reglab/housing_qa huggingface dataset:
74 OK Stat § 74-1326 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1326. Fee schedules.

|The Office of Management and Enterprise Services shall make available, upon request, copies of relevant fee schedules to participating health care providers. |Added by Laws 1999, c. 209, § 3, eff. July 1, 1999. Amended by Laws 2012, c. 304, § 970.
74 OK Stat § 74-1327 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1327. Health benefit plans offered by Office of Management and Enterprise Services – Optometrists to be permitted to provide services for vision care or medical diagnosis and treatment for the eye.

|A. All health benefit plans offered by the Office of Management and Enterprise Services which provide for services for vision care or medical diagnosis and treatment for the eye shall allow optometrists to be providers of those services. All such health 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 health benefit plan offered by the Office 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 health benefit plans offered by the Office 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 maintenance organization in a manner that is without bias for or discrimination against a particular category or categories of providers.D. No health 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 a health benefit plan offered by the Office which provides for 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 health benefit plans offered by the Office 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, § 4, eff. Nov. 1, 2000. Amended by Laws 2012, c. 304, § 971.
74 OK Stat § 74-1328 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1328. Reimbursement of claims within certain time period.

|A. The contracted claims administrator for the Office of Management and Enterprise Services shall reimburse all clean claims of an enrollee, an assignee of the enrollee, or a health care provider within forty-five (45) calendar days after receipt of the claim by the entity. |B. As used in this section, "clean claim" means a claim that has no defect or impropriety, including a lack of any required substantiating documentation, or particular circumstance requiring special treatment that impedes prompt payment.C. 1. If a claim or any portion of a claim is determined to have defects or improprieties, including a lack of any required substantiating documentation, or a particular circumstance requiring special treatment, the enrollee, assignee of the enrollee, or health care provider shall be notified in writing within thirty (30) calendar days after receipt of the claim by the contracted claims administrator for the Office. The written notice shall specify the portion of the claim that is causing a delay in processing and explain any additional information or corrections needed. Failure of the Office's claims administrator to provide the enrollee, assignee of the enrollee, or health care provider with such notice shall constitute prima facie evidence that the claim will be paid in accordance with the terms of the health benefit claims administration contract.2. The portion of the claim that is accurate shall be paid within forty-five (45) calendar days after receipt of the claim by the claims administrator for the Office.D. Upon receipt of the additional information or corrections which led to the claim's being delayed and a determination that the information is accurate, the claims administrator for the Office shall either pay or deny the claim or a portion of the claim within forty-five (45) calendar days.E. Payment shall be considered made on:1. The date a draft or other valid instrument which is equivalent to the amount of the payment is placed in the United States mail in a properly addressed, postpaid envelope; or2. If not so posted, the date of delivery.F. An overdue payment shall bear simple interest at the rate of ten percent (10%) per year.G. In the event litigation should ensue based upon such a claim, the prevailing party shall be entitled to recover a reasonable attorney fee to be set by the court and taxed as costs against the party or parties who do not prevail.Added by Laws 2001, c. 65, § 3, eff. July 1, 2001. Amended by Laws 2002, c. 155, § 1, eff. July 1, 2002; Laws 2012, c. 304, § 972.
74 OK Stat § 74-1329 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1329. Health Savings Account - Contributions.

|The Office of Management and Enterprise Services shall contract with a vendor to make available a health savings account to all enrollees in the HealthChoice qualified high-deductible health plan. Any employer or employee contributions to the health savings account shall be allowable as a remittance to the vendor through payroll deduction in conjunction with the employer's Section 125 Plan and shall not be subject to any assessment of administrative fees by the Office of Management and Enterprise Services or any state agency for remittance to the vendor. The State of Oklahoma and the Office of Management and Enterprise Services shall take necessary measures to make any employer or employee health savings account contributions permissible under the state's Section 125 Plan. |Added by Laws 2011, c. 326, § 5, eff. Nov. 1, 2011. Amended by Laws 2012, c. 304, § 973.
74 OK Stat § 74-1329.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1329.1. Mutual accountability incentive program – Contractual requirement.

