reglab/statecodes huggingface dataset:
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 25 - Withdrawal of a Certificate › Section 310:657-25-1 - Conditions to revoke or suspend

Current through Vol. 41, No. 20, July 1, 2024
The Commissioner may revoke or suspend a certificate issued
				  to a Plan, or take such other steps as appropriate, if the Plan:
(1) Is not in compliance with the Act or OAC
				310:657;
(2) Violated its health
				service contracts;
(3) Is unable to
				fulfill its obligations under outstanding contracts for the benefit of
				employees;
(4) Attempted to
				merchandise its services in such a manner as to misrepresent its services or
				capacity for service or has engaged in deceptive, misleading, or unfair
				practices in advertising, merchandising or promoting towards providers,
				employees, insurers or insureds;
(5) Did not correct an impairment as required
				under OAC
				310:657-15-6;
				or
(6) Knowingly uses or has
				knowingly used a provider who does not have a license, certificate or other
				authority to practice or furnish medical or health services.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 14 Ok
				  Reg 2264, eff 6-12-97; Amended at 23 Ok Reg 2404, eff
				  6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 25 - Withdrawal of a Certificate › Section 310:657-25-2 - Suspended certificate

Current through Vol. 41, No. 20, July 1, 2024
(a) While a
				Plan's certificate is suspended, the Plan shall not, advertise or solicit
				additional business.
(b) The order
				suspending the certificate shall specify the period of suspension and
				conditions to be met for reinstatement.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 25 - Withdrawal of a Certificate › Section 310:657-25-3 - Revoked certificate

Current through Vol. 41, No. 20, July 1, 2024
(a) The Plan
				shall conduct no business except as may be essential to the orderly conclusion
				of its affairs when a Plan's certificate is revoked. The Commissioner may order
				such operations as needed to afford employees a practical opportunity for
				medical and health services.
(b)
				The Plan shall not apply for certification for at least two (2) years after a
				certificate is revoked. The Plan shall follow the procedures for an initial
				application specified at OAC 310:657-21 and shall submit evidence that the
				conditions causing the revocation have been corrected.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 25 - Withdrawal of a Certificate › Section 310:657-25-4 - Person requesting action

Current through Vol. 41, No. 20, July 1, 2024
An action to revoke or suspend a certificate may be requested
				  by the Commissioner, the Department, or any other person.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 27 - Reports and Filings › Section 310:657-27-1 - Annual reports

Current through Vol. 41, No. 20, July 1, 2024
(a) By May 1 of
				each year, the Plan shall file:
(1) Financial
				statements which exhibit the Plan's financial condition on December 31 of the
				prior year and its income and expenses that year. These statements shall be
				prepared in accordance with accounting principles generally accepted in the
				United States of America. The Plan shall supplement the statements with any
				information requested by the Commissioner. Such statements shall be subscribed
				and sworn to by the president, secretary and other officers, with original
				signatures. A statement of financial condition shall include:
(A) A balance sheet; and
(B) Revenues and expenses;
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 27 - Reports and Filings › Section 310:657-27-2 - Application form changes

Current through Vol. 41, No. 20, July 1, 2024
Any material change in the information submitted in the
				  application shall be submitted to the Department, including:
(1) The approved geographic service area or
				the organizational structure, including owner or operator;
(2) Provider agreements which may affect
				services available to employees, at least thirty (30) days before execution or
				termination of such agreements;
(3)
				Any request for changes in the approved quality assurance program, at least
				thirty (30) days before the proposed change;
(4) The chief executive officer or medical
				director, to be reported upon the termination or starting of employment, with
				biographical information for the new appointee;
(5) Ten (10) percent or more in provider
				hours of operation;
(6) Essential
				content in marketing materials, before issuance; and,
(7) Approval issued by a voluntary body or
				agency and relied upon by the Commissioner under OAC 310:657-23.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 27 - Reports and Filings › Section 310:657-27-3 - Commissioner review

Current through Vol. 41, No. 20, July 1, 2024
The Commissioner shall have thirty (30) days after receipt to
				  approve or deny proposed changes or required filings.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 27 - Reports and Filings › Section 310:657-27-4 - Maintenance of records

