reglab/housing_qa huggingface dataset:
36 OK Stat § 36-6054 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6054. Definitions.

|As used in the Health Care Freedom of Choice Act: |1. “Accident and health insurance policy” or “policy” means any policy, certificate, contract, agreement or other instrument that provides accident and health insurance, as defined in Section 703 of this title, to any person in this state;2. “Ambulatory surgical center” means any ambulatory surgery facility licensed by the State Department of Health as defined in Section 2657 of Title 63 of the Oklahoma Statutes;3. “Home care agency” means any sole proprietorship, partnership, association, corporation, or other organization which administers, offers, or provides home care services, for a fee or pursuant to a contract for such services, to clients in their place of residence. The term “home care agency” shall not include an individual who contracts with the Department of Human Services to provide personal care services; provided, such individual shall not be exempt from certification as a home health aide;4. “Hospital” means any facility as defined in Section 1-701 of Title 63 of the Oklahoma Statutes;5. “Insured” means any person entitled to reimbursement for expenses of health care services and procedures under an accident and health insurance policy issued by an insurer;6. “Insurer” means any entity that provides an accident and health insurance policy in this state, including but not limited to a licensed insurance company, a not-for-profit hospital service and medical indemnity corporation, a fraternal benefit society, a multiple employer welfare arrangement, or any other entity subject to regulation by the Insurance Commissioner;7. “Practitioner” means any person holding a valid license to practice medicine and surgery, osteopathic medicine, chiropractic, podiatric medicine, optometry or dentistry, pursuant to the state licensing provisions of Title 59 of the Oklahoma Statutes; and8. “Preferred provider organization (PPO)” means a network of practitioners, hospitals, home care agencies or ambulatory surgical centers, which have entered into a contract with an insurer to provide health care services under the terms and conditions established in the contract.Added by Laws 1989, c. 37, § 1, eff. Nov. 1, 1989. Amended by Laws 1994, c. 342, § 19, eff. Sept. 1, 1994; Laws 1996, c. 76, § 1, eff. Nov. 1, 1996; Laws 1999, c. 331, § 2, eff. Nov. 1, 1999.
36 OK Stat § 36-6056 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6056. Place where services may be performed.

|Services and procedures covered under an accident and health insurance policy may be performed at any hospital, home care agency or ambulatory surgical center where a practitioner is authorized to practice, doctor's office or clinic, at the choice of the insured, or the insured's parent or guardian if the insured is a minor, and the practitioner who is providing the services and procedures. |Added by Laws 1971, c. 183, § 6. Amended by Laws 1989, c. 37, § 3, eff. Nov. 1, 1989; Laws 1996, c. 76, § 3, eff. Nov. 1, 1996; Laws 1999, c. 331, § 4, eff. Nov. 1, 1999.
36 OK Stat § 36-6057 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6057. Denial under policy coverage as void – Compliance with act.

|A. Any provision, exclusion or limitation in an accident and health insurance policy which: |1. Denies an insured, or the insured's parent or guardian if the insured is a minor, the free choice of any practitioner or the use of any hospital, home care agency or ambulatory surgical center where the practitioner is authorized to practice, doctor's office or clinic; or2. Otherwise conflicts with any provision of the Health Care Freedom of Choice Act,shall, to the extent of the denial or conflict, be void, but such voidance shall not affect the validity of the other provisions of the policy.B. Any policy form presently approved for use containing any provision, exclusion or limitation determined by the Insurance Commissioner to be in conflict with any provision of the Health Care Freedom of Choice Act shall be brought into compliance with the act by the filing of a rider, an endorsement, or a new or revised policy form approved by the Commissioner.Added by Laws 1971, c. 183, § 7. Amended by Laws 1989, c. 37, § 4, eff. Nov. 1, 1989; Laws 1996, c. 76, § 4, eff. Nov. 1, 1996; Laws 1999, c. 331, § 5, eff. Nov. 1, 1999.
36 OK Stat § 36-6057.1 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6057.1. Examination and enforcement by Commissioner – Attorneys’ fees.

