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This page lists some of the action toward parity compliance undertaken by Oklahoma regulatory agencies since 2008.

Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org.

Action in the Regulatory Arena

8/2015

The Oklahoma Insurance Department issued this press release that notified the public that “All insurance plans are required by law” to cover behavioral health conditions, including inpatient care and outpatient care. It advised Oklahoma residents that if they have “more questions about mental health insurance coverage, call the Oklahoma Insurance Department.”

7/2004

Primary Focus: Mandated Benefit: Provider
Agency: Insurance Department
Title/Description: Basic Health Care Services
Citation: Okla. Admin. Code § 365:40-5-20
Summary: Basic health care services shall include, among other services, 20 outpatient visits per enrollee per year, as may be necessary and appropriate for short-term evaluative or crisis intervention mental health services, or both, and the diagnosis, medical treatment and referral services (including referral services to appropriate ancillary services) for the abuse of or addiction to alcohol and drugs.
Effective Date: July 14, 2004
Notes: N/A

Oklahoma Parity Law

There are several sections of the state insurance law about parity. This section contains relevant definitions for the subsequent sections.

This section requires large employer fully insured plans to cover services for the following conditions that are designated as “severe mental illness”:

  • Schizophrenia
  • Bipolar disorder
  • Major depressive disorder
  • Panic disorder
  • Obsessive compulsive disorder
  • Schizoaffective disorder

Plans are not required to cover services for other mental health conditions and substance use disorders, but if they do the coverage must be the same as what is required for “severe mental illness.”

Coverage for severe mental illness, and any other covered behavioral health conditions, must “be equal to” and “no more restrictive” than what is in place for other medical services for the following:

Plans cannot use any treatment limitation for behavioral health services that is not in place for other medical services.

Plans must cover either 26 days of inpatient care or the same inpatient day limit that is used for other medical care, whichever is greater.

This section allows plans to file for an exemption if they can demonstrate that coverage of “severe mental illness” caused premiums to rise by at least 2% over the course of a year.

Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.

Common Violations

Definition

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