SB 202 modifies eligibility rules for self-funded health plans to participate in Oklahoma's Medicaid premium assistance program. It allows small businesses and public entities using self-funded health plans to qualify if the plan was already used by an employer in the program as of May 1, 2024, or if it’s owned by a local government public trust. This change specifically affects small employers (under 250 employees) and public-sector health plans seeking to access state premium assistance. The bill aims to expand coverage options for low-income workers by making more health plan types eligible for state-funded premium support.
This bill changes Oklahoma Medicaid rules for autism treatment coverage. It requires a diagnosis of autism spectrum disorder by specific licensed providers (like neurologists, developmental pediatricians, or psychologists) to qualify for applied behavior analysis (ABA) therapy. The bill prohibits Medicaid from requiring re-diagnoses after an initial diagnosis and mandates in-person ABA services while allowing remote supervision via telehealth. It directly affects Oklahoma Medicaid recipients with autism spectrum disorder seeking ABA therapy.
This bill authorizes an emergency appropriation of approximately $19.66 million to the Oklahoma Department of Mental Health and Substance Abuse Services. The funds must come from the Rate Preservation Fund in the State Treasury and are designated specifically for Title XIX services, which are Medicaid-funded mental health and substance abuse programs. The legislation includes an emergency provision, allowing the funding to take effect immediately upon the governor's approval without waiting for the regular budget cycle. This action provides direct financial resources to the state agency responsible for administering mental health and substance abuse services.
HB 1484, known as "Rain's Law," requires Oklahoma public schools to provide annual, research-based instruction on fentanyl abuse prevention and drug poisoning awareness to students in grades 6 through 12. The bill mandates that this instruction cover suicide prevention, fentanyl abuse and addiction prevention, local resource access, and health education about fentanyl use. Schools must incorporate this content into health classes, and the State Department of Education will develop curriculum standards and resources to support implementation. The law also designates a week for "Fentanyl Poisoning Awareness Week" to align with National Red Ribbon Week, with age-appropriate instruction determined by each school district.
SB 1837 requires the Oklahoma Health Care Authority (OHCA) to seek a federal exemption allowing Medicaid providers in rural counties (population ≤60,000) to provide case management and develop person-centered plans for home- and community-based services. This directly affects rural healthcare providers who currently face restrictions under federal regulation 42 C.F.R. §441.301(c)(1)(vi). The bill mandates OHCA to establish conflict-of-interest protections for exempt providers, separating case management and provider functions within organizations. The exemption would permit these rural providers to deliver services without federal barriers, effective November 1, 2026.
SB 1383 requires Oklahoma Medicaid to cover diabetes self-management education and support (DSMES) for beneficiaries with diabetes. It mandates the Oklahoma Health Care Authority to develop a state plan amendment for this coverage after completing a feasibility study and reporting on costs, clinical evidence, and pilot results. The bill defines DSMES as personalized education covering healthy eating, physical activity, blood sugar monitoring, and medication management. This policy change directly affects Oklahoma Medicaid enrollees diagnosed with diabetes by expanding their covered health services. The bill becomes effective November 1, 2026.
SB 1329 requires Medicaid providers in Oklahoma to screen women for postpartum depression during any in-person visit with a Medicaid member or her infant within one year after childbirth. This screening must be reimbursed under the state Medicaid program, directly affecting Medicaid providers and pregnant/postpartum women enrolled in Medicaid. The bill mandates the Oklahoma Health Care Authority to seek necessary federal approval and develop implementing rules. It becomes effective November 1, 2026, aiming to integrate mental health checks into routine postpartum care.
SB 1421 requires all clinical staff, direct care staff, and volunteers working with minor children in Oklahoma mental health facilities or programs certified by the Department of Mental Health and Substance Abuse Services to complete nonphysical intervention training. The training covers nonviolent conflict resolution, communication skills, and promoting dignity, and must be completed within 30 days of hire with annual updates. Staff or volunteers cannot intervene with a minor child without this training. The bill takes effect November 1, 2026, applying to facilities receiving state funding through contracts with the Department.
SB 1564 requires Oklahoma's Medicaid program (Oklahoma Health Care Authority and its contractors) to use a specific billing code (HCPCS G0330) for facility fees related to dental surgeries under general anesthesia in operating rooms. This applies exclusively to surgeries performed on individuals with intellectual or developmental disabilities, such as those at ambulatory surgical centers. The bill mandates that the Authority set a reimbursement rate reflecting actual service costs, and all contractors must pay at least that rate for these claims. The policy change takes effect July 1, 2026.
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.