|The Office of Management and Enterprise Services shall contract for 2012 with a vendor that offers a Health Insurance Portability and Accountability Act (HIPAA) compliant web-based, doctor-patient mutual accountability incentive program. The purpose of the contract is to conduct a pilot project to test the value proposition of a program that offers financial incentives to both the health care provider and the patient for each care encounter in which the provider and patient incorporate evidence-based medicine treatment guidelines, patient health education remedies and other proven medical interventions made available and recorded through the program in the rendering and utilization of health care. The Office shall use operating funds to underwrite the cost of this pilot project and shall not pass these costs along to the participating state agencies, or school boards or providers. The Office may retain or share with participating state agencies or school boards any savings realized as a result of the pilot program. The program will demonstrate a self-sustaining financial model that, through the savings incurred by better utilization health care programs, will offset the costs of this program with savings. This program will offer the health care provider the flexibility to use the health care provider's clinical judgment to adhere to or deviate from the program's treatment guidelines and still receive a financial incentive, as long as the health care provider communicates care guidelines and patient health education remedies to the patient that include an explanation of the provider's adherence or reason for nonadherence to the guideline. The vendor managing the pilot program shall offer a financial reward to the patient for responding to the vendor's guidelines for care and patient education remedies by demonstrating the patient's understanding of the patient's health condition, by declaring or demonstrating adherence to recommended care, by agreeing to allow the patient's physician to view patient's responses and acknowledge the patient's health accomplishments, and by judging the quality of care given to the patient against these guidelines and recommended care. Any communications to patient and provider shall be in compliance with all HIPAA regulations and standards. Participation in the program shall be voluntary to both the provider and patient on an encounter-by-encounter basis. The program shall be offered and administered by the program vendor through an Internet application that is HIPAA-compliant. This pilot project shall include a minimum of fifteen thousand beneficiaries of the Office to achieve a statistical significance and collect and analyze data over a period of three (3) years in order to determine the program's effectiveness and ability to become self-funded. |Added by Laws 2011, c. 326, § 6, eff. Nov. 1, 2011. Amended by Laws 2012, c. 304, § 974.
74 OK Stat § 74-1331 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1331. Short title.

|Sections 108 through 111 of this act shall be known and may be cited as the "State Employees Disability Program Act". |Added by Laws 1985, c. 203, § 108, operative July 1, 1985.
74 OK Stat § 74-1332 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1332. Establishment of plan - Contents - Participation - Administration - Funding - Coverage - Grievance procedure - Claims administration.

|A. The State and Education Employees Group Insurance Board shall establish a Disability Insurance Program for state employees. The program shall consist of a long-term disability plan and a short-term disability plan. Participation in the program shall be limited to state employees who have been state employees for a period of not less than one (1) month and who are eligible for enrollment in the Health Insurance Plan administered by the Board. No state employee shall be eligible to receive any benefits from the long-term disability program unless the state employee has used all of the sick leave of the employee. The Board shall promulgate such rules as are necessary for adoption and administration of the Disability Insurance Program, including but not limited to benefit eligibility requirements, methods for computing benefit amounts, benefits amounts, and verification of medical and health status of employees applying for or receiving benefits. |B. The Disability Insurance Program shall be funded from appropriations made by the Legislature. Employees shall not be required to make contributions to participate in the program.C. Employee disability insurance coverage shall begin on March 1, 1986.D. The Board shall establish a grievance procedure by which a three-member grievance panel established in the same manner as specified in paragraph 6 of Section 1306 of this title shall act as an appeals body for complaints regarding the allowance and payment of claims, eligibility, and other matters. The grievance procedure provided by this subsection shall be the exclusive remedy available to persons having complaints against the insurer. Such grievance procedure shall be subject to the Oklahoma Administrative Procedures Act, including provisions for the review of agency decisions by the district court. The grievance panel shall schedule a hearing regarding the allowance and payment of claims, eligibility and other matters within sixty (60) days from the date the grievance panel receives a written request for a hearing. Upon written request to the grievance panel received not less than ten (10) days before the hearing date, the grievance panel shall cause a full stenographic record of the proceedings to be made by a licensed or certified court reporter at the insured employee's expense.E. The Board may establish a claim processing division for claims administration or may contract for claims administration services with a private insurance carrier or a company that specializes in claims administration of any insurance that the Board may be directed to offer.Added by Laws 1985, c. 203, § 109, operative July 1, 1985. Amended by Laws 1986, c. 150, § 20, emerg. eff. April 29, 1986; Laws 1989, c. 322, § 10, operative July 1, 1989; Laws 1991, c. 86, § 1, eff. July 1, 1991; Laws 1992, c. 367, § 9, eff. July 1, 1992; Laws 2000, c. 353, § 49, eff. Nov. 1, 2000; Laws 2001, c. 197, § 8, emerg. eff. May 7, 2001.
74 OK Stat § 74-1332.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1332.1. Collection of premiums - Deposit - Monthly statement of revenues and disbursements - Annual report - Continuation of dependent health coverage of disability recipients - Deduction of premiums for disability recipients.