Current through Vol. 41, No. 20, July 1, 2024
A Plan shall maintain records or information used to prepare
				  required reports for at least five (5) years.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 27 - Reports and Filings › Section 310:657-27-5 - Documents as public record

Current through Vol. 41, No. 20, July 1, 2024
All applications shall be available for public inspection in
				  the Department offices during normal working hours. This applies to
				  applications reviewed or under review by the Commissioner. All applications,
				  filings and reports required under OAC 310:657 shall be public documents,
				  except those containing trade secrets, privileged commercial or financial
				  information, or confidential quality or utilization review materials. Financial
				  information required under OAC 310:657-27 shall not be privileged
				  information.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 29 - Restricted and Prohibited Acts › Section 310:657-29-1 - Restricted provision of services

Current through Vol. 41, No. 20, July 1, 2024
A Plan which has been granted a certificate to operate shall
				  provide services only those persons who work, reside, or work and reside in its
				  approved geographic service area.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 29 - Restricted and Prohibited Acts › Section 310:657-29-2 - Prohibited acts

Current through Vol. 41, No. 20, July 1, 2024
(a) No person may
				operate a Plan in Oklahoma, nor use the phrase "workplace medical plan," nor
				imply that it is a workplace medical plan, unless that person first obtains a
				certificate.
(b) No Plan shall
				imply that certification qualifies the Plan to provide services except as
				authorized under the Act and OAC 310:657.
(c) A Plan, its employees and agents shall
				not:
(1) Pay claims reviewers based on
				reductions, unless the reductions are based on uniformly applied protocols
				designed to detect billing errors and duplicate charges;
(2) Compel an injured worker or a provider
				to:
(A) Accept less than the full settlement
				of a claim;
(B) File suit to obtain
				full settlement;
(C) Accept a
				lesser, interim figure as a premature final settlement; or
(3) Knowingly misrepresent reimbursement
				criteria and time frames to employees, a provider, an insurer, an insured, or
				their representatives.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 29 - Restricted and Prohibited Acts › Section 310:657-29-3 - Enforcement

Current through Vol. 41, No. 20, July 1, 2024
If a person violates OAC 310:657-29, the Commissioner shall
				  send written notice to the person to cease and desist the violation. If any
				  person continues the violation, the Commissioner may seek an injunction to
				  prohibit the continued offering of service.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 31 - Terminating and Continuing Services › Section 310:657-31-1 - Terminating services

Current through Vol. 41, No. 20, July 1, 2024
(a) A Plan shall
				notify an insurer, an employer, providers, and open cases at least sixty (60)
				days before terminating services or not renewing the insurer's, employer's or
				provider's contract.
(b) Before
				terminating services, a plan shall make all necessary arrangements to provide
				the employer/payer with the medical records and all open or recent cases that
				have not previously been provided.
(c) An agreement between a provider and a
				Plan shall require the provider to notify the Plan at least sixty (60) days
				before termination of the agreement.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 14 Ok
				  Reg 2264, eff 6-12-97; Amended at 23 Ok Reg 2404, eff
				  6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 31 - Terminating and Continuing Services › Section 310:657-31-2 - Bankruptcy strategy [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Revoked at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 31 - Terminating and Continuing Services › Section 310:657-31-3 - Dismissal from the Plan for cause

Current through Vol. 41, No. 20, July 1, 2024
A Plan may request dismissal from the Plan of an employee for
				  documented abusive, disruptive or threatening behavior which impairs the Plan's
				  ability to provide services. Dismissal shall comply with the insurer's or
				  insured's contract.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 14 Ok
				  Reg 2264, eff 6-12-97; Amended at 23 Ok Reg 2404, eff
				  6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 31 - Terminating and Continuing Services › Section 310:657-31-4 - Notice

Current through Vol. 41, No. 20, July 1, 2024
A Plan shall notify the Commissioner in writing at least
				  ninety (90) days before any cessation of business. The Plan shall submit all
				  notices and agreements before their release and effective
				  dates.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 33 - Powers of a Plan › Section 310:657-33-1 - Powers

