Section 6570.8 - [Effective 1/1/2025]A. A health benefit plan may not revoke, limit, condition, or restrict a prior authorization if care is provided within forty-five (45) business days from the date the health care provider received the prior authorization unless the enrollee was no longer eligible for care on the day care was provided.B. A health benefit plan must pay a contracted health care provider at the contracted payment rate for a health care service provided by the health care provider per a prior authorization, unless:1. The health care provider knowingly and materially misrepresented the health care service in the prior authorization request with the specific intent to deceive and obtain an unlawful payment from a utilization review entity;2. The health care service was no longer a covered benefit on the day it was provided;3. The health care provider was no longer contracted with the patient's health benefit plan on the date the care was provided;4. The health care provider failed to meet the utilization review entity's timely filing requirements; or5. The patient was no longer eligible for health care coverage on the day the care was provided.Okla. Stat. tit. 36, § 6570.8
Added by Laws 2024, c. 303,s. 9, eff. 1/1/2025.