Oklahoma § 36-1219.2 - Definitions

§ 36-1219.2. Definitions

As used in the Health Care Fraud Prevention Act:

1. “Accident and health insurance policy” means any policy,

certificate, contract, agreement or other instrument that provides

accident and health insurance, as defined in Section 703 of this

title, to any person in this state;

2. “Health care provider” means a physician, hospital,

ambulatory surgical center, pharmacy, pharmacist, laboratory, or any

other state-licensed or state-recognized provider of health care

services;

3. “Insured” means any person entitled to reimbursement for

expenses of health care services and procedures under an accident

and health insurance policy issued by an insurer;

Oklahoma Statutes - Title 36. Insurance

4. “Insurer” means any entity that provides an accident and

health insurance policy in this state, including but not limited to

a licensed insurance company, a not-for-profit hospital service and

medical indemnity corporation, a fraternal benefit society, a

multiple employer welfare arrangement, or any other entity subject

to regulation by the Insurance Commissioner;

5. ”Perferred provider organization” means any entity defined

as a “preferred provider organization (PPO)” in Section 6054 of this

title; and

6. “Third-party administrator” means any person defined as an

“administrator” in Section 1442 of this title.

Added by Laws 2000, c. 353, § 5, eff. Nov. 1, 2000.