|A. The State and Education Employees Group Insurance Board shall collect from state agencies each month, the premium amount, as determined by the Board, for each employee of a state agency that participates in the Disability Insurance Program. Said sum shall be deposited in the State Employees Disability Insurance Reserve Fund for use in accordance with law. |B. The State and Education Employees Group Insurance Board shall submit a monthly statement of the revenues and disbursements of the Disability Insurance Program to the Governor, the Speaker of the House of Representatives, the President Pro Tempore of the Senate and the Legislative Service Bureau. The Legislative Service Bureau shall distribute copies of such monthly statements to the fiscal staff of the House of Representatives and the State Senate.C. On or before March 1 of each year, the State and Education Employees Group Insurance Board shall submit a report of the actuarially-determined future needs of the Disability Insurance Program. Said report shall be submitted and distributed as provided for in subsection B of this section.D. The Board shall provide for the continuation of dependent health coverage to disability recipients for that period of time when the employee is qualified as disabled but not yet received disability benefit income.E. The Board shall deduct all dependent health coverage premiums due and owing from the first retroactive disability payment and each payment thereafter.Added by Laws 1990, c. 204, § 5, emerg. eff. May 10, 1990; Laws 1991, c. 86, § 2, eff. July 1, 1991.
74 OK Stat § 74-1332.2 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1332.2. Disability Insurance Program - Election to participate - Continued employee status during disability.

|A. Beginning July 1, 1990, persons who are active employees of the Oklahoma Employment Security Commission may elect to participate in the Disability Insurance Program. Any election to participate shall be received by the State and Education Employees Group Insurance Board prior to January 1, 1991. Employees who do not elect to participate in the disability program shall not thereafter be eligible to participate in the State Disability Insurance Program unless their present disability insurance coverage is canceled by the insurer offering said coverage. In the event of such cancellation, all participants in the agency offered disability plan shall be immediately transferred to the state disability insurance plan. Any person who does not qualify for the Commission disability plan prior to their transfer to the State Plan shall participate in the state disability insurance program. |B. Oklahoma Employment Security Commission employees who are or become disabled pursuant to the provisions of the agency disability plan shall retain their status as an employee so long as their disability continues.Added by Laws 1990, c. 303, § 5, emerg. eff. May 30, 1990.
74 OK Stat § 74-1333 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1333. State Employees Disability Insurance Reserve Fund.

|A. There is hereby created in the State Treasury the State Employees DisabilityInsurance Reserve Fund. All appropriations, dividend payments, and investment income received pursuant to the provisions of the State Employees Disability Insurance Act, Section 1331 et seq. of this title, shall be deposited in the reserve fund. |B. The monies in said reserve fund shall be invested by the State and Education Employees Group Insurance Board in the manner specified in Section 6 of this act. The Board shall have responsibility for management of the fund.C. Money payable to the claims administrator and all expenses in connection with the Disability Insurance Program shall be paid from the reserve fund.Added by Laws 1985, c. 203, § 110, operative July 1, 1985. Amended by Laws 1986, c. 150, § 21, emerg. eff. April 29, 1986; Laws 1989, c. 318, § 12, operative July 1, 1989.
74 OK Stat § 74-1335 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1335. County or city participation.

