Oklahoma HB4462 regulates health insurance prior authorizations, exempting certain providers from these requirements under specific conditions.
Oklahoma HB4462 establishes rules for health insurance prior authorizations, particularly for network providers. Insurers can exempt qualified network providers from prior authorization if they provided a specific service to at least seven patients in 2025. Exemptions can be rescinded if the provider knowingly misrepresented services. Insurers must notify providers of exemption decisions and allow reconsideration. Utilization review organizations must ensure adverse determinations are made by qualified physicians and make appeal processes accessible.
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