|A. In order to enforce the provisions of the Health Care Freedom of Choice Act, the Insurance Commissioner may conduct an examination of insurers’ and preferred provider organizations’ claims files pursuant to the procedure set forth in Section 1250.4 of this title. |B. The Commissioner, upon finding an insurer in violation of any provision of the Health Care Freedom of Choice Act, may issue a cease and desist order to the insurer directing the insurer to stop such unlawful practices. If the insurer refuses or fails to comply with the order, the Commissioner shall have the authority to revoke or suspend the insurer’s certificate of authority. The Commissioner shall use the authority specified in this subsection to the extent deemed necessary to obtain the insurer’s compliance with the order. The Attorney General shall offer assistance if requested by the Commissioner to enforce the Commissioner’s orders.C. Reasonable attorney fees shall be awarded to the Commissioner if judicial action is necessary for the enforcement of the orders. Such fees shall be based upon those prevailing in the community. Fees collected by the Commissioner without the assistance of the Attorney General shall be credited to the Insurance Commissioner’s Revolving Fund. Fees collected by the Attorney General shall be credited to the Attorney General’s Revolving Fund.Added by Laws 1999, c. 331, § 6, eff. Nov. 1, 1999. Amended by Laws 2000, c. 353, § 43, eff. Nov. 1, 2000.
36 OK Stat § 36-6057.2 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6057.2. Penalties.

|For any violation of the Health Care Freedom of Choice Act, the Insurance Commissioner may, after notice and opportunity hearing, subject an insurer or practitioner to an administrative penalty of not less than One Hundred Dollars ($100.00) nor more than Five Thousand Dollars ($5,000.00) for each occurrence. Such administrative penalty may be enforced in the same manner in which civil judgments may be enforced. The penalties collected shall be placed in the Insurance Commissioner’s Revolving Fund. |Added by Laws 1999, c. 331, § 7, eff. Nov. 1, 1999.
36 OK Stat § 36-6057.3 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6057.3. Judicial review.

|Any insurer or practitioner affected by an order of the Insurance Commissioner issued pursuant to the Health Care Freedom of Choice Act may seek judicial review of such order pursuant to Article II of the Administrative Procedures Act. |Added by Laws 1999, c. 331, § 8, eff. Nov. 1, 1999.
36 OK Stat § 36-6057.4 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6057.4. Rules.

|The Insurance Commissioner shall promulgate rules for the implementation and administration of the Health Care Freedom of Choice Act. |Added by Laws 1999, c. 331, § 9, eff. Nov. 1, 1999.
36 OK Stat § 36-6058 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6058. Newly-born children - Health insurance benefits.

|A. All individual and group health insurance policies providing coverage on an expense incurred, fixed, or capitated basis, and all individual and group insurance policies, certificates, service or indemnity type contracts issued by insurance companies, health maintenance organizations, nonprofit corporations, or charitable and benevolent corporations established for the purpose of operating a nonprofit hospital service, indemnity, fixed or capitated plan, or a nonprofit medical or indemnity plan, and all self-insurers which provide coverage for a family member of the insured or subscriber shall, as to such family member's coverage, also provide that the health insurance benefits applicable for children shall be payable with respect to a newly born child of the insured or subscriber from the moment of birth. |B. The coverage for newly born children shall consist of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. Such coverage shall also include transportation necessary for the provision of medical care for such newly born children when (1) the newly born is transported to the nearest hospital capable of providing the medically necessary treatment on a timely basis, and (2) the mode of transportation is the most economical consistent with the well-being of the newly born. Transportation coverage shall not exceed the reasonable costs of providing such service and an itemized statement of costs shall accompany each claim.The provisions of this subsection shall not apply to policies involving Medicare and supplements to Medicare.C. If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within thirty-one (31) days after the date of birth in order to have the coverage continue beyond such thirty-one-day period.Added by Laws 1975, c. 87, § 1, operative Sept. 1, 1975. Amended by Laws 1984, c. 129, § 1, eff. July 1, 1985; Laws 2006, c. 264, § 63, eff. July 1, 2006.
36 OK Stat § 36-6060 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060. Definitions – Mammography screening.