|A. A county, upon adoption of a resolution by the board of county commissioners, may participate in the Disability Insurance Program administered by the Oklahoma Employees Insurance and Benefits Board. Upon the filing of a certified copy of the resolution with the Board, the county shall become a participant on the first day of the second full month following the filing of the resolution. All employees of any county electing to participate in the Program shall have disability insurance coverage. The county shall forward to the Board, at such times as determined by the Board, the contributions necessary to pay for the disability insurance coverage of the employees of the county. The Board shall determine the amount of contribution required for the disability insurance coverage. |B. A city, upon adoption of a resolution by the municipal governing body, may participate in the Disability Insurance Program administered by the Oklahoma Employees Insurance and Benefits Board. Upon the filing of a certified copy of the resolution with the Board, the city shall become a participant on the first day of the second full month following the filing of the resolution. All employees of any city electing to participate in the Program shall have disability insurance coverage. The city shall forward to the Board, at such times as determined by the Board, the contributions necessary to pay for the disability insurance coverage of the employees of the city. The Board shall determine the amount of contribution required for the disability insurance coverage.Added by Laws 1989, c. 84, § 3, operative July 1, 1989.Amended by Laws 2016, c. 201, § 1, eff. Nov. 1, 2016.
74 OK Stat § 74-1341 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1341. Short title.

|Sections 5 through 10 of this act shall be known and may be cited as the "State Employees Flexible Benefits Act". |Added by Laws 1989, c. 370, § 5, operative July 1, 1989.
74 OK Stat § 74-1342 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1342. Definitions.

|As used in the State Employees Flexible Benefits Act, Section 1341 et seq. of this title: |1. "Board" means the State and Education Employees Group Insurance Board;2. "Flexible benefits plan" means a written plan providing benefits to eligible employees which meets the requirements of Title 26, Section 125 et seq. of the Internal Revenue Code of the United States and regulations promulgated thereunder;3. "Employee" means any person eligible to participate in the State and Education Employees Group Insurance Act, Section 1301 et seq. of this title, or an employee of the Oklahoma Employment Security Commission. "Employee" shall not include a person who is an employee of the State Regents for Higher Education or any institution under the authority of the State Regents for Higher Education or any person who is an employee of any school district or political subdivision of this state, except as provided for in Section 1348 of this title;4. "Employer" means any state agency, board, commission, department, institution, authority, officer, bureau, council, office or other entity created by the Oklahoma Constitution or statutes, but shall not include any school district, or political subdivision of the state, except as provided for in Section 1348 of this title. Provided the term "employer" shall also mean the State Regents for Higher Education or any institution under the authority of the State Regents for Higher Education upon agreement between the State Regents for Higher Education or the appropriate governing board of an institution under the authority of the State Regents for Higher Education and the Council; and5. "Salary adjustment agreement" means a written agreement between an eligible employee and an employer whereby the employer agrees to adjust the salary of the employee by a stated amount or an amount equal to the cost of benefits selected under a flexible benefits plan and the employer agrees to contribute such amount to cover certain costs of the benefits selected by the eligible employee.Added by Laws 1989, c. 370, § 6, operative July 1, 1989. Amended by Laws 1991, c. 219, § 11, emerg. eff. May 22, 1991; Laws 1992, c. 163, § 1, eff. July 1, 1992; Laws 1993, c. 359, § 7, eff. July 1, 1993.
74 OK Stat § 74-1343 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1343. Design, development, implementation or administration of employees flexible benefits plan - Personnel - Contracts.

|The Board shall retain qualified agencies, persons or entities to design, develop, communicate, implement or administer the state employees flexible benefits plan. The Board shall solicit proposals on a competitive bid basis for such agencies, persons or entities according to the standards set out in the Oklahoma Central Purchasing Act, Section 85.1 et seq. of this title. When requested by the Board, the Office of Management and Enterprise Services shall assist the Board in the process of selecting contracts for the design, development, communication or implementation of the state employees flexible benefits plan. |When awarding a contract for services pursuant to this subsection, the Board shall satisfy itself that the contractor has no interests which would impair its ability to perform the tasks and services required and that the contractor will exercise independent judgment when performing its responsibilities under the act and under the agreement.Added by Laws 1989, c. 370, § 7, operative July 1, 1989. Amended by Laws 1990, c. 244, § 11, eff. July 1, 1991; Laws 1991, c. 219, § 12, emerg. eff. May 22, 1991; Laws 2012, c. 304, § 975.
74 OK Stat § 74-1344.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1344.1. Enrollment materials from vendors with authorized payroll deductions.

|Materials from vendors that have an authorized payroll deduction for state employees pursuant to Section 7.10 of Title 62 of the Oklahoma Statutes or Section 1701 of this title shall be placed in the annual benefit enrollment materials provided to state employees and their dependents. |Added by Laws 2005, c. 215, § 2, eff. July 1, 2005. Amended by Laws 2006, c. 231, § 7, eff. July 1, 2006.