reglab/housing_qa huggingface dataset:
63 OK Stat § 63-5003 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5003. Legislative declaration - Purpose.

|A. The Legislature recognizes that the state is a major purchaser of health care services, and the increasing costs of such health care services are posing and will continue to pose a great financial burden on the state. It is the policy of the state to provide comprehensive health care as an employer to state employees and officials and their dependents and to those who are dependent on the state for necessary medical care. It is imperative that the state develop effective and efficient health care delivery systems and strategies for procuring health care services in order for the state to continue to purchase the most comprehensive health care possible. |B. It is therefore incumbent upon the Legislature to establish the Oklahoma Health Care Authority whose purpose shall be to:1. Purchase state and education employees' health care benefits and Medicaid benefits;2. Study all state-purchased and state-subsidized health care, alternative health care delivery systems and strategies for the procurement of health care services in order to maximize cost containment in these programs while ensuring access to quality health care; and3. Make recommendations aimed at minimizing the financial burden which health care poses for the state, its employees and its charges, while at the same time allowing the state to provide the most comprehensive health care possible.Added by Laws 1993, c. 332, § 1.
63 OK Stat § 63-5004 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5004. Short title.

|Sections 1 through 14 of this act shall be known and may be cited as the "Oklahoma Health Care Authority Act". |Added by Laws 1993, c. 332, § 2.
63 OK Stat § 63-5005 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5005. Definitions.

|For purposes of the Oklahoma Health Care Authority Act: |1. "Administrator" means the chief executive officer of the Authority;2. "Authority" means the Oklahoma Health Care Authority;3. "Board" means the Oklahoma Health Care Authority Board;4. "Health services provider" means health insurance carriers, pre-paid health plans, hospitals, physicians and other health care professionals, and other entities who contract with the Authority for the delivery of health care services to state and education employees and persons covered by the state Medicaid program; and5. "State-purchased health care" or "state-subsidized health care" means medical and health care, pharmaceuticals and medical equipment purchased with or supported by state and federal funds through the Oklahoma Health Care Authority, the Department of Mental Health and Substance Abuse Services, the State Department of Health, the Department of Human Services, the Department of Corrections, the Department of Veterans Affairs, other state agencies administering state-purchased or state-subsidized health care programs, the Oklahoma State Regents for Higher Education, the State Board of Education and local school districts.Added by Laws 1993, c. 332, § 3. Amended by Laws 1997, c. 109, § 1, eff. Nov. 1, 1997.
63 OK Stat § 63-5006 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5006. Oklahoma Health Care Authority - Creation - Powers and duties - Personnel.

|A. There is hereby created the Oklahoma Health Care Authority. The Authority shall have the power and duty to: |1. Purchase health care benefits for Medicaid recipients, and others who are dependent on the state for necessary medical care, as specifically authorized by law;2. Enter into contracts for the delivery of state-purchased health care and establish standards and criteria which must be met by entities to be eligible to contract with the Authority for the delivery of state-purchased health care;3. Develop a proposed standard basic health care benefits package or packages to be offered by health services providers, for Medicaid recipients;4. Study all matters connected with the provision of state-purchased and state-subsidized health care coverage;5. Develop and submit plans, reports and proposals, provide information and analyze areas of public and private health care interaction pursuant to the provisions of the Oklahoma Health Care Authority Act;6. Serve as a resource for information on state-purchased and state-subsidized health care access, cost containment and related health issues;7. Administer programs and enforce laws placed under the jurisdiction of the Authority pursuant to the Oklahoma Health Care Authority Act, and such other duties prescribed by law;8. Collaborate with and assist the Insurance Commissioner in the development of a Uniform Claim Processing System for use by third-party payors and health care providers;9. Collaborate with and assist the State Department of Health with the development of licensure standards and criteria for pre-paid health plans; and10. Exercise all incidental powers which are necessary and proper to carry out the purposes of the Oklahoma Health Care Authority Act.B. All positions within the Authority shall be unclassified until approval of the annual business and personnel plan submitted by January 1, 1995, by the Governor and the Legislature. In the annual business plan submitted January 1, 1995, the Board shall include a personnel plan which shall list, describe and justify all unclassified positions within the Authority and their compensation. All other employees and positions shall be classified and subject to the provisions of the Merit System of Personnel Administration as provided in the Oklahoma Personnel Act.Added by Laws 1993, c. 332, § 4. Amended by Laws 1995, c. 204, § 6, eff. July 1, 1995; Laws 1999, c. 87, § 1, emerg. eff. April 13, 1999.
63 OK Stat § 63-5007 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5007. Oklahoma Health Care Authority Board.

