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Health Care Related Measures Become Effective November 1, 2021
(Bill number is link to legislation)
– Requires insurance providers to make certain notifications when clean claims are denied and allows for the insured to appeal. As referenced in the legislation:
Upon receiving written notice of denial, a recipient (i.e. physician, patient, etc.) may submit a detailed appeal in writing explaining why the claims should be approved. If the insurer denies the appeal, the insurer shall address in writing the specific details included in the written appeal and provide the phone number of a health plan representative at the department of appeals of the insurer.
– Creates the Oklahoma Telemedicine Act which expands definitions and standards for telemedicine within statute in preparation for health insurance pay parity requirements housed within
to be effective January 1, 2022 .
– Creates the “Transparency in Heath Care Prices Act” which requires health care providers and facilities to make prices for certain health care services publicly available.
– Prohibits insurers from removing medical providers from an existing insurance network while a policy is in effect for informing enrollees of the full range of physicians and providers available to them and requires certain notice upon referral.
– Places a cap on required payments for insulin by insureds, regardless of total amount or type of insulin necessary, such provisions not to prevent providers from charging insureds less than the cap.
– Co-Pay Accumulator: Makes failing to include certain payments on behalf of enrollees when calculating total contributions towards out-of-pocket maximums an unfair claim settlement practice for pharmacy benefits providers.
– Permits certain death certificates to be signed by advanced practice registered nurses.
Several abortion-related measures were also slated to go into effect on November 1, but the Oklahoma Supreme Court issued a temporary injunction pending appeal which currently prohibits the implementation of these laws.