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OHCA Policies and Rules

OHCA Policies and Rules Main Page

317:55-3-3. Enrollee rights

[Revised 07-01-23]

(a) In accordance with 42 C.F.R. § 438.100, state and federal regulations, and all contractual requirements, the CE and DBM shall allow the Enrollee the right to:

(1) Receive information on the SoonerSelect program and the CE or DBM;

(2) Receive information on all available treatment options and alternatives;

(3) Participate in decisions regarding their healthcare;

(4) Free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation; and

(5) Request and receive a copy of their medical records in accordance with all HIPAA rules.

(b) Each Enrollee is free to exercise their rights without the CE or DBM treating them adversely.

(c) The CE or DBM may not otherwise discriminate against Enrollees on the basis of race, color, national origin, sex, sexual orientation, gender identity, health status, need for medical services, or disability and may not use any policy or practice that has the effect of discriminating on the basis of race, color or national origin, sex, sexual orientation, gender identity, or disability. If the CE or DBM fails to comply with OAC 317:55-3-3, the OHCA may impose any or all the CE intermediate sanctions, found at OAC 317:55-5-10 and the CE Contract, or DBM administrative remedies, found at OAC 317:55-5-11 and the DBM Contract.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.

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Oklahoma Health Care Authority

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Oklahoma City, OK 73105

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The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.