Healthcare (Insurance)

in committee · Oklahoma · Senate Feb 26, 2025

SB 1064: Health insurance; establishing guidelines for step therapy protocol. Effective date,

SB 1064 requires health insurance plans in Oklahoma to use evidence-based clinical guidelines when creating step therapy protocols (where insurers mandate trying cheaper drugs first). It mandates that insurers provide a clear, accessible process for doctors and patients to request exceptions when step therapy blocks necessary medications, and they must grant exceptions if the doctor provides justification (e.g., prior drug failure, adverse reactions, or medical necessity). Insurers must respond to exception requests within 72 hours (24 hours for emergencies), and failure to respond on time automatically grants the exception. The bill directly affects insurers, healthcare providers, and patients using prescription drugs covered under step therapy protocols.

Topics ✓ HealthcareSupports HealthcareMandates evidence-based step therapy protocols and exception processes for necessary medications, improving patient access and protecting rights. Directly addresses insurance coverage within healthcare policy.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Oklahoma · Senate Feb 3, 2026

SB 1306: Prescription drugs; prohibiting insurer from modifying coverage under certain conditions; providing civil penalty; promulgating rules. Effective date.

This bill prevents health insurers from changing coverage for a prescription drug after it has been preapproved and the patient has already started taking it. It specifically prohibits insurers from increasing costs, denying coverage, moving the drug to a higher-cost tier, or switching to a generic without consent. Exceptions only apply if the FDA issues a safety warning or the drug manufacturer discontinues production. This directly protects patients with ongoing prescriptions who rely on specific medications.

Topics ✓ HealthcareSupports HealthcarePrevents insurers from changing coverage/costs for preapproved drugs, protecting patient access and rights to ongoing prescriptions without consent, aligning with healthcare protection indicators.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Oklahoma · Senate Mar 11, 2025

SB 1036: Ambulance service; requiring coverage for certain services. Effective date.

SB 1036, the "Oklahoma Triage, Treat, and Transport to Alternative Destination Act," requires health insurers in Oklahoma to cover specific ambulance services starting January 1, 2026. It mandates coverage for ambulance providers treating patients in place, triaging/treating/transporting to lower-acuity facilities (like urgent care or mental health centers), or for encounters resulting in no transport. This affects insurers, ambulance services, and people covered by health insurance plans. The law excludes hospitals, dialysis centers, and residential settings from "alternative destinations" and sets minimum reimbursement rates for ambulance services. It applies to all new or renewed health insurance contracts on or after the effective date.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for non-transport ambulance services including mental health centers, expanding access to lower-acuity care without hospital transport.95% confidence

Sub-Topics Insurance Mental Health

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passed · Oklahoma · House Apr 1, 2025

HB 1769: Insurance; purchase of benefits by school district employees; enrollment period; effective date.

HB 1769 modifies Oklahoma school district health insurance benefits for employees. It sets minimum monthly flexible benefit allowances: $69.71 for certified staff (like teachers) and $189.69 for support staff (like aides) if they opt out of the district’s health plan. Employees who don’t use their full allowance to cover health benefits receive the excess as taxable cash payments. The bill requires annual enrollment between November 1 and December 15, with specific rules for mid-year terminations and unused allowances.

Topics ✓ HealthcareSupports HealthcareMandates minimum health benefit allowances for school employees, ensuring baseline coverage under district plans and preventing benefit reduction.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentSets minimum health benefit allowances for school employees, allowing unused portions as taxable cash, expanding employee benefits under employment standards.95% confidence

Sub-Topics Insurance

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in committee · Oklahoma · House Feb 4, 2025

HB 1473: Revenue and taxation; Health Care Sharing Ministry Tax Parity Act; definitions; income tax deduction; effective date.

HB 1473, the "Health Care Sharing Ministry Tax Parity Act," allows Oklahoma residents who are active members of qualifying health care sharing ministries (HCSMs) to deduct their membership contributions from their state income taxes starting in 2026. It treats these deductions similarly to health insurance premiums, applying to self-employed individuals, employer contributions (as nontaxable benefits), and individuals covering themselves or dependents. To claim the deduction, members must provide documentation of contributions and membership, and false claims could result in $500 penalties per offense and three years of ineligibility. Funds received from HCSMs for medical expenses will not be considered taxable income under Oklahoma law.

Topics ✓ Budget & TaxesSupports Budget & TaxesAllows tax deduction for health care sharing ministry memberships, providing tax relief similar to health insurance premiums, directly impacting state taxation policy.95% confidence ✓ HealthcareSupports HealthcareAllows tax deductions for health care sharing ministry memberships, treating them like insurance premiums to expand coverage alternatives and improve access to health coverage options.85% confidence

Sub-Topics Income Tax Insurance

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signed · Oklahoma · House May 19, 2025

HB 2052: Health insurance; exemption of certain domestic health maintenance organizations from certain provisions of the Health Maintenance Organizations Act; effective date.

