Overview
Oklahoma operates a volunteer all-payer claims database. Approximately 1 million people’s claims are in this database, accounting for about 25% of Oklahoma’s total population. The legislature also introduced legislation to promote price transparency and cost containment in recent terms, including protection against surprise billing and a Right to Shop program that would require insurance carriers to establish for all health care plans a program in which enrollees are directly incentivized to shop for lower-cost participating health care providers or health care entities for comparable health care services. Incentives may include cash payments, gift cards or credits or reductions of premiums, copayments, cost-sharing or deductibles.
In the insurance market, Oklahoma uses the federally facilitated marketplace. Blue Cross Blue Shield of Oklahoma was the only carrier offering plans on the state’s exchange until 2018. Since then, more plans have joined the exchange, effectively decreasing the rates of BCBS. To provide additional insurance alternatives in Oklahoma, the legislature also enacted the Health Care Choice Act to allow the state to enter into compacts with other states so that health plans domiciled in those states could be sold to Oklahoma residents without having to obtain an Oklahoma certificate of authority.
Oklahoma was awarded a CMS State Innovation Model grant in 2014, which authorized the Oklahoma State Department of Health’s Center for Health Innovation and Effectiveness to utilize multi-payer value-based payment models to improve healthcare quality and bend the cost curve. In recent terms, the state legislature also proposed a public option bill that would authorize the Oklahoma Health Care Authority to implement a Medicaid Buy-In program in the state.
See below for an overview of existing Oklahoma state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 2/6/2023 - 5/26/2023 (2023-2024 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 1006 – Oklahoma
Introduced: 2021 Status: Enacted
An Act relating to health care; creating the Transparency in Health Care Prices Act; defining terms; requiring health care providers to make available the health care prices for certain health care services; providing for disclosure; …
HB 1013 – Oklahoma
Introduced: 2018 Status: Inactive / Dead
MODIFYING PROVISIONS RELATED TO THE NURSING PRACTICE ACT: The introduced measure will give full practice authority to advanced practice registered nurses and repeals the Formulary Advisory Council within the Nursing Practice Act.
HB 1019 – Oklahoma
Introduced: 2021 Status: Enacted
HB 1019 caps the amount that a covered person is required to pay for insulin not to exceed $30 for a 90-day supply.
HB 1053 – Oklahoma
Introduced: 2019 Status: Inactive / Dead
Insurance; creating the Out-of-Network Surprise Billing Transparency Act; instructing the Oklahoma Insurance Department to promulgate rules for implementation of program; effective date.
HB 1058 – Oklahoma
Introduced: 2019 Status: Inactive / Dead
Insurance; employee insurance benefits; HMO plans; effective date: HB1058, as introduced, removes the requirement that the Oklahoma Employees Insurance and Benefits Board contract with and offer HMO plans. The board would instead contract with one …
Okla. Stat. tit. 36, § 6530.3. Eligible Persons: Oklahoma Health Insurance Market Stabilization Act – Oklahoma
Introduced: Status: Enacted
All residents of Oklahoma who are not inmates and are not receiving other state health benefits are covered under this act.
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Okla. Stat. tit. 36, § 6530.5. Board of Directors–Duties–Sunset of Program: Oklahoma Individual Health Insurance Market Stabilization Act – Oklahoma
Introduced: Status: Enacted
Statute lays out the duties of the board of directors under the Oklahoma Individual Health Insurance Market Stabilization Program. See definition section Okla. Stat. tit. 36, § 6530.2.
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Okla. Stat. tit. 36, § 6530.9. Unfair practice–Separating individual employees from group health insurance coverage: Oklahoma Health Insurance Market Stabilization Act – Oklahoma
Introduced: Status: Enacted
It is an unfair business practice for an employer to refer an employee to this program when the employer offers group health insurance for its employees.
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Okla. Stat. tit. 36, § 6552. Definitions: Hospital and Medical Services Utilization Review Act – Oklahoma
Introduced: Status: Enacted
Definitions related to the Hospital and Medical Services Utilization Review Act
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Okla. Stat. tit. 36, § 6553. Private review agents–Certification required–Exemptions: Hospital and Medical Services Utilization Review Act – Oklahoma
Introduced: Status: Enacted
A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or …
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Pharmaceutical Care Management Association (PCMA) v. Mulready – Oklahoma
District Court: District Court of Western District of Oklahoma Status: Decided
The 2019 Oklahoma law, Patient’s Right to Pharmacy Choice Act, targets PBM conflict of interest by prohibiting higher reimbursement rates for PBM-owned pharmacies and bans …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Oklahoma’s fiscal year begins on July 1 and ends on June 30 in the following year. Oklahoma enacts its annual budget during the regular legislative session. View the current budget information here.
KEY RESOURCES
- Oklahoma State Legislature
- Oklahoma Office of the Attorney General
- Oklahoma Insurance Department
- OK2SHARE