Oklahoma § 56-4006 - Mental health and substance use disorder coverage —

§ 56-4006. Mental health and substance use disorder coverage —

Parity analysis.

A. For Medicaid managed care plans, the Oklahoma Health Care

Authority shall ensure that the insurers, health plans, and managed

care plans comply with federal and state laws, rules, and

regulations applicable to coverage for mental health or substance

use disorder services.

B. Contracts with Medicaid managed care plans must require

entities to conduct regular parity compliance analysis that contain

the information described in 42 U.S.C., Section 300gg–26(a)(8)(i-v)

for each nonquantitative treatment limitation imposed on mental

health or substance use disorder benefits in any classification of

care.

C. Contracts with Medicaid managed care plans must include

language requiring managed care plans and entities to conduct parity

analysis described in subsection B of this section for a

nonquantitative treatment limitation whenever as-written or inoperation changes or amendments are made to that nonquantitative

treatment limitation, including prior authorization requirements.

D. State Medicaid programs and Children's Health Insurance

Programs (CHIP) must review and compile the analysis from all

managed care, CHIP, and alternative benefit plans to ensure

compliance and address any noncompliance through a standardized

process to mitigate findings of noncompliance.

E. The Oklahoma Health Care Authority shall develop a

standardized process for receiving, investigating, substantiating,

and resolving parity complaints.

F. The Oklahoma Health Care Authority shall make public the

surveys, financial analysis, managed care contract audits, deidentified substantiated parity complaints, and parity reports

prepared by the managed care entities and plans and the reports they

submit to document parity compliance.

G. The Oklahoma Health Care Authority shall also make public

any parity analysis, summary, or report submitted to the Centers for

Medicare and Medicaid Services regarding the Oklahoma Medicaid

managed care program within thirty (30) days of the state's

submission of these reports to the Centers for Medicare and Medicaid

Services.

Added by Laws 2025, c. 118, § 1, eff. Nov. 1, 2025.

NOTE: Editorially renumbered from § 4005 of this title to avoid

duplication in numbering.

Oklahoma Statutes - Title 56. Poor Persons