|A. For the purposes of this section, |1. "Health benefit plan" means any plan or arrangement as defined in subsection C of Section 6060.4 of this title;2. "Low-dose mammography" means:a.the x-ray examination of the breast using equipment specifically dedicated for such purpose, with an average radiation exposure delivery of less than one rad mid-breast and with two views for each breast,b.digital mammography, orc.breast tomosynthesis;3. "Breast tomosynthesis" means a radiologic mammography procedure involving the acquisition of projection images over a stationary breast to produce cross-sectional digital three-dimensional images of the breast from which breast cancer screening diagnoses may be made.B. All health benefit plans shall include the coverage specified by this section for a low-dose mammography screening for the presence of occult breast cancer. Such coverage shall not:1. Be subject to the policy deductible, co-payments and co-insurance limits of the plan; or2. Require that a female undergo a mammography screening at a specified time as a condition of payment.C. 1. Any female thirty-five (35) through thirty-nine (39) years of age shall be entitled pursuant to the provisions of this section to coverage for a low-dose mammography screening once every five (5) years.2. Any female forty (40) years of age or older shall be entitled pursuant to the provisions of this section to coverage for an annual low-dose mammography screening.Added by Laws 1988, c. 118, § 9, eff. Nov. 1, 1988. Amended by Laws 1989, c. 287, § 1, eff. Nov. 1, 1989; Laws 1993, c. 165, § 1, eff. Sept. 1, 1993; Laws 1994, c. 294, § 10, eff. Sept. 1, 1994; Laws 2001, c. 408, § 1, eff. July 1, 2001; Laws 2002, c. 78, § 1, emerg. eff. April 15, 2002; Laws 2008, c. 184, § 23, eff. July 1, 2008; Laws 2010, c. 222, § 29, eff. Nov. 1, 2010; Laws 2018, c. 158, § 1, eff. Nov. 1, 2018.
36 OK Stat § 36-6060.1 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.1. Bone density testing.

|A. All individual and group health insurance policies providing coverage on an expense incurred basis, and all individual and group service or indemnity type contracts issued by a nonprofit corporation which provide coverage for a female forty-five (45) years of age or older in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall include the coverage specified by this section for a bone density test to qualified individuals covered by the policy when such test is requested by a primary care or referral physician. The test shall be subject to the policy deductible, copayments and coinsurance limits of the plan; provided, however, no policy or contract shall be required to reimburse more than One Hundred Fifty Dollars ($150.00) for any such test. |B. For purposes of this section:1. "Qualified individual" means an individual:a.with an estrogen hormone deficiency,b.with:(1)vertebral abnormalities,(2)primary hyperparathyroidism, or(3)a history of fragility bone fractures,c.who is receiving long-term glucocorticoid, ord.who is currently under treatment for osteoporosis; and2. "Bone density test" means a medically accepted measurement of bone mass used to detect low bone mass and to determine a qualified individual's risk for osteoporosis.Added by Laws 1996, c. 102, § 1, eff. Nov. 1, 1996.
36 OK Stat § 36-6060.3a (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.3a. Annual obstetrical/gynecological examinations.

|A. Any health benefit plan, including the State and Education Employees Group Health Insurance plan, that is offered, issued or renewed in this state on or after January 1, 2005, that provides medical and surgical benefits shall provide coverage for routine annual obstetrical/gynecological examinations. |B. The benefit required to be provided by this section shall in no way diminish or limit diagnostic benefits otherwise allowable under a health benefit plan.C. Nothing in this section shall be construed as requiring such routine annual examination to be performed by an obstetrician, gynecologist, or obstetrician/gynecologist.D. As used in this section, “health benefit plan” means any plan or arrangement as defined in subsection C of Section 6060.4 of this title, except that the term “health benefit plan” does not include policies or certificates issued to individuals or groups with fewer than fifty employees.E. The provisions of this section shall not apply to policies or certificates issued to individuals or groups with fewer than fifty employees.Added by Laws 2004, c. 397, § 1, eff. Nov. 1, 2004. Amended by Laws 2010, c. 222, § 32, eff. Nov. 1, 2010.
36 OK Stat § 36-6060.4 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.4. Child immunization coverage.

