HB 4294: Health insurance; fair coverage; epilepsy; termination of coverage; devices; surgeries; effective date. - Oklahoma

Floor (House) → Floor (Senate) · 3 edits

MINOR

The bill was amended to move from the House to the Senate floor, resulting in a significant restructuring of the text. The most substantive change is the reordering of the bill's sections: the effective date was moved to Section 2, and a new Section 2 was added containing the original Section 2 content. Additionally, the committee report attribution was updated to reflect the Senate Health and Human Services Committee instead of the Commerce Committee.

Scope change

The bill's scope and applicability remain unchanged; it still mandates equal health insurance coverage for individuals with epilepsy and covers neurostimulation devices. The changes are primarily organizational and procedural, affecting the bill's structure and committee attribution rather than its legal requirements.

TECHNICAL

The bill's title page and header information were updated to reflect the Senate Floor Version, including the date April 20, 2026, and the specific committee sponsors.

The bill's text was reorganized; the original Section 2 (effective date) was moved to Section 2, and a new Section 2 was inserted containing the original Section 2 text regarding neurostimulation devices.

The committee report attribution was changed from the House Committee on Commerce and Economic Development Oversight to the Senate Committee on Health and Human Services.

HB4294 (4-27-26) (MCINTOSH) WDFA2.PDF → Floor (House) · 5 edits

MODERATE

The bill was completely rewritten on the House floor, replacing a proposed amendment to the 340B drug pricing program with a new law focused on epilepsy coverage. The original text aimed to regulate how hospitals report 340B drug discounts and charity care usage, but the final version now mandates that all health insurance policies provide the same coverage for individuals with epilepsy regardless of their diagnosis and prohibits insurers from terminating coverage based on an epilepsy diagnosis.

Scope change

The bill's scope shifted entirely from regulating hospital drug pricing programs (340B) to establishing specific health insurance protections for people with epilepsy.

SCOPE

All provisions related to the 340B drug discount program, including definitions for '340B entity' and reporting requirements for drug savings and charity care, were removed.

ELIGIBILITY

New requirements were added mandating that all health insurance policies provide identical coverage and benefits to individuals diagnosed with epilepsy as they do to those without the diagnosis.

A new prohibition was added preventing insurers from terminating or refusing to renew coverage solely because an individual has been diagnosed with epilepsy.

REQUIREMENT

New requirements were added to ensure coverage for medically necessary neurostimulation devices for epilepsy when prescribed by a licensed physician.

TIMELINE

The effective date was set to November 1, 2026, replacing the previous timeline associated with the 340B reporting requirements.

HB4294 (4-27-26) (MCINTOSH) FA2.PDF → HB4294 (4-27-26) (MCINTOSH) WDFA2.PDF · 1 edit

MINOR

The only change between these two versions is the document timestamp, which was updated from April 27 to April 29. There are no substantive policy changes, no new requirements, and no modifications to the bill's scope or text.

TECHNICAL

Updated the document metadata timestamp to reflect a later revision time.

Proposed Policy Committee Substitute 1 → House Committee Substitute · 3 edits

MINOR

The bill was amended to change its title from a 'Proposed Policy Committee Substitute' to a 'Committee Substitute,' indicating it has moved to a different legislative stage. The amendment also updated the bill's tracking numbers and dates to reflect the House Committee's version, while the core policy text regarding epilepsy coverage remains unchanged.

Scope change

The bill's scope and applicability remain unchanged; only the procedural metadata and title have been updated.

TECHNICAL

The title was changed from 'Proposed Policy Committee Substitute' to 'Committee Substitute' to reflect the bill's progression in the legislative process.

The bill's tracking number was updated from Req. No. 16370 to Req. No. 16894, and the sponsor date was changed from 02/13/26 to 03/03/26.

The sponsor attribution was updated to include 'TKR of the Senate' alongside 'Pae of the House,' reflecting the House Committee's amendments.

Engrossed → Proposed Policy Committee Substitute 1 · 1 edit

MINOR

The bill was completely rewritten by the Policy Committee to replace the original text. The new version maintains the core requirement that health insurers cannot deny coverage or terminate policies based on an epilepsy diagnosis. It also retains the mandate for coverage of medically necessary neurostimulation devices for SUDEP prevention, provided they are prescribed by an active treating physician. The effective date remains November 1, 2026.

Scope change

The scope of the bill remains unchanged; it still applies to all individual and group health insurance policies providing medical and surgical benefits in Oklahoma.

TECHNICAL

The entire text of the bill was deleted and replaced with a new version that reorganizes the content and updates the header information to reflect the committee substitute status.

Amended And Engrossed → Engrossed · 2 edits · Apr 30, 2026

MINOR

The amendment restores the original title of the bill, which was previously removed, and adds a new House coauthor. These changes are primarily technical and procedural, ensuring the document correctly identifies the bill's subject matter and its sponsors.

TECHNICAL

The bill title was restored to reflect the original subject matter regarding health insurance coverage for individuals with epilepsy.

A new House coauthor, Hefner, was added to the list of bill sponsors.

Enrolled (final version) → Amended And Engrossed · 4 edits · Apr 30, 2026

MODERATE

The bill was amended to correct formatting errors and update the legislative history, including changing the House passage date to March 24, 2026. The core policy requirements regarding fair coverage for individuals with epilepsy, protection against termination of coverage, and mandates for neurostimulation device coverage remain unchanged.

Scope change

No substantive change to the bill's scope or applicability; changes are limited to formatting, title restoration, and updating the House passage date.

TIMELINE

The House passage date was updated from May 5, 2026, to March 24, 2026, reflecting the actual legislative history.

TECHNICAL

The document title was corrected from 'Enrolled' to 'Engrossed Senate Amendment' to accurately reflect the current version of the bill.

A new House coauthor, Hefner, was added to the list of sponsors.

The original title text was removed and replaced with a placeholder describing the bill's subject matter.

Introduced → Enrolled (final version) · 4 edits · Mar 25, 2026

MODERATE

The bill was finalized and enrolled for signing, converting it from a draft introduced in the House to a final version approved by both chambers and the Governor. The substantive policy language regarding epilepsy coverage remains identical to the introduced version, ensuring individuals with epilepsy receive equal benefits and that insurers cannot terminate coverage based on this diagnosis. The final version also includes standard administrative sections for the Governor's signature and the Secretary of State's enrollment.

Scope change

The bill's scope and applicability remain unchanged; the differences are purely procedural, reflecting the bill's progression through the legislative process to its final enrolled state.

TECHNICAL

The document header was updated to reflect the bill's final status as 'Enrolled House Bill' rather than 'As Introduced', and the list of sponsors was expanded to include the Senate sponsor.

Standard administrative text for the Governor's approval and the Secretary of State's enrollment was added to the final version.

Drafting notes, page numbers, and the 'As Introduced' label were removed as the bill was finalized.

The layout and line breaks were adjusted to fit the standard enrolled bill format, though the legal text content is identical.

Health insurance; fair coverage; epilepsy; termination of coverage; devices; surgeries; effective date.

What changed between versions

How they voted

Actions timeline

Sponsors