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.
SB 1409 – Oklahoma
Introduced: 2022 Status: Inactive / Dead
Health maintenance organizations; establishing provisions for preauthorization exemption. SB 1409 authorizes health benefit plans that use a preauthorization process to exempt a physician or provider from obtaining preauthorization for any health care service if such …
SB 142 – Oklahoma
Introduced: 2023 Status: In Process
lowers the price cap on a 30-day supply of insulin from $30.00 to $25.00. The measure also provides that if the price of an FDA-approved diabetes equipment or supply product cost exceeds $35.00, the health …
SB 143 – Oklahoma
Introduced: 2023 Status: In Process
provides that any high deductible health plan, as defined in current law, shall allow an insured member to set aside funds on a tax-free basis, up to the contribution limit provided in Section 223 of …
SB 144 – Oklahoma
Introduced: 2023 Status: In Process
directs the Insurance Department to compile list of prescription drugs that the Department determines to be essential for treating diabetes. The list will include price increases for said drugs. Any manufacturer of a drug that …
SB 145 – Oklahoma
Introduced: 2023 Status: In Process
prohibits insurers from modifying an insured’s coverage of a prescription drug if drug had been previously preauthorized for coverage, the insured already received the drug, and a practitioner continues to prescribe the drug. If the …
HB 1157 – Oklahoma
Introduced: 2019 Status: Enacted
An Act relating to health care; creating the Oklahoma Medicaid Reform Act; providing for noncodification; and providing an effective date.
HB 2191 – Oklahoma
Introduced: 2