effective and termination dates, claim\n\nsubmission address, and employer’s mailing address.\n\nD. The Oklahoma Health Care Authority Board shall promulgate\n\nrules governing the exchange of information under this section.\n\nSuch rules shall be consistent with all laws relating to the\n\nconfidentiality or privacy of personal information or medical\n\nrecords including, but not limited to, provisions under the federal\n\nHealth Insurance Portability and Accountability Act (HIPAA).","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":"ec2d7883f96c2fa5a559518ec7ac1c05ad50a6b1ba65cfc74f8b540756e98a0f","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-5051.4","next":"us-ok/okla.-stat.-tit.-63-63-5052"},"notice":"GroundRules: Original legal text. Not legal advice."}