Medicaid; specifying certain qualifications for appeals; providing for recovery of certain costs. Effective date.

Summary

The bill changes Oklahoma’s Medicaid appeal process so that any denied claim must be reviewed by a licensed physician, psychologist, or mental‑health professional rather than automated software. Providers have six months to file an appeal, and reviewers must have the appropriate specialty, no conflict of interest, and must consider all clinical information. If the appeal is upheld, the claimant can request a fair hearing and the reviewer may be reimbursed for time spent on the appeal.

AI-generated summary — may be incomplete or inaccurate. Verify against the official bill text.

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