OAC 310:659-3-4
Conflict of interest
Cite as Okla. Admin. Code § 310:659-3-4
(a) An independent quality examiner contracted by an HMO or a
qualified person contracted by the Department pursuant to 36
O.S. Section 6929 shall:
(1) Have knowledge and expertise in the area they are
contracted to review; and
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OAC 310:659
OKLAHOMA STATE DEPARTMENT OF HEALTH
(2) Have no history of disciplinary action or sanctions
related to quality of care, fraud, or other criminal activity.
(b) No contracted examiner or qualified person shall have any
material, professional, familial or financial conflict of
interest with:
(1) The HMO;
(2) Any officer, director, or management employee of the HMO;
(3) Any provider contracted with the HMO; or
(4) Any other HMO in the service area.
(c) A potential reviewer or qualified person shall disclose
information regarding potential conflicts of interest to all
parties to the review.
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