|A. There is hereby created the Oklahoma Health Care Authority Board which shall consist of the following nine (9) members: |1. Five members appointed by the Governor;2. Two members appointed by the Speaker of the House of Representatives; and3. Two members appointed by the President Pro Tempore of the Senate.B. Each member shall serve at the pleasure of his or her appointing authority and may be removed or replaced without cause. Any member of the Board shall be prohibited from voting on any issue in which the member has a direct financial interest. The Administrator of the Oklahoma Health Care Authority shall be an ex officio member of the Board, but shall be entitled to vote only in case of a tie vote.C. The Board shall have the power and duty to:1. Establish the policies of the Oklahoma Health Care Authority;2. Adopt and promulgate rules as necessary and appropriate to carry out the duties and responsibilities of the Authority. The Board shall be the rulemaking body for the Authority; and3. Adopt, publish and submit by January 1 of each year to the Governor, the President Pro Tempore of the Senate, and the Speaker of the House of Representatives appropriate administrative policies and the business plan for that year. All actions governed by the administrative policies and annual business plan shall be examined annually in an independent audit.D. A majority of the members of the Board shall constitute a quorum for the transaction of business and for taking any official action. Official action of the Board must have a favorable vote by a majority of the members present.E. Members appointed pursuant to subsection A of this section shall serve without compensation but shall be reimbursed for expenses incurred in the performance of their duties in accordance with the State Travel Reimbursement Act.F. The Board and the Authority shall act in accordance with the provisions of the Oklahoma Open Meeting Act, the Oklahoma Open Records Act and the Administrative Procedures Act.Added by Laws 1993, c. 332, § 5. Amended by Laws 1994, c. 282, § 2, eff. July 1, 1994; Laws 1995, c. 98, § 1, eff. July 1, 1995; Laws 1995, c. 204, § 7, eff. July 1, 1995; Laws 1998, c. 143, § 1, eff. July 1, 1998; Laws 2002, c. 375, § 13, eff. Nov. 5, 2002; Laws 2019, c. 9, § 1, emerg. eff. March 13, 2019.
63 OK Stat § 63-5007.1 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5007.1. Oklahoma Medicaid Accountability and Outcomes Act.

|A. This act shall be known and may be cited as the "Oklahoma Medicaid Accountability and Outcomes Act". |B. 1. Subject to the availability of funds, the Joint Legislative Oversight Committee for the Oklahoma Health Care Authority shall enter into a contract for a study of the Oklahoma Medicaid Program. The contract shall be executed with an organization having nationally recognized expertise in the area of health care and health care service delivery.2. The study shall include the entire Oklahoma Medicaid Program, including the Medicaid managed care programs and services delivered pursuant to the Oklahoma Medicaid Program Reform Act of 2003.3. The purpose of the study shall be to evaluate access to care, health care outcomes, and the quality and cost of health care and related services delivered through the Oklahoma Medicaid Program.4. A report of the study and findings shall be made to the Oklahoma Health Care Authority Board, the Governor, and the appropriate committees of the Oklahoma State Senate and the Oklahoma House of Representatives.Added by Laws 2002, c. 489, § 1, eff. Nov. 1, 2002. Amended by Laws 2003, c. 464, § 9, eff. July 1, 2003.
63 OK Stat § 63-5008 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5008. Administrator - Qualifications - Status - Powers and duties - Contract bidding process - Advisory committees.