|A. A health benefit plan delivered, issued for delivery or renewed in this state on or after January 1, 1998, that provides benefits for the dependents of an insured individual shall provide coverage for each child of the insured, from birth through the date the child is eighteen (18) years of age for: |1. Immunization against:a.diphtheria,b.hepatitis B,c.measles,d.mumps,e.pertussis,f.polio,g.rubella,h.tetanus,i.varicella,j.haemophilus influenzae type B, andk.hepatitis A; and2. Any other immunization subsequently required for children by the State Board of Health.B. Benefits required pursuant to subsection A of this section shall not be subject to a deductible, co-payment, or coinsurance requirement.C. 1. For purposes of this section, "health benefit plan" means a plan that:a.provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, andb.is offered by any insurance company, group hospital service corporation, the State and Education Employees Group Insurance Board, or health maintenance organization that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an evidence of coverage, or, to the extent permitted by the Employee Retirement Income Security Act of 1974, 29 U.S.C., Section 1001 et seq., by a multiple employer welfare arrangement as defined in Section 3 of the Employee Retirement Income Security Act of 1974, or any other analogous benefit arrangement, whether the payment is fixed or by indemnity.2. The term "health benefit plan" shall not include:a.a plan that provides coverage:(1)only for a specified disease or diseases or under an individual limited benefit policy,(2)only for accidental death or dismemberment,(3)only for dental or vision care,(4)a hospital confinement indemnity policy,(5)disability income insurance or a combination of accident-only and disability income insurance, or(6)as a supplement to liability insurance,b.a Medicare supplemental policy as defined by Section 1882(g)(1) of the Social Security Act (42 U.S.C., Section 1395ss),c.workers' compensation insurance coverage,d.medical payment insurance issued as part of a motor vehicle insurance policy,e.a long-term care policy, including a nursing home fixed indemnity policy, unless a determination is made that the policy provides benefit coverage so comprehensive that the policy meets the definition of a health benefit plan, orf.short-term health insurance issued on a nonrenewable basis with a duration of six (6) months or less.Added by Laws 1997, c. 75, § 1, eff. Nov. 1, 1997. Amended by Laws 2000, c. 61, § 1, eff. Nov. 1, 2000; Laws 2003, c. 464, § 6, eff. July 1, 2003; Laws 2006, c. 264, § 65, eff. July 1, 2006; Laws 2010, c. 222, § 33, eff. Nov. 1, 2010; Laws 2016, c. 73, § 7, eff. Nov. 1, 2016.
36 OK Stat § 36-6060.4a (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.4a. Claims in conjunction with arrest or pretrial detention.

|A. No health benefit plan, including, but not limited to, the State and Education Employees Group Health Insurance Plan, that is offered, issued or renewed in the state on or after January 1, 2009, shall exclude otherwise allowable claims which occur in conjunction with the arrest or pretrial detention of the policyholder prior to adjudication of guilt and sentencing to incarceration of the policyholder. The reimbursement rate for out-of-network claims for these services shall be set at the current Medicare rate. |B. As used in this section, “health benefit plan” means any plan or arrangement as defined in subsection C of Section 6060.4 of this title.Added by Laws 2008, c. 351, § 1, eff. Nov. 1, 2008. Amended by Laws 2010, c. 222, § 34, eff. Nov. 1, 2010.
36 OK Stat § 36-6060.5 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.5. Oklahoma Breast Cancer Patient Protection Act.

