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 2785 requires Oklahoma's Office of Management and Enterprise Services (OMES) to implement stricter budget oversight for the Department of Mental Health and Substance Abuse Services. It mandates OMES to review agency budgets against actual spending before releasing funds, prohibit contracts without clear cost limits, restrict multi-year contract encumbrances to current-year funds, and block payments for unapproved expenses. The bill also requires OMES to report monthly revenue and spending status to the Governor, legislature leadership, and relevant committees. This directly affects state budget management for mental health services by adding specific financial controls to prevent overspending. The law takes immediate effect due to an emergency declaration.
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.
HB 2788 transfers specific funds back into Oklahoma's Statewide Recovery Fund from several existing programs. It moves $1.56 million from domestic violence services, $162,668 from food assistance programs, $1.49 million from health workforce initiatives, $2.16 million from rural healthcare, $5 million from medical facilities, $20.5 million from mental health hospital construction, and $3.3 million from water resources projects. All transfers align with recommendations from the Joint Committee on Pandemic Relief Funding. The bill takes effect July 1, 2025, and was enacted without the governor's signature on May 29, 2025.
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.
HB 2782 creates a "Rate Preservation Fund" within Oklahoma's Health Care Authority to prevent cuts to Medicaid reimbursement rates for healthcare providers when the state's federal Medicaid funding percentage decreases. The bill allows the Authority to use fund monies to maintain these rates and permits temporary transfers of up to one-third of the fund's balance to other Medicaid program accounts for cash flow needs - provided the funds are fully repaid to the preservation fund by year-end. This directly affects hospitals, clinics, and other Medicaid providers who rely on stable reimbursement rates. The law also declares an emergency to take immediate effect.
SB 176 requires health insurance plans to cover certain prescription drugs that were previously not included in standard coverage. It directly affects health insurance providers and policyholders by mandating this specific coverage for eligible medications. The key provision is a new requirement for all health benefit plans to include these designated prescriptions without prior authorization or excessive cost-sharing. The law became effective on May 29, 2025, after the Governor did not sign it.
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.
HB 2797 prohibits Oklahoma's Health Care Authority (OHCA) from using statistical methods like extrapolation to audit Medicaid home and community-based service claims, which could require providers to repay overpayments. It invalidates all past audits using these methods (January 2020-November 2025) and voids related repayment demands. The bill requires OHCA and the Department of Human Services to jointly develop new audit standards and provide training for providers by November 2027. It also mandates compliance with existing fraud reporting rules and updates audit responsibilities for Medicaid waiver programs.
