Library: Policy

317:30-5-42.17. Non-covered services

Revised 9-12-22

        In addition to the general program exclusions [Oklahoma Administrative Code (OAC) 317:30-5-2(a)(2)] the following are excluded from coverage:

(1) Inpatient admission for diagnostic studies that could be performed on an outpatient basis.

(2) Procedures that result in sterilization which do not meet the guidelines set forth in this Chapter.

(3) Reversal of sterilization procedures for the purposes of conception are not covered.

(4) Medical services considered experimental or investigational. For more information regarding coverage of clinical trials, see OAC 317:30-3-57.1.

(5) Payment for removal of benign skin lesions for adults.

(6) Visual aids.

(7) Charges incurred while the member is in a skilled nursing or swing bed.