|A. The Administrator of the Oklahoma Health Care Authority shall have the training and experience necessary for the administration of the Authority. The Administrator shall be appointed by the Governor with the advice and consent of the Senate and shall serve at the pleasure of the Governor and may be removed or replaced without cause. Compensation for the Administrator shall be determined by the Governor. The Administrator may be removed from office by a two-thirds (2/3) vote of the members elected to and constituting each chamber of the Legislature. |B. The Administrator of the Oklahoma Health Care Authority shall be the chief executive officer of the Authority and shall act for the Authority in all matters except as may be otherwise provided by law. The powers and duties of the Administrator shall include but not be limited to:1. Supervision of the activities of the Authority;2. Formulation and recommendation of rules for approval or rejection by the Oklahoma Health Care Authority Board and enforcement of rules and standards promulgated by the Board;3. Preparation of the plans, reports and proposals required by the Oklahoma Health Care Authority Act, Section 5003 et seq. of this title, other reports as necessary and appropriate, and an annual budget for the review and approval of the Board;4. Employment of such staff as may be necessary to perform the duties of the Authority including but not limited to an attorney to provide legal assistance to the Authority for the state Medicaid program; and5. Establishment of a contract bidding process which:a.encourages competition among entities contracting with the Authority for state-purchased and state-subsidized health care; provided, however, the Authority may make patient volume adjustments to any managed care plan whose prime contractor is a state-sponsored, nationally accredited medical school. The Authority may also make education or research supplemental payments to state-sponsored, nationally accredited medical schools based on the level of participation in any managed care plan by managed care plan participants,b.coincides with the state budgetary process, andc.specifies conditions for awarding contracts to any insuring entity.C. The Administrator may appoint advisory committees as necessary to assist the Authority with the performance of its duties or to provide the Authority with expertise in technical matters.Added by Laws 1993, c. 332, § 6. Amended by Laws 1994, c. 382, § 46, eff. Sept. 1, 1994; Laws 1995, c. 1, § 21, emerg. eff. March 2, 1995; Laws 1995, c. 330, § 1, emerg. eff. June 8, 1995; Laws 1996, c. 3, § 11, emerg. eff. March 6, 1996; Laws 2019, c. 9, § 2, emerg. eff. March 13, 2019.NOTE: Laws 1994, c. 282, § 3 repealed by Laws 1995, c. 1, § 40, emerg. eff. March 2, 1995. Laws 1995, c. 204, § 8 repealed by Laws 1996, c. 3, § 25, emerg. eff. March 6, 1996.
63 OK Stat § 63-5009.1 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5009.1. Oklahoma Health Care Authority - Acceptance of federal grants - Appropriations in advance.

|A. 1. The Oklahoma Health Care Authority may accept grants from the federal government of monies or services for the purpose of augmenting any assistance program or other program within the jurisdiction of the Authority or to reimburse the state for any such assistance payments. |2. The Authority shall comply with the requirements of any federal agency governing the federal grants in any manner not inconsistent with the Constitution and laws of this state.B. The Authority may make apportionments in advance of funds under its control, in accordance with the requirements of the federal government, when such funds are to be matched in whole or in part by federal funds; provided, the provisions of this subsection shall not authorize the Authority to make apportionments in advance of such funds in violation of any constitutional or statutory restrictions or provisions.Added by Laws 1996, c. 177, § 1, eff. Nov. 1, 1996.
63 OK Stat § 63-5009.4 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5009.4. Advisory Task Force on SoonerCare – Duties.

|A. The duties of the Advisory Task Force on SoonerCare shall include: |1. Addressing methods of educating SoonerCare members regarding access to and proper utilization of emergency medical services provided by hospitals and other health care providers;2. Reviewing the eligibility determination process of the Department of Human Services to ensure accuracy on physician assignments and adequacy of education regarding availability of and access to services;3. Reviewing issues related to notification of participants by contracting providers as a condition of payment;4. Actively promoting equitable reimbursement rates for emergency room screening; and5. Addressing patient and provider educational endeavors necessary for expansion of SoonerCare to the Aged, Blind and Disabled and Title XXI populations.B. The Task Force shall make recommendations to the Governor, the President Pro Tempore of the Senate and the Speaker of the House of Representatives no later than January 31, 2001.Added by Laws 1999, c. 32, § 2, emerg. eff. April 5, 1999.
63 OK Stat § 63-5009.5 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5009.5. Acturarial certification of Medicaid managed care plan capitation rates.

|Contracted Medicaid managed care plan capitation rates shall be certified as actuarially sound and shall reflect any Legislative or Authority programmatic or administrative changes. The results of the actuarial certification shall be disclosed to the public at least thirty (30) days prior to implementation of the modification. |Added by Laws 2002, c. 489, § 2, eff. Nov. 1, 2002.
63 OK Stat § 63-5009.6 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5009.6. Diabetes self-management training report.