Current through Vol. 41, No. 20, July 1, 2024
The powers of a Plan include the following:
(1) Making transactions between affiliated
				entities, including loans and the transfer of responsibility under all
				contracts between affiliates or between the Plan and its parent;
(2) Furnishing medical and health services
				through providers, associations or agents which contract with or are employed
				by the Plan;
(3) Contracting with
				any person for the performance on its behalf of functions such as marketing and
				administration; and
(4) Marketing
				of products with an insurer or insured, if the company offering each product is
				clearly identified.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 14 Ok
				  Reg 2264, eff 6-12-97; Amended at 23 Ok Reg 2404, eff
				  6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 33 - Powers of a Plan › Section 310:657-33-2 - Notice of exercise of powers

Current through Vol. 41, No. 20, July 1, 2024
A Plan shall file notice and supporting information with the
				  Department before the exercise of any power under OAC 310:657-33. The
				  Commissioner shall disapprove an exercise of power if it will affect the Plan's
				  financial soundness and endanger its ability to meet its obligations. The
				  Commissioner shall have no more than thirty (30) days to act on the
				  notice.
Added at 12 Ok Reg 2977,
				  eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff
				  6-13-96
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 35 - Enrollment and Election Process [Revoked] › Section 310:657-35-1 - Obligations of Plan and insurer or insured [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 16 Ok Reg 683,
				  eff 1-5-99 (emergency); Added at 16 Ok Reg 1410, eff 5-27-99; Revoked at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 657 - Certified Workplace Medical Plans › Subchapter 35 - Enrollment and Election Process [Revoked] › Section 310:657-35-2 - Description of the notice and election form [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 16 Ok Reg 683,
				  eff 1-5-99 (emergency); Added at 16 Ok Reg 1410, eff 5-27-99; Revoked at 23 Ok
				  Reg 2404, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 1 - General Provisions [REVOKED] › Section 310:658-1-1 - Purpose [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 1 - General Provisions [REVOKED] › Section 310:658-1-2 - Definitions [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 3 - Applying for a Certificate [REVOKED] › Section 310:658-3-1 - Application required [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 3 - Applying for a Certificate [REVOKED] › Section 310:658-3-2 - Description of application form [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-1 - Procedures for informed consent [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-2 - Independence and objectivity of review organization and process [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-3 - Independence and objectivity of health care professionals [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-4 - Identity of physician [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-5 - Confidentiality of records and information [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-6 - Expedited appeals [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-7 - Fair business practices [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 5 - Standards for Independent Review Organizations [REVOKED] › Section 310:658-5-8 - Other duties of independent review organizations [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 7 - Issuance or Denial of Certificate [REVOKED] › Section 310:658-7-1 - Conditions for issuance or renewal [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 7 - Issuance or Denial of Certificate [REVOKED] › Section 310:658-7-2 - Duration of certificate [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 7 - Issuance or Denial of Certificate [REVOKED] › Section 310:658-7-3 - Denial or nonrenewal of application [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 7 - Issuance or Denial of Certificate [REVOKED] › Section 310:658-7-4 - Certificate transfer [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 9 - Duties of Health Benefit Plans [REVOKED] › Section 310:658-9-1 - Information provided to the Department [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 9 - Duties of Health Benefit Plans [REVOKED] › Section 310:658-9-2 - Information provided to independent review organization [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 11 - Forms for Use by Insured Persons [REVOKED] › Section 310:658-11-1 - Request for external review form [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 11 - Forms for Use by Insured Persons [REVOKED] › Section 310:658-11-2 - Medical records release form [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 11 - Forms for Use by Insured Persons [REVOKED] › Section 310:658-11-3 - Informed consent form [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 13 - Department Procedures [REVOKED] › Section 310:658-13-1 - Request for external review form [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 13 - Department Procedures [REVOKED] › Section 310:658-13-2 - List of certified independent review organizations [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 15 - Reporting Requirements [REVOKED] › Section 310:658-15-1 - Records [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 15 - Reporting Requirements [REVOKED] › Section 310:658-15-2 - Annual reports [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 15 - Reporting Requirements [REVOKED] › Section 310:658-15-3 - Decision filings [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 658 - Independent Review Organization Certification Rules [REVOKED] › Subchapter 17 - Prohibited Acts [REVOKED] › Section 310:658-17-1 - Prohibited acts [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 17 Ok Reg 688,
				  eff 12-16-99 (emergency); Added at 17 Ok Reg 2056, eff
				  6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 1 - General Provisions [Revoked] › Section 310:660-1-1 - Purpose [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Revoked at 17 Ok Reg
				  2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 1 - General Provisions [Revoked] › Section 310:660-1-2 - Definitions [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Amended at 10 Ok Reg
				  4223, eff 8-1-93 (emergency); Amended at 11 Ok Reg 3847, eff 7-11-94; Revoked
				  at 17 Ok Reg 2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-1 - Fees [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Revoked at 17 Ok Reg
				  2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-2 - Laboratories eligible for licensure [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Amended at 10 Ok Reg
				  4223, eff 8-1-93 (emergency); Amended at 11 Ok Reg 3847, eff 7-11-94; Revoked
				  at 17 Ok Reg 2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-3 - Tests and standards [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Amended at 10 Ok Reg
				  4223, eff 8-1-93 (emergency); Amended at 11 Ok Reg 3847, eff 7-11-94; Revoked
				  at 17 Ok Reg 2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-4 - Personnel [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Revoked at 17 Ok Reg
				  2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-5 - Procedures for licensure [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Revoked at 17 Ok Reg
				  2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-6 - Revocation and reinstatement [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Amended at 10 Ok Reg
				  4223, eff 8-1-93 (emergency); Amended at 11 Ok Reg 3847, eff 7-11-94; Revoked
				  at 17 Ok Reg 2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 660 - HIV Laboratory Testing Regulations [Revoked] › Subchapter 3 - Licensure [Revoked] › Section 310:660-3-7 - Inspections [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 10 Ok Reg 79,
				  eff 10-5-92 (emergency); Added at 10 Ok Reg 1703, eff 6-1-93; Revoked at 17 Ok
				  Reg 2061, eff 6-12-00
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 1 - General Provisions › Section 310:661-1-1 - Purpose

