Oklahoma § 56-4006 Mental health and substance use disorder coverage —

Oklahoma Statutes

§ 56-4006 — Mental health and substance use disorder coverage —

Oklahoma·Title 56 Poor Persons

Parity analysis.

A.For Medicaid managed care plans, the Oklahoma Health Care Authority shall ensure that the insurers, health plans, and managed care plans comply with federal and state laws, rules, and regulations applicable to coverage for mental health or substance use disorder services.

B.Contracts with Medicaid managed care plans must require entities to conduct regular parity compliance analysis that contain the information described in 42 U.S.C., Section 300gg–26(a)(8)(i-v) for each nonquantitative treatment limitation imposed on mental health or substance use disorder benefits in any classification of care.

C.Contracts with Medicaid managed care plans must include language requiring managed care plans and entities to conduct parity analysis described in subsection B of this sect

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Parity analysis. A. For Medicaid managed care plans, the Oklahoma Health Care Authority shall ensure that the insurers, health plans, and managed care plans comply with federal and state laws, rules, and regulations applicable to coverage for mental health or substance use disorder services. B. Contracts with Medicaid managed care plans must require entities to conduct regular parity compliance analysis that contain the information described in 42 U.S.C., Section 300gg–26(a)(8)(i-v) for each nonquantitative treatment limitation imposed on mental health or substance use disorder benefits in any classification of care. C. Contracts with Medicaid managed care plans must include language requiring managed care plans and entities to conduct parity analysis described in subsection B of this section for a nonquantitative treatment limitation whenever as-written or in- operation changes or amendments are made to that nonquantitative treatment limitation, including prior authorization requirements. D. State Medicaid programs and Children's Health Insurance Programs (CHIP) must review and compile the analysis from all managed care, CHIP, and alternative benefit plans to ensure compliance and address any noncompliance through a standardized process to mitigate findings of noncompliance. E. The Oklahoma Health Care Authority shall develop a standardized process for receiving, investigating, substantiating, and resolving parity complaints. F. The Oklahoma Health Care Authority shall make public the surveys, financial analysis, managed care contract audits, de- identified substantiated parity complaints, and parity reports prepared by the managed care entities and plans and the reports they submit to document parity compliance. G. The Oklahoma Health Care Authority shall also make public any parity analysis, summary, or report submitted to the Centers for Medicare and Medicaid Services regarding the Oklahoma Medicaid managed care program within thirty (30) days of the state's submission of these reports to the Centers for Medicare and Medicaid Services.

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