Oklahoma § 36-6974 - Credentials — Reimbursement and requirements for

§ 36-6974. Credentials — Reimbursement and requirements for

physicians and optometrists — Subcontracts.

A. 1. No agreement between an insurer or a prepaid vision plan

and a vision care provider shall require that a provider participate

with or be credentialed by any specific prepaid vision plan as a

condition for participation in the health care network of the

insurer to provide covered services to its enrollees.

2. In the event that a vision care provider is credentialed by

an insurer or vision care plan organization, no insurer or vision

care plan organization shall construe re-credentialing as recontracting with a vision care provider. All contracts shall be

distinct and separate documents from any credentialing materials.

B. Any insurer issuing or renewing a health benefit plan or

prepaid vision plan which provides coverage for services rendered by

a duly licensed physician or osteopath that are within the scope of

practice of a duly licensed optometrist shall provide the same

reimbursement for services to optometrists as allowed for those

services rendered by physicians or osteopaths.

C. No insurer or prepaid vision plan organization shall require

an optometrist to meet terms and conditions that are not required of

a physician or osteopath as a condition for participation in its

provider network for the provision of services that are within the

scope of practice of an optometrist.

D. If a vision care provider enters into any subcontract

agreement with another provider to provide his or her licensed

health care services to the enrollee, dependent of the enrollee, or

an enrollee of a managed care plan where the subcontracted provider

will bill the managed care plan or enrollee directly for the

subcontracted services, the subcontract agreement shall meet all

requirements of this act.

Added by Laws 2024, c. 360, § 3, emerg. eff. May 30, 2024.