Section 313A - DefinitionsA. As used in this section: 1.a. "Health benefit plan" means a plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, and(2) is offered by any insurance company, group hospital service corporation, the State and Education Employees Group Insurance Board, or a health maintenance organization that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an evidence of coverage, or, to the extent permitted by the Employee Retirement Income Security Act of 1974, 29 U.S.C., Section 1001 et seq., by a multiple employer welfare arrangement as defined in Section 3 of the Employee Retirement Income Security Act of 1974, or any other analogous benefit arrangement, whether the payment is fixed or by indemnity.b. "Health benefit plan" shall not include: (1) a plan that provides coverage: (a) only for a specified disease or diseases or under an individual limited benefit policy, (b) only for accidental death or dismemberment,(c) for dental or vision care,(d) a hospital confinement indemnity policy,(e) disability income insurance or a combination of accident-only and disability income insurance, or(f) as a supplement to liability insurance,(2) a Medicare supplemental policy as defined by Section 1882(g)(1) of the Social Security Act (42 U.S.C. , Section 1395ss), (3) worker's compensation insurance coverage,(4) medical payment insurance issued as part of a motor vehicle insurance policy,(5) a long-term care policy, including a nursing home fixed indemnity policy, unless a determination is made that the policy provides benefit coverage so comprehensive that the policy meets the definition of a health benefit plan, or(6) short-term health insurance issued on a nonrenewable basis with a duration of six (6) months or less; and 2. "Prior authorization" means a utilization management criterion utilized to seek permission or waiver of a drug to be covered under a health prior authorization.B. Notwithstanding any other provision of law to the contrary, in order to establish uniformity in the submission of prior authorization forms, on or after January 1, 2014, a health benefit plan shall utilize prior authorization forms for obtaining any prior authorization for prescription drug benefits. A form shall not exceed three pages in length, excluding any instructions or guiding documentation and a health benefit plan may customize the content of the form specific to the prescription drug for which the prior authorization is being requested. A health benefit plan may make the form accessible through multiple computer operating systems. Additionally, upon request, the health benefit plan shall make a copy of the form available to the Insurance Commissioner.Okla. Stat. tit. 63, § 313A
Added by Laws 2013 , c. 362, s. 1, eff. 8/23/2013.