Oklahoma § 36-1219.3 - Discounted reimbursement and disclosure of

§ 36-1219.3. Discounted reimbursement and disclosure of

reimbursement terms prohibited.

A. An insurer or third-party administrator shall not reimburse

a health care provider on a discounted fee basis for covered

services that are provided to an insured unless:

1. The insurer or third-party administrator has contracted with

either:

a.

the health care provider, or

b.

a preferred provider organization which has contracted

with the health care provider;

2. The health care provider has agreed to provide health care

services under the terms of the contract; and

3. The insurer or third-party administrator has agreed to

provide coverage for those health care services under an accident

and health insurance policy.

B. A party to a preferred provider contract, including a

contract with a preferred provider organization, may not sell,

lease, or otherwise transfer information regarding the payment or

reimbursement terms of the contract without the express authority

and prior adequate notification of the other contracting parties.

Added by Laws 2000, c. 353, § 6, eff. Nov. 1, 2000.