A. The specifications drawn by the Oklahoma Health Care Authority for the health insurance plan shall provide for comprehensive hospital medical and surgical benefits. The health insurance plan may limit coverage for a particular illness, disease, injury or condition; but, except for such limits, shall not exclude or limit particular services or procedures that can be provided for the diagnosis and treatment of an illness, disease, injury or condition, so long as the services and procedures provided are of sound efficacy, are medically necessary, and fall within the licensed scope of practice of the practitioner providing same. The health insurance plan may contract with providers for specific services based on levels of outcomes defined by the Authority and achieved by the provider. The health insurance plan may provide for the application of deductibles and copayment or coinsurance provisions that are based on contracts with providers for specific services based on levels of outcomes or cost. B. The life insurance plan shall include Accidental Death and Dismemberment Benefits and additional optional life insurance coverage.
Okla. Stat. tit. 74, § 1307
Specifications - Limitations on benefits - Exceptions
Added by Laws 1967, c. 374, § 7, emerg. eff
Official source: Oklahoma Legislature. Reproduced from public-domain Oklahoma statutes; confirm against the official source for the current text. Not legal advice.