Oklahoma Code § 36-6803

Title 36. Insurance: Coverage of services – Requirements for insurers
Open in Lexace · Ask the AI about this section
A.  For services that a health care professional determines to
be appropriately provided by means of telemedicine, health care
service plans, disability insurer programs, workers' compensation
programs, or state Medicaid managed care program contracts issued,

amended, or renewed on or after January 1, 1998, shall not require
person-to-person contact between a health care professional and a
patient.
B.  Subsection A of this section shall apply to health care
service plan contracts with the state Medicaid managed care program
only to the extent that both of the following apply:
1.  Telemedicine services are covered by, and reimbursed under,
the fee-for-service provisions of the state Medicaid managed care
program; and
2.  State Medicaid managed care program contracts with health
care service plans are amended to add coverage of telemedicine
services and make any appropriate capitation rate adjustments.
C.  Any health benefit plan that is offered, issued or renewed
in this state by an insurer on or after the effective date of this
act shall provide coverage of health care services provided through
telemedicine, as provided in this section.
D.  An insurer shall not exclude a service for coverage solely
because the service is provided through telemedicine and is not
provided through in-person consultation or contact between a health
care professional and a patient when such services are appropriately
provided through telemedicine.  An insurer may limit coverage of
services provided by telehealth consistent with coding and clinical
standards recognized by the American Medical Association or the
Centers for Medicare and Medicaid Services as covered if delivered
by telehealth or telemedicine, except as agreed to by the insurer
and provider.
E.  An insurer shall reimburse the treating health care
professional or the consulting health care professional for the
diagnosis, consultation or treatment of the patient delivered
through telemedicine services on the same basis and at least at the
rate of reimbursement that the insurer is responsible for coverage
for the provision of the same, or substantially similar, services
through in-person consultation or contact.
F.  An insurer shall not apply any deductible to telemedicine
services that accumulates separately from the deductible that
applies in the aggregate to all items and services covered under the
health benefit plan.
G.  Any copayment or coinsurance applied to telemedicine
benefits by an insurer shall not exceed the copayment or coinsurance
applied to such benefits when provided through in-person
consultation or contact.
H.  An insurer shall not impose any annual or lifetime
durational limits or annual or lifetime dollar maximums for benefits
or services provided through telemedicine that are not equally
imposed upon all terms and services covered under the health benefit
plan.

I.  An insurer shall not impose any type of utilization review
on benefits provided through telemedicine unless such type of
utilization review is imposed when such benefits are provided
through in-person consultation or contact.  Any type of utilization
review that is imposed on benefits provided through telemedicine
shall not occur with greater frequency or more stringent application
than such form of utilization review is imposed on such benefits
provided through in-person consultation or contact.
J.  An insurer shall not restrict coverage of telemedicine
benefits or services to benefits or services provided by a
particular vendor, or other third party, or benefits or services
provided through a particular electronic communications technology
platform; provided, that nothing shall require an insurer to cover
any electronic communications technology platform that does not
comply with applicable state and federal privacy laws.
K.  An insurer shall not place any restrictions on prescribing
medications through telemedicine that are more restrictive than what
is required under applicable state and federal law.
L.  No later than January 1, 2023, the State Department of
Health shall request a report from the Statewide Health Information
Exchange that will provide the following data:
1.  The number of providers using telehealth, including the
location, frequency and specific services for which telehealth is
utilized; and
2.  The overall cost and cost savings associated with the
utilization of telehealth services.

‹ Prev All Oklahoma sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.