|A. This section shall be known and may be cited as the "Oklahoma Breast Cancer Patient Protection Act". |B. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 1998, that provides medical and surgical benefits with respect to the treatment of breast cancer and other breast conditions shall ensure that coverage is provided for not less than forty-eight (48) hours of inpatient care following a mastectomy and not less than twenty-four (24) hours of inpatient care following a lymph node dissection for the treatment of breast cancer.C. Nothing in this section shall be construed as requiring the provision of inpatient coverage where the attending physician in consultation with the patient determines that a shorter period of hospital stay is appropriate.D. Any plan subject to subsection B of this section shall also provide coverage for reconstructive breast surgery performed as a result of a partial or total mastectomy. Because breasts are a paired organ, any such reconstructive breast surgery shall include coverage for all stages of reconstructive breast surgery performed on a nondiseased breast to establish symmetry with a diseased breast when reconstructive surgery on the diseased breast is performed, provided that the reconstructive surgery and any adjustments made to the nondiseased breast must occur within twenty-four (24) months of reconstruction of the diseased breast.E. In implementing the requirements of this section, a health benefit plan may not modify the terms and conditions of coverage based on the determination by an enrollee to request less than the minimum coverage required pursuant to subsections B and D of this section.F. A health benefit plan shall provide notice to each insured or enrollee under the plan regarding the coverage required by this section in the evidence of coverage of the plan, and shall provide additional written notice of the coverage to the insured or enrollee as follows:1. In the next mailing made by the plan to the employee;2. As part of any yearly informational packet sent to the enrollee; or3. Not later than December 1, 1997;whichever is earlier.G. As used in this act, "health benefit plan" means any plan or arrangement as defined in subsection C of Section 6060.4 of this title.H. The Insurance Commissioner shall promulgate any rules necessary to implement the provisions of this section.Added by Laws 1997, c. 135, § 1, eff. Nov. 1, 1997. Amended by Laws 2003, c. 464, § 7, eff. July 1, 2003; Laws 2010, c. 222, § 35, eff. Nov. 1, 2010.
36 OK Stat § 36-6060.6 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.6. Dental procedures for certain minor and severely disabled persons.

|A. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 1999, that provides hospitalization benefits shall provide coverage for anesthesia expenses including anesthesia practitioner expenses for the administration of the anesthesia, and hospital and ambulatory surgical center expenses associated with any medically necessary dental procedure when provided to a covered person who is: |1. Severely disabled; or2.a.A minor eight (8) years of age or under, and who has a medical or emotional condition which requires hospitalization or general anesthesia for dental care, orb.A minor four (4) years of age or under, who in the judgment of the practitioner treating the child, is not of sufficient emotional development to undergo a medically necessary dental procedure without the use of anesthesia.B. A health benefit plan may require prior authorization for either inpatient or outpatient hospitalization for dental care in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.C. Coverage provided for in subsection A of this section shall be subject to the same annual deductibles, copayments or coinsurance limits as established for all other covered benefits under the health benefit plan.D. As used in this section, "health benefit plan" means any plan or arrangement as defined in subsection C of Section 6060.4 of this title.Added by Laws 1998, c. 66, § 1, eff. Nov. 1, 1998. Amended by Laws 1999, c. 98, § 1, eff. July 1, 1999; Laws 2010, c. 222, § 36, eff. Nov. 1, 2010.
36 OK Stat § 36-6060.7 (2021)
2021 Oklahoma Statutes|Title 36. Insurance|§36-6060.7. Audiological services and hearing aids for children.

|A. 1. Any health benefit plan that is offered, issued, or renewed on or after the effective date of this act shall provide coverage for audiological services and hearing aids for children up to eighteen (18) years of age. |2. Such coverage:a.shall only apply to hearing aids that are prescribed, filled and dispensed by a licensed audiologist, andb.may limit the hearing aid benefit payable for each hearing-impaired ear to every forty-eight (48) months; provided, however, coverage may provide for up to four additional ear molds per year for children up to two (2) years of age.B. Nothing in this section shall be construed to extend the practice or privileges of any health care provider beyond that provided in the laws governing the practice and privileges of the provider.C. As used in this section, “health benefit plan” means any plan or arrangement as defined in subsection C of Section 6060.4 of this title.Added by Laws 1999, c. 136, § 1, eff. Nov. 1, 1999. Amended by Laws 2002, c. 30, § 1, eff. Nov. 1, 2002; Laws 2010, c. 222, § 37, eff. Nov. 1, 2010.