OK HB4462

Non-urgent prior authorization requests are automatically approved if the utilization review organization fails to respond within 72 hours (plus one business day if applicable); urgent care requests are automatically approved if no response within 24 hours

All prior authorization decisions and adverse determinations must be made by qualified physicians who are board-eligible in the relevant specialty, supervised by an Oklahoma-licensed medical director, and whose compensation is not tied to denial rates

Physicians and health care professionals must be able to evaluate and reject artificial intelligence recommendations when making prior authorization determinations

Beginning January 1, 2027, insurers must exempt network providers from prior authorization for specific services if the provider performed that service for at least 7 patients in 2025 and achieved a 90% or higher approval rate

Appeals of adverse determinations must be decided within 72 hours for non-urgent requests or 24 hours for urgent requests by a different physician than the one who made the original denial; the Oklahoma Insurance Commissioner receives rulemaking authority to implement the act effective November 1, 2026