Oklahoma

Quick Facts

Key Provisions

• A Direct Primary Care (DPC) membership agreement is legally defined as a contract between a primary care provider and a patient for services rendered in exchange for a flat, periodic fee.
• Under Okla. Stat. tit. 36, § 4604, DPC agreements are explicitly declared not to be insurance and are therefore exempt from regulation by the Oklahoma Insurance Department.
• Providers operating under a DPC agreement are prohibited from billing any third parties, such as insurance companies, on a fee-for-service basis for care covered by the membership.
• The law requires that all DPC arrangements be formalized through a written contract between the provider and the patient or their legal representative.
• The agreement must allow for termination by either the provider or the patient at any time, provided that written notice is given.
• Upon termination of the agreement, the provider is legally required to provide the patient with a full refund of any prepaid, unearned membership fees.
• While a flat monthly fee is the standard, the law permits additional per-visit charges, but stipulates that any such charge must be less than the monthly equivalent of the periodic fee.
• The statute applies to "primary care providers," a term that is not narrowly defined, allowing for participation by various licensed professionals within their scope of practice.
• Unlike many other states, Oklahoma's DPC law does not mandate that the patient agreement include a specific disclosure stating that the DPC membership is not health insurance.

Medication Dispensing

Medication dispensing in Oklahoma DPC practices is governed by the rules of various professional licensing boards. While physicians generally have the authority to dispense pre-packaged medications from their offices, there are specific limitations for other providers. According to the Oklahoma Administrative Code (§ 435:15-11-1(h)), Physician Assistants (PAs) are explicitly prohibited from dispensing drugs. However, they are permitted to request, receive, and distribute professional drug samples to patients under policies established by their supervising physician. Similarly, research indicates that Nurse Practitioners (NPs) are also generally limited to distributing samples rather than dispensing medications from an in-office pharmacy. DPC practices planning to offer in-office dispensing should consult the Oklahoma Board of Pharmacy and their specific licensing boards for comprehensive guidance.