Oklahoma's SB 773 regulates pharmacy benefit managers (PBMs) by prohibiting unfair practices that affect independent pharmacies and patients. It requires PBMs to pay independent pharmacies the same reimbursement rate for identical drugs as they pay PBM-owned pharmacies, banning "spread pricing" where PBMs charge plans more than they pay pharmacies. The bill also prohibits PBMs from charging pharmacies fees for claim submission, network enrollment, or claims processing, and restricts retroactive payment reductions except for fraud or audit errors. These changes directly impact PBMs, pharmacies, and health plans operating in Oklahoma, aiming to ensure fairer payment practices. The bill was vetoed by the governor but overridden by the legislature on May 29, 2025.
HB 2048, the "340B Nondiscrimination Act," prohibits health insurers, pharmacy benefits managers (PBMs), and third-party payors from discriminating against healthcare providers participating in the federal 340B drug discount program. It specifically bans lower reimbursement rates for 340B drugs, extra fees or administrative burdens for 340B entities, exclusion from provider networks based on 340B status, and requirements to disclose 340B-specific billing details. The law applies to all 340B entities - such as community health centers and hospitals participating in the federal program - and ensures they receive equal treatment in billing, reimbursement, and network access. Enforcement is handled by the Attorney General, with the Oklahoma Medicaid program excluded from these provisions.
This bill requires Oklahoma health insurance plans to cover low-dose mammography screenings for breast cancer without cost-sharing (such as deductibles or copays). It mandates coverage once every five years for women aged 35-39 and annually for women 40 and older. The law also requires coverage for necessary diagnostic and supplemental breast exams, including those for high-risk cases like dense breast tissue. The policy takes effect November 1, 2025.
HB 1808, now law in Oklahoma, reforms health insurance prior authorization and step-therapy rules to improve patient access to medications. It requires insurers to grant exceptions to step-therapy protocols (where patients must try cheaper drugs first) if a medication is contraindicated, ineffective based on medical history, or causes harm - covering specific scenarios like prior adverse reactions or stability on a current treatment. The bill mandates insurers respond to urgent prior authorization requests within 24 hours and non-urgent requests within 2 business days, with requests deemed approved if deadlines are missed. It also ensures continuity of coverage for stable treatments when switching plans (90-day protection) and requires insurers to cover at least one readily available asthma controller medication per class without prior authorization.
SB 1135 allocates $100,000 from Oklahoma's General Revenue Fund to the Oklahoma Health Care Authority for the 2025-2026 fiscal year to support its operations. The bill declares an emergency to allow immediate implementation upon approval. This legislation provides specific funding for the Authority's duties without altering existing health insurance or tax policies.
SB 1178 appropriates $100,000 from Oklahoma's General Revenue Fund to the Department of Human Services for fiscal year 2026 to support its existing mental health and substance abuse services duties. The bill directly affects state-funded mental health programs by providing dedicated funding for current operations. It includes an emergency clause, allowing it to take immediate effect without the governor's signature, which occurred on May 29, 2025. This is a procedural funding measure with no new policy requirements, solely allocating existing resources. The appropriation is limited to the specified amount and purpose as defined in the bill text.
SB 109 requires Oklahoma health insurance plans to cover genetic testing for inherited cancer risks and evidence-based cancer imaging for individuals with a personal or family history of cancer or increased cancer risk. This coverage must be provided without patient cost-sharing (such as deductibles or copays) when ordered by a healthcare provider following current medical guidelines, including those from the National Comprehensive Cancer Network. The law applies to all health benefit plans offered in Oklahoma starting November 1, 2025, ensuring these preventive services are accessible without financial barriers. It does not affect health savings account eligibility for non-preventive services but guarantees coverage for preventive care under federal guidelines.
SB 1136 allocates $100,000 from Oklahoma's General Revenue Fund to the Oklahoma Health Care Authority (OHCA) for unspecified duties required by law. The bill directly affects the OHCA, which administers state health care programs, by providing dedicated funding for its operations. It requires the agency to use these specific funds for purposes outlined in existing law, though the bill does not detail the exact programs or services. The funding is effective immediately upon the bill's passage, declared an emergency for public health and safety reasons. This is a routine appropriations measure with no new policy requirements or beneficiary changes.
SB 1141 allocates $100,000 from unallocated state general revenue funds to Oklahoma's Department of Mental Health and Substance Abuse Services for its existing statutory duties. The bill requires these specific funds to be used for mental health services without creating new programs or altering current service requirements. An emergency clause makes the law effective immediately upon passage, bypassing the typical governor's signature requirement. The bill became law on May 29, 2025, after being passed without gubernatorial action.
SB 146 expands mental wellness services provided by Oklahoma's Department of Public Safety to include retirees of public safety personnel (such as police and firefighters), in addition to current employees. It creates a dedicated revolving fund (Section 9102) to finance these services and strengthens privacy protections by prohibiting the sharing of individual mental health data without consent, while allowing aggregate data use for policy improvements (Section 9101). The bill also mandates that all Mental Wellness Division resources operate separately from other department divisions. These changes took effect November 1, 2025, after becoming law without the Governor's signature on May 29, 2025.