|A. The Oklahoma Health Care Authority shall examine the feasibility of a state plan amendment to the Oklahoma Medicaid Program for diabetes self-management training (DSMT). |B. By December 1, 2018, the Authority shall submit a report to the President Pro Tempore of the Senate, the Speaker of the House of Representatives and the Governor estimating the potential costs to the state, clinical findings, reviews of pilot projects and research from other states on the effects of DSMT on persons with a diabetes diagnosis.C. Beginning July 1, 2019, and subject to the availability of funding, the Authority shall draft a state plan amendment for DSMT for persons with a diabetes diagnosis. The provisions of this subsection shall only apply if the report required by subsection B of this section demonstrates DSMT to be evidence-based and essential to qualifying participants in the Oklahoma Medicaid Program.D. As used in this section, "diabetes self-management training (DSMT)" means the process of facilitating the knowledge, skill and ability necessary for diabetes self-care. This process requires incorporating the patient's unique needs and experiences into an individualized education and support plan that promotes new behaviors and solutions, including, but not limited to, healthy eating, physical activity, self-monitoring and medication use.Added by Laws 2018, c. 34, § 1, eff. Nov. 1, 2018.
63 OK Stat § 63-5010 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5010. Analysis of state health care programs - Exploration of cost containment and delivery alternatives.

|A. The Oklahoma Health Care Authority shall analyze the state-purchased and state-subsidized health care programs and explore options for cost containment and delivery alternatives for those programs that are consistent with the purposes of those programs, including, but not limited to: |1. Creation of economic incentives for the persons for whom the state purchases or subsidizes health care to appropriately utilize and purchase health care services, including the development of flexible benefit plans to offset increases in individual financial responsibility;2. Utilization of provider arrangements that encourage cost containment and ensure access to quality care, including, but not limited to, prepaid delivery systems, utilization review, and prospective payment methods;3. Coordination of state agency efforts to purchase drugs effectively;4. Development of recommendations and methods for purchasing medical equipment and supporting services on a volume discount basis; and5. Development of data systems to obtain utilization data from state-purchased and state-subsidized health care programs in order to identify cost centers, utilization patterns, provider and hospital practice patterns, and procedure costs.B. 1. The Authority shall prepare for the Governor, the Legislature and the Joint Legislative Oversight Committee for the Oklahoma Health Care Authority an annual report on the savings realized and all costs incurred in the implementation of any drug cost containment programs including, but not limited to:a.development and implementation of a drug prior authorization list, andb.other uses of prior authorizations.2. Costs shall include direct costs such as staffing, contracts and other resources used.Added by Laws 1993, c. 332, § 8. Amended by Laws 2004, c. 218, § 1, eff. Nov. 1, 2004.
63 OK Stat § 63-5011 (2021)
2021 Oklahoma Statutes|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.

|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; and4. 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.
63 OK Stat § 63-5011.1 (2021)
2021 Oklahoma Statutes|Title 63. Public Health and Safety|§63-5011.1. State-purchased health care benefits – Optometrists to be permitted to provide vision care or medical diagnosis and treatment of the eye.

|A. All state-purchased and state-subsidized health care benefit plans, including but not limited to Medicaid, which offer services for vision care or medical diagnosis and treatment for the eye shall allow optometrists to be providers of those services. Such state-purchased and state-subsidized health care benefit plans shall also require equal payment for the same services provided by an optometrist if the services are within the scope of practice of optometry. |B. With respect to optometric services, any state-purchased and state-subsidized health care benefit plan, including but not limited to Medicaid, which uses a gatekeeper or equivalent for referrals for services for vision care or for medical diagnosis and treatment of the eye, shall require such covered services be provided on a referral basis within the medical group or network at the request of an enrollee who has a condition requiring vision care or medical diagnosis and treatment of the eye if:1. A referral is necessitated in the judgment of the primary care physician; and2. Treatment for the condition falls within the licensed scope of practice of an optometrist.C. All state-purchased and state-subsidized health care benefit plans shall have a defined set of standards and procedures for selecting providers, including specialists, to serve enrollees. The standards and procedures shall be drafted in such a manner that they are applicable to all categories of providers and shall be utilized by the health plan in a manner that is without bias for or discrimination against a particular category or categories of providers.D. No health care benefit plan specified by this section shall require a provider to have hospital privileges if hospital privileges are not usual and customary for the services the provider provides.E. Nothing in this section shall be construed to:1. Prohibit any state-purchased and state-subsidized health care benefit plan which offers services for vision care or medical diagnosis and treatment for the eye from determining the adequacy of the size of its network;2. Prohibit an optometrist from agreeing to a fee schedule;3. Limit, expand, or otherwise affect the scope of practice of optometry; or4. Alter, repeal, modify or affect the laws of this state except where such laws are in conflict or are inconsistent with the express provisions of this section.F. Existing state-purchased and state-subsidized health care benefit plans shall comply with the requirements of this section upon issuance or renewal on or after the effective date of this act.Added by Laws 2000, c. 54, § 3, eff. Nov. 1, 2000.