HB 2052 exempts certain domestic health maintenance organizations (HMOs) that exclusively contract with Oklahoma's Medicaid program (via the Oklahoma Health Care Authority) from most state health insurance regulations. These HMOs, which serve only Medicaid recipients and no other patients, are no longer subject to specific provisions of the Health Maintenance Organizations Act, including requirements about benefit coverage and certain administrative rules. The exemption applies solely to services provided to Medicaid recipients under Oklahoma Statutes Title 56, Section 4002.2. The law became effective November 1, 2025, after passing without the Governor's signature.

Topics ✗ HealthcareOpposes HealthcareExempts Medicaid-only HMOs from benefit coverage requirements, reducing regulatory oversight for services to vulnerable patients.85% confidence

Sub-Topics Insurance Medicaid

died · Oklahoma · House Feb 11, 2026

HB 2931: Insurance; Oklahoma Life and Health Insurance Guaranty Association coverage; annuities; effective date.

This bill clarifies eligibility for Oklahoma's Life and Health Insurance Guaranty Association coverage when an insurer fails. It ensures Oklahoma residents automatically receive coverage for life, health, and annuity policies, while non-residents may qualify only if the insurer was based in Oklahoma and no other state provides coverage. The bill specifically excludes structured settlement annuities from certain coverage rules and prevents duplicate coverage across states. It does not create new benefits but defines who qualifies under existing law, excluding reinsurance, self-funded employer plans, and certain policy features like dividends or marketing claims.

Topics ✓ HealthcareSupports HealthcareEnsures automatic health insurance coverage for Oklahoma residents when insurers fail, protecting access to health coverage without restrictions or defunding.95% confidence

Sub-Topics Insurance

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died · Oklahoma · House Feb 5, 2025

HB 1119: Oklahoma Right to Shop Act; definitions; shared savings incentive program and insurance carrier obligations; effective date.

HB 1119 creates an optional "shared savings incentive program" for Oklahoma health insurance carriers, allowing them to offer financial rewards to people with health insurance who choose providers charging less than the average rate paid by the insurer for comparable services. The bill requires carriers to provide incentives of at least 25% of the savings generated when enrollees use out-of-network providers who agree to accept rates below the average allowed amount, calculated as a cash payment or credit toward deductibles. Carriers must disclose program details, publish provider rates and incentives online, and report participation data annually to the Insurance Department. The law takes effect November 1, 2025, and applies to all health benefit plans offered by Oklahoma-licensed insurance carriers.

Topics ✓ HealthcareSupports HealthcareCreates shared savings incentives (25% cash rewards) for lower-cost provider use, promoting affordable access and cost reduction in healthcare services.85% confidence

Sub-Topics Insurance

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in committee · Oklahoma · Senate Feb 11, 2025

SB 1025: Health care; creating the Oklahoma Rebate Pass-Through and Pharmacy Benefits Manager Meaningful Transparency Act of 2025; clarifying authority to take certain actions. Effective date.

SB 1025, titled the Oklahoma Rebate Pass-Through and Pharmacy Benefits Manager Meaningful Transparency Act of 2025, requires pharmacy benefits managers (PBMs) to disclose their "aggregate retained rebate percentage" - the portion of drug rebates they retain instead of passing to health plans. It directly affects PBMs and covered entities like insurers, hospitals, and employers providing health coverage in Oklahoma. Key provisions mandate PBMs to calculate and report this percentage annually, define terms for transparency, establish cost-sharing rules, and create penalties for noncompliance. The bill aims to increase clarity around how drug rebates flow through the system, without altering health plan benefits or formulary requirements.

Topics ✓ HealthcareSupports HealthcareMandates PBMs to disclose rebate retention rates, promoting transparency to potentially lower drug costs for health plans and patients.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Oklahoma · House Feb 19, 2026

HB 2942: Revenue and taxation; Health Care Sharing Ministry Tax Parity Act; definitions; income tax deduction; effective date.

HB 2942, the "Health Care Sharing Ministry Tax Parity Act," allows Oklahoma residents who are active members of Health Care Sharing Ministries (HCSMs) to deduct their qualified health care sharing expenses from their state income tax starting in 2027. It directly affects Oklahoma residents using HCSMs - non-profit organizations that share medical costs based on shared ethical or religious beliefs - by granting them tax treatment similar to health insurance premiums. Key provisions include permitting deductions for self-employed individuals and employer contributions (treated as nontaxable benefits), requiring documentation to claim the deduction, and ensuring funds received from HCSMs are not considered taxable income. The bill takes effect November 1, 2026, with the Oklahoma Tax Commission overseeing implementation and reporting.

Topics ✗ Budget & TaxesOpposes Budget & TaxesCreates new tax deduction for HCSM members, reducing state tax revenue and expanding tax breaks beyond standard health insurance.95% confidence ✓ HealthcareSupports HealthcareAllows tax deduction for HCSM expenses, treating them like insurance premiums, expanding tax-advantaged healthcare access for religious/ethical groups.90% confidence

Sub-Topics Income Tax Insurance

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