Current through Vol. 41, No. 20, July 1, 2024
This Chapter establishes the minimum criteria for the
				  issuance and renewal of a hospice license and the procedure for enforcement of
				  the Act.
Added at 9 Ok Reg 1985,
				  eff 6-11-92
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 1 - General Provisions › Section 310:661-1-3 - Applicability

Current through Vol. 41, No. 20, July 1, 2024
No public or private agency or person shall establish,
				  conduct or maintain a hospice or hold itself out to the public as a hospice
				  without first obtaining a license from the State Department of
				  Health.
Added at 10 Ok Reg 77,
				  eff 10-5-92 (emergency); Added at 10 Ok Reg 1705, eff 6-1-93; Amended at 14 Ok
				  Reg 2106, eff 4-7-97 (emergency); Amended at 14 Ok Reg 2269, eff
				  6-12-97
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-1 - Licensure

Current through Vol. 41, No. 20, July 1, 2024
(a)
Applicant.
Any public or
				private agency or person desiring to establish a hospice in Oklahoma shall
				apply for and obtain a license from the Department.
(b)
Application.
An application
				for a hospice license shall be filed on a form prescribed by the Department and
				shall be accompanied by the information required by the Act.
(c)
Plan of delivery.
The
				initial application shall be accompanied by a plan of delivery of home and
				inpatient hospice services to patients and their families. The plan shall
				include, but not be limited to, those items listed in the Act.
(d)
Expiration/renewal.
(1)
First-year license.
(A) The first-year license shall expire one
				(1) year from the date of issuance unless suspended or revoked. A hospice
				holding a first-year license is required to successfully complete an initial
				inspection by representatives of the Department prior to the provision of
				services and shall be subject to a follow-up inspection after providing hospice
				services for at least six (6) months. The Department may require any hospice to
				renew the first-year license for one additional year. A hospice shall not hold
				a first-year license for more than twenty-four (24) months.
(B) A follow-up survey that demonstrates
				compliance with the Act and these rules shall be required prior to a hospice
				program being issued a permanent license.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-2 - Deadlines for applications

