§ 6552. Definitions
Oklahoma Statutes AnnotatedTitle 36. InsuranceEffective: May 12, 2021
Effective: May 12, 2021
36 Okl.St.Ann. § 6552
§ 6552. Definitions
As used in the Hospital and Medical Services Utilization Review Act:
1. “Utilization review” means a system for prospectively, concurrently and retrospectively reviewing the appropriate and efficient allocation of hospital resources and medical services given or proposed to be given to a patient or group of patients. It does not include an insurer's normal claim review process to determine compliance with the specific terms and conditions of the insurance policy;
(1) a health maintenance organization issued a license pursuant to Section 2501 et seq. of Title 63 of the Oklahoma Statutes, unless the health maintenance organization is federally regulated and licensed and has on file with the Insurance Commissioner a plan of utilization review carried out by health care professionals and providing for complaint and appellate procedures for claims, or
Credits
Laws 1991, c. 294, § 2, eff. Nov. 1, 1991; Laws 2021, c. 478, § 34, emerg. eff. May 12, 2021.
36 Okl. St. Ann. § 6552, OK ST T. 36 § 6552
Current with emergency effective legislation through Chapter 257 of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
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