SB 515: Health insurance; authorizing health care provider to accept certain payments; requiring application of certain charge to deductible and maximum out-of-pocket expense. Effective date. - Oklahoma

Floor (House) → Floor (Senate) · 4 edits

MODERATE

The bill was revised from a House version to a Senate version with significant changes to the statute number, scope of applicability, and effective date. The Senate version moved the codification from Section 6060.51 to Section 6046 of Title 36 and simplified the act's purpose statement. The Senate version also changed the effective date to November 1, 2025, and added a committee report indicating the bill should pass as amended.

Scope change

The bill's scope was narrowed in its purpose statement from a broad health care services description to a more specific focus on health insurance and payment acceptance procedures. The codification section number changed from 6060.51 to 6046.

TECHNICAL

The statute codification section changed from 6060.51 to 6046 of Title 36 of the Oklahoma Statutes.

A committee report was added to the Senate version recommending the bill pass as amended.

TIMELINE

The effective date was changed to November 1, 2025, with a committee report added recommending passage as amended.

REQUIREMENT

The purpose statement was simplified from a detailed list of health care service provisions to a concise summary focusing on payment acceptance and documentation requirements.

SB515 (3-24-25) (FRIX) FS FA1.PDF → Floor (House) · 3 edits

MINOR

The bill was converted from a Senate floor substitute version to a House floor version with several substantive changes. The most significant change is the addition of two new sponsors from the House (Moore and Wolfley) to the list of sponsors. The bill's substantive policy content regarding healthcare services, payment acceptance, and billing prohibitions remained largely unchanged, though formatting and page numbering were adjusted for the House floor version.

Scope change

The bill's scope and applicability remain unchanged; the only scope-related change is the addition of two House sponsors to the legislative record.

TECHNICAL

Added two House representatives (Moore and Wolfley) to the list of bill sponsors, changing the sponsor list from Senate-only to include House members.

Changed document header from 'FLOOR SUBSTITUTE FOR SENATE BILL NO. 515' to 'ENGROSSED SENATE BILL NO. 515' to reflect the bill's progression through the legislative process.

Removed page numbers and formatting markers from the Senate version that were not needed in the House floor version.

Enrolled (final version) → SB515 (3-24-25) (FRIX) FS FA1.PDF · 3 edits

MINOR

This bill was reformatted from an enrolled version to a floor substitute version, primarily changing the layout and page numbering while keeping the substantive policy language identical. The core provisions regarding out-of-pocket payments, provider billing restrictions, and insurance carrier obligations remain unchanged.

TECHNICAL

Page numbering and formatting were reorganized to reflect floor substitute status rather than enrolled status, with page numbers shifting from sequential 1-5 to a new 1-4 layout with request numbers.

The sponsor list was slightly reordered, moving Schreiber from the House sponsors to a separate line after the Senate sponsors.

The title page header changed from 'ENROLLED SENATE' to 'FLOOR SUBSTITUTE' indicating this version was prepared for floor consideration rather than final passage.

Engrossed → Enrolled (final version) · 4 edits · May 12, 2025

MODERATE

The bill was finalized from its engrossed version with minor formatting and sponsor name updates. The substantive policy content regarding health care payment rules, out-of-pocket protections, and carrier obligations remains unchanged from the previous version.

Scope change

No substantive change to the bill's scope or applicability; only administrative updates to sponsor names and formatting.

TECHNICAL

Updated Senate and House sponsor names to reflect final enrolled version with additional sponsors added (Hamilton, Moore, Wolfley, Hays, Roberts).

Changed page headers from 'ENGROSSED' to 'ENROLLED' to indicate final legislative status.

Minor formatting adjustments to spacing and alignment throughout the document.

POLICY

All substantive policy provisions regarding health care payment acceptance, out-of-pocket counting, and carrier obligations remain identical to the engrossed version.

Introduced → Engrossed · 6 edits · Mar 25, 2025

MODERATE

The bill was significantly rewritten and expanded from its original version. The original bill focused narrowly on health care providers accepting direct payments from enrollees, while the engrossed version adds comprehensive definitions, allows enrollees to send documentation to carriers after negotiating lower prices, and clarifies how out-of-pocket payments apply to deductibles based on network status.

Scope change

The bill's scope expanded from a narrow focus on provider payment acceptance to a broader framework covering enrollee payment options, documentation requirements, carrier obligations, and detailed definitions of covered plans and services.

DEFINITION

New comprehensive definitions were added for 'health benefit plan', 'health care provider', and 'health care service', including specific exclusions for limited benefit policies, Medicare supplements, workers' compensation, and short-term insurance.

REQUIREMENT

Enrollees can now electronically send documentation to carriers after negotiating lower prices, including service details, provider information, orders, and proof of negotiated costs.

New provisions require carriers to count out-of-pocket payments toward deductibles and out-of-pocket maximums, with attribution to in-network or out-of-network deductibles based on provider network status.

Health care providers must accept negotiated payments as full payment and cannot bill enrollees or health benefit plans for any balance between the collected amount and the billed charge.

ELIGIBILITY

The requirement for applying payments toward deductibles was expanded to include services where enrollees negotiated lower costs than the plan's average allowed amount, with specific conditions about provider billing practices.

TECHNICAL

The codification section was changed from Section 6046 of Title 36 to Section 6060.51 and 6060.52 of Title 36.

Health insurance; authorizing health care provider to accept certain payments; requiring application of certain charge to deductible and maximum out-of-pocket expense. Effective date.

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