Current through Vol. 41, No. 20, July 1, 2024
The license application must be filed in accordance with the
				  following deadlines:
(1) A first-year
				hospice license is filed at least thirty (30) days before beginning operations.
(2) License application following
				a transfer of ownership or operation, is filed at least thirty (30) days prior
				to the transfer. If the Department finds that an emergency exists which
				threatens the welfare of patients, the thirty (30) day advance filing notice
				may be waived.
(3) Renewal of an
				existing licensed hospice is filed at least sixty (60) days prior to the
				expiration date of the license.
(4)
				If relocation is considered, the hospice must file an amended application with
				the address change at least thirty (30) days prior to the intended relocation.
				No fee for processing the license address change will be required.
(5) Incomplete first-year license
				applications received by the Department will be summarily dismissed after
				thirty (30) days of applicant notification of an incomplete application.
				Thereafter, a new application and initial fee will be required.
Added at 14 Ok Reg 2106,
				  eff 4-7-97 (emergency); Added at 14 Ok Reg 2269, eff 6-12-97; Amended at 23 Ok
				  Reg 2412, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-3 - Where to file

Current through Vol. 41, No. 20, July 1, 2024
The application and the license fee must be submitted to the
				  Department. The effective date will be the date a complete application and fee
				  are received. All fees are non-refundable.
Added at 14 Ok Reg 2106,
				  eff 4-7-97 (emergency); Added at 14 Ok Reg 2269, eff
				  6-12-97
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-4 - Transfer of ownership of a licensed hospice

Current through Vol. 41, No. 20, July 1, 2024
(a) The license of a hospice shall not be
				subject to sale, assignment, or other transfer, voluntary or
				involuntary.
(b) If an entity is
				considering acquiring a licensed hospice, then it must submit to the Department
				30 days before the effective date of the acquisition:
(1) an application [See OAC
				310:661-2-5]
				;
(2) a non-refundable two thousand
				dollars ($2,000) fee [See OAC
				310:661-2-6]
				;
(3) a copy of the executed sales
				agreement; and
(4) an additional
				five hundred dollars ($500) for each alternate administrative office operated
				by the agency, if applicable.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-5 - License application form

Current through Vol. 41, No. 20, July 1, 2024
The applicant for a license must file the following
				  application form: Application for License to Operate a Hospice (ODH Form 924).
				  This form requests: amount of fee submitted; name of hospice; location and
				  mailing address of hospice; name and title of chief executive officer; fiscal
				  year ending date; operating entity name and address; type of operating entity;
				  board of directors; complete disclosure of ownership including name, finding
				  and mailing address, and percentage of ownership for every stockholder having
				  at least five percent (5%) ownership in the hospice; name, signature, and title
				  of position of persons making the application; and an affidavit attesting to
				  the information provided.
Added at 14 Ok Reg 2106,
				  eff 4-7-97 (emergency); Added at 14 Ok Reg 2269, eff 6-12-97; Amended at 23 Ok
				  Reg 2412, eff 6-25-06
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-6 - Licensure fees

Current through Vol. 41, No. 20, July 1, 2024
(a) There is a
				non-refundable $500 fee for an application for a first-year license to
				establish or operate a hospice and a non-refundable $1,500 fee for a first-year
				license.
(b) There is a
				non-refundable $2,000 fee for a renewal application for an existing permanent
				hospice license.
(c) A late
				renewal fee of $50 will be charged for any hospice submitting an application
				for renewal within 30 days after the expiration date of the license.
Added at 16 Ok Reg 2518,
				  eff 6-25-99; Amended at 21 Ok Reg 1303, eff 5-27-04; Amended at 23 Ok Reg 2412,
				  eff 6-25-06; Amended at 24 Ok Reg 2004, eff
				  6-25-07
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 2 - Licenses › Section 310:661-2-7 - Plan review fees

Current through Vol. 41, No. 20, July 1, 2024
(a) Each hospice
				inpatient facility construction project will be charged a review fee based on
				the cost of the design and construction of the building project as follows:
(1) Project cost less than $10,000.00:
				$250.00 Fee
(2) Project cost
				$10,000.00 to $50,000.00: $500.00 Fee
(3) Project cost $50,000.00 to $250,000.00:
				$1000.00 Fee
(4) Project cost
				$250,000.00 to $1,000,000.00: $1500.00 Fee
(5) Project Cost greater than $1,000,000.00:
				$2000.00 Fee
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-1 - Licensure [AMENDED AND RENUMBERED TO 310:661-2-1]

Current through Vol. 41, No. 20, July 1, 2024
Added at 9 Ok Reg 1985,
				  eff 6-11-92; Amended and renumbered to 310:661-2-1 at 14 Ok Reg 2106, eff
				  4-7-97 (emergency); Amended and renumbered to 310:661-2-1 at 14 Ok Reg 2269,
				  eff 6-12-97
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-2 - Organization

Current through Vol. 41, No. 20, July 1, 2024
(a)
Organization and administration of
				services.
The hospice must organize, manage, and administer its
				resources to provide the hospice care and services to patients, caregivers and
				families necessary for the palliation and management of the terminal illness
				and related conditions.
(b)
Serving the hospice patient and family.
The hospice must provide
				hospice care that:
(1) Optimizes comfort and
				dignity; and
(2) Is consistent with
				patient and family needs and goals, with patient needs and goals as
				priority.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-3 - Medical records

Current through Vol. 41, No. 20, July 1, 2024
(a) The hospice
				must establish and maintain a medical record for each individual receiving care
				and services. The record must be complete, timely and accurately documented,
				and readily accessible.
(b) The
				medical record must contain sufficient information to justify the diagnosis and
				warrant the treatment and services provided. Entries are made and signed by the
				person providing the services. The record must include all care and services
				whether furnished directly or under arrangements by the hospice. Each record
				must contain at least the following:
(1)
				Identification data;
(2) Initial
				and subsequent assessments;
(3)
				Plan of care;
(4) Consent,
				authorization and election forms;
(5) Medical history; and
(6) Complete documentation of all care,
				services and events including evaluations, treatments, progress notes,
				laboratory and x-ray reports, and discharge summary.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-3.1 - Clinical records

Current through Vol. 41, No. 20, July 1, 2024
(a)
General.
A clinical record containing past and current findings is
				maintained for each hospice patient. The clinical record contains accurate
				clinical information that is available to the patient's attending physician and
				hospice staff. The clinical record may be maintained electronically.
(b)
Content.
Each patient's
				record must include the following:
(1) The
				initial plan of care, updated plans of care, initial assessment, comprehensive
				assessment, updated comprehensive assessments, and clinical notes;
(2) Signed copies of the notice of patient
				rights;
(3) Responses to
				medications, symptom management, treatments, and services;
(4) Outcome measure data elements, as
				described in
				310:661-5-3.1;
(5) Physician certification of terminal
				illness;
(6) Any advance
				directives; and
(7) Physician
				orders.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-4 - Confidentiality

Current through Vol. 41, No. 20, July 1, 2024
(a) Medical records must be kept
				confidential. Only authorized personnel have access to the record. Written
				consent of the patient, patient representative, the court appointed guardian or
				a court order will be accepted as authority for release of medical
				information.
(b) An individual who
				is, or has been, a patient of a physician, hospital, or other medical facility,
				except psychiatric, is entitled to access information contained in the
				individual's own medical records upon request. A request for minors may be made
				by parents or legal guardian. The hospice must furnish a copy of the medical
				record upon payment for the charge of such copy.
Added at 9 Ok Reg 1985,
				  eff 6-11-92; Amended at 14 Ok Reg 2106, eff 4-7-97 (emergency); Amended at 14
				  Ok Reg 2269, eff 6-12-97
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-5.1 - Number of continuing education hours required

Current through Vol. 41, No. 20, July 1, 2024
(a) All hospice administrators operating a
				hospice program in this state are required to complete eight (8) hours of
				continuing education each calendar year.
(b) Hours of continuing education may be
				completed in person or online.
(c)
				Membership in a statewide organization relating to hospice care will be
				considered as completion of one (1) hour of ethics credit each year.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-5.2 - Acceptable continuing education

Current through Vol. 41, No. 20, July 1, 2024
(a)
				Continuing education curriculum content is acceptable when it includes at least
				one of the following components:
(1)
				Administrative skills, duties, and responsibilities;
(2) Administrative procedures and strategic
				planning;
(3) Community relations
				and public information;
(4) Fiscal
				and information data management;
(5) Human relations;
(6) Ethics; or
(7) State and federal statutes and rules
				applicable to Hospice service delivery.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 3 - Administration › Section 310:661-3-5.3 - Documentation of attendance

Current through Vol. 41, No. 20, July 1, 2024
(a) A hospice
				administrator must maintain in their personal records verification of course
				attendance, completion, or membership documents. Acceptable documents include
				the following:
(1) A continuing education
				validation form furnished by the presenter;
(2) A certificate or letter of attendance or
				completion with an agenda or content outline; or
(3) An official college transcript showing
				courses completed with credit issued or audit credit.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 5 - Minimum Standards › Section 310:661-5-1 - Admission

Current through Vol. 41, No. 20, July 1, 2024
(a) Admission to a hospice will be in accord
				with the Act.
(b) Hospice services
				will be available twenty-four (24) hours a day, seven (7) days a
				week.
(c) A hospice program will
				not impose the dictates of any value or belief system on its patients and their
				families.
(d) A hospice will
				coordinate its service with those of the patient's primary or attending
				physician, all hospice caregivers, and nursing facility staff if a patient
				resides in a nursing facility.
(e)
				The hospice team will be responsible for coordination and continuity between
				inpatient and home care aspects of care.
Added at 9 Ok Reg 1985,
				  eff 6-11-92; Amended at 14 Ok Reg 2106, eff 4-7-97 (emergency); Amended at 14
				  Ok Reg 2269, eff 6-12-97
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 5 - Minimum Standards › Section 310:661-5-1.1 - Admission to hospice care

Current through Vol. 41, No. 20, July 1, 2024
(a) The
				hospice admits a patient only on the recommendation of the medical advisor in
				consultation with, or with input from, the patient's attending physician (if
				any).
(b) In reaching a decision to
				certify that the patient is terminally ill, the hospice medical advisor must
				consider at least the following information:
(1) Diagnosis of the terminal condition of
				the patient;
(2) Other health
				conditions, whether related or unrelated to the terminal condition; and
(3) Current clinically relevant
				information supporting all diagnoses.
Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 5 - Minimum Standards › Section 310:661-5-1.2 - Discharge from hospice care

Current through Vol. 41, No. 20, July 1, 2024
(a)
Reasons for discharge.
A hospice may discharge a patient if:
(1) The patient moves out of the hospice's
				service area or transfers to another hospice;
(2) The hospice determines that the patient
				is no longer terminally ill; or
(3)
				The hospice determines, under a policy set by the hospice for the purpose of
				addressing discharge for cause that meets the requirements of paragraphs
				(a)(3)(A) through (a)(3) (D) of this section, that the patient's (or other
				persons in the patient's home) behavior is disruptive, abusive, or
				uncooperative to the extent that delivery of care to the patient or the ability
				of the hospice to operate effectively is seriously impaired. The hospice will
				do the following before it seeks to discharge a patient for cause:
(A) Advise the patient that a discharge for
				cause is being considered;
(B)
				Document efforts to resolve the problem(s) presented by the patient's behavior
				or situation;
(C) Ascertain that
				the patient's proposed discharge is not due to the patient's use of necessary
				hospice services; and
(D) Document
				the problem(s) and efforts made to resolve the problem(s)and enter this
				documentation into its medical records.