Bill > HB4462

Introduced Session

An Act relating to health insurance; providing definitions; establishing that non-urgent care prior authorization requests shall be deemed approved if the utilization review organization fails to take certain action; granting the utilization review organization additional time for decision if network provider is requested to provide additional information; providing requirements for additional information requests; requiring network provider to submit new prior authorization request if they fail to provide all clinical information; requiring network providers to submit non-urgent care requests at least six days before scheduled health care service; establishing that urgent care prior authorization requests shall be deemed approved if the utilization review organization fails to take certain action; requiring network provider to submit additional information within twenty four hours of receiving request; directing utilization review organizations to ensure requests for prior authorization are made by physician or other competent health care professional; requiring utilization review organizations to include certain information with notice of adverse determination; requiring utilization review organizations to ensure adverse determinations are made by qualified physicians; directing utilization review organizations to make appeals process readily accessible on website; requiring response to appeals within certain timeframe; requiring appeals to be decided by physician other than physician who made original adverse determination; directing insurers to exempt certain network providers from obtaining prior authorization for covered health care services; clarifying that exemption shall be effective for succeeding year upon determination by utilization review organization; permitting insurers to rescind exemption for certain actions by health care professional; permitting insurers to automatically renew exemption if certain conditions are met; directing insurers to make written notice of a decision granting or declining renewal of an exemption; providing required contents for notice of rescission or declination of exemption; requiring insurer afford a health care professional reasonable opportunity to challenge grounds for a decision; directing for reconsideration to be performed by qualified physician; clarifying decision on reconsideration is final; requiring information be held in strictest confidence; clarifying health care professional whose exemption was rescinded or not renewed for certain reasons remains automatically eligible for an exemption; establishing that these exemptions do not apply to experimental health care services; granting the Oklahoma Insurance Commissioner rule making authority; providing for codification; and providing an effective date.

AI Summary

Carl Newton (R)*, 

Second Reading referred to Rules (on 02/03/2026)

Official Document