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 Oklahoma Statutes (Last Updated: September 18, 2014)
 Title 63. PUBLIC HEALTH AND SAFETY

  § 63-5011. State-purchased health care benefits – Utilization and financial data review – Collection of cost and quality of service data.  

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  • A.  The Authority shall:

    1.  Require utilization review and financial data review from participating entities which contract with the Authority for state-purchased and state-subsidized health care on a quarterly basis;

    2.  Centralize enrollment files for all persons covered by state-purchased and state-subsidized health care benefit plans;

    3.  Develop enrollment demographics on a plan-specific basis; and

    4.  Establish methods for collecting, analyzing, and disseminating information on the cost and quality of services rendered by health care providers to all persons covered by such plans.

    B.  The administrator may require that any entity that contracts for the delivery of services pursuant to a state-purchased or state-subsidized health care benefit plan administered by the Authority shall provide to said administrator all information deemed necessary to fulfill the administrator's duties as set forth in the Oklahoma Health Care Authority Act, Section 5003 et seq. of this title.  All data related to claims and produced pursuant to the Oklahoma Health Care Authority Act shall be the property of this state.

    C.  Any savings realized pursuant to this section and Section  5009 of this title shall not be used to increase benefits unless such use is authorized by law.

Added by Laws 1993, c. 332, § 9.  Amended by Laws 1994, c. 282, § 5, eff. July 1, 1994; Laws 1999, c. 87, § 2, emerg. eff. April 13, 1999.