HB 3645 Oklahoma House · 2026 Regular Session

Hospice care; requirements; allowing for hospice determination by physicians in certain situations; effective date.

HB 3645 amends Oklahoma's hospice care requirements to expand eligibility determination options when patients lack legal representatives. It allows hospice admission decisions by a licensed long-term care administrator (with 6 months oversight and two physician approvals), two physicians reviewing medical history, or a primary care physician managing care for six months. The bill maintains existing standards like 24/7 care, bereavement programs, and prohibitions on improper patient solicitation. It directly affects hospice providers and patients without appointed guardians, ensuring timely access to hospice services under defined criteria.

Issues: ✓ Healthcare

Bill status passed 3 of 5 stages cleared

Introduction

Feb 2026

Committee Review

Apr 2026

House Passage

Mar 2026

Senate Passage

Governor

Introduced Feb 2, 2026 Last action Apr 23, 2026

Maddy AI version diff · 3 comparisons

What changed between versions

Floor (House) → Floor (Senate) · 5 edits

MODERATE

The bill was converted from a House version to a Senate version, which involved significant structural and formatting changes. Substantively, the Senate version reorganized the hospice requirements, clarifying that most services must be provided directly by the licensee while allowing contracts for specific elements. It also expanded the list of individuals authorized to elect hospice benefits on behalf of a patient when they lack capacity, adding specific criteria for long-term care administrators and primary care physicians.

Scope change

The scope of the bill remains hospice care regulation, but the applicability of service delivery rules was clarified to distinguish between direct provision and contracted services.

REQUIREMENT

Clarified that the majority of hospice services must be provided directly by the licensee, while allowing contracts for specific elements provided direct patient care is maintained.

Added a prohibition on charging fees for services provided directly by the hospice team that duplicate contracted services.

Added a new requirement that hospice programs must provide a continuum of care providers throughout the length of care and into the bereavement period.

Reorganized admission criteria to explicitly include the patient and family's desire, the attending physician's participation, and the diagnosis and prognosis.

ELIGIBILITY

Expanded the list of individuals who can elect hospice benefits for a patient lacking capacity to include licensed long-term care administrators and primary care physicians meeting specific experience criteria.

Floor votes · House Mar 10, 2026

How they voted

89–6

Passed · 5 other

Total votes 100

Mar 10, 2026

D Democratic18

17 Yea 1 Nay

94% Yea

R Republican82

72 Yea 5 Nay 5

87% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Apr 21, 2026

Upper · Passed

Reported Do Pass as amended Judiciary committee; CR filed

upper

Mar 11, 2026

Introduced

First Reading

upper

Mar 11, 2026

Lower · Passed

Engrossed, signed, to Senate

lower

Mar 10, 2026

Committee

Referred for engrossment

lower

Mar 10, 2026

Lower · Passed

Third Reading, Measure passed: Ayes: 88 Nays: 6

lower

Feb 25, 2026

Lower · Passed

CR; Do Pass Health and Human Services Oversight Committee

lower

Feb 11, 2026

Lower · Passed

Policy recommendation to the Health and Human Services Oversight committee; Do Pass Public Health

lower

Feb 3, 2026

Committee

Referred to Public Health

lower

Feb 2, 2026

Introduced

First Reading

lower

2 primary · 0 co-sponsors