Okla. Admin. Code § 310:657-9-1

Current through Vol. 41, No. 19, June 17, 2024

Section 310:657-9-1 - Access to providers

(a) The Commissioner shall presume a proposed service area to be reasonable if the mean travel time is thirty (30) minutes or less from six (6) points on the area boundary to the nearest primary care delivery sites in that area, and sixty (60) minutes or less to specialty service providers.

(b) The Commissioner may approve a service area with travel times of greater than thirty (30) minutes to primary services, or sixty (60) minutes to specialty services, based on the following:

(1) Providers are not available in the area;

(2) Providers are available but do not meet the Plan's reasonable credentialing requirements;

(3) Providers are unwilling or unable to enter a reasonable health services contract with the Plan;

(4) Residents of the area customarily travel longer times to reach medical and health providers; or

(5) Providers have access to air ambulance services to transport injured workers.

(c) OAC 310:657-9 shall be construed to foster Plans in all areas of Oklahoma. These provisions shall not be interpreted to threaten the health and safety of employees or to impair the present system of service delivery in Oklahoma.

Okla. Admin. Code § 310:657-9-1

Added at 12 Ok Reg 2977, eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok Reg 2404, eff 6-25-06