OAC 310:657-29-2
Prohibited acts
Cite as Okla. Admin. Code ยง 310:657-29-2
(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:
OAC 310:657 OKLAHOMA STATE DEPARTMENT OF HEALTH
(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.