SB 207 establishes the Oklahoma Rare Disease Advisory Council within the State Department of Health to address the needs of Oklahomans living with rare diseases (defined as conditions affecting fewer than 200,000 people nationally). The Council, composed of 13 diverse members including patients, caregivers, healthcare providers, researchers, and industry representatives, will conduct public hearings, develop policy recommendations, and create emergency care protocols to improve access to specialists, diagnostics, and equitable treatment. The bill also modifies Oklahoma’s newborn screening program to require an educational initiative for treatable genetic disorders, aiming to prevent intellectual disabilities and reduce infant mortality through early intervention. This legislation directly affects rare disease patients, their families, healthcare providers, and state agencies responsible for public health programs in Oklahoma.
HB 2513, titled the "Oklahoma Mental Health Reform Act of 2025," proposed creating a position requiring an individual with specific qualifications to address the Department of Mental Health and Substance Abuse Services' court-ordered consent decree. The bill specified requirements for this appointee and included an emergency provision. It was scheduled to take effect November 1, 2025, but was pocket-vetoed by the Governor on May 30, 2025, with the veto taking effect June 15, 2025, meaning it never became law. The bill directly affected the Department's compliance with its existing legal agreement but was not enacted.
HB 2262 requires nursing homes, assisted living facilities, and other care providers marketing specialized dementia care to publicly disclose detailed information about their services. Facilities must submit a standardized form to Oklahoma's State Department of Health, covering staff ratios, care plans, facility design, activities, fees, and family involvement - ensuring transparency for residents and families considering placement. The bill mandates posting this disclosure online and in facilities, with the Department reviewing it during inspections. It directly affects dementia care providers and supports informed decisions by families seeking appropriate care.
HB 1576 requires Oklahoma Medicaid to cover rapid whole genome sequencing (RWGS) for eligible beneficiaries under age 21 with complex or acute illnesses of unknown cause while receiving critical care in a hospital. It mandates coverage only when specific medical criteria are met, such as symptoms suggesting broad genetic testing needs, timely diagnosis being critical for treatment, and conditions like congenital anomalies or abnormal test results. The bill also ensures genetic data used for diagnosis is protected under HIPAA, allows research use only with explicit patient or guardian consent (with opt-out rights), and requires the Oklahoma Health Care Authority to implement rules and seek federal approval for coverage. This policy directly affects Medicaid-covered children and teens in intensive care with undiagnosed conditions.
HB 1224 allows certain minors to consent to specific health services without parental approval, including treatment for pregnancy, sexually transmitted infections, substance abuse, or sexual assault. Parents generally retain access to their minor child's medical records, but this right is limited when the minor uses the bill's self-consent provisions for the listed health conditions. Health professionals must make a reasonable attempt to notify parents for emergency care but are not required to inform them for most other services covered under the bill. The bill also protects health providers from liability when acting in good faith under these rules, ensuring minors' confidentiality in sensitive health matters.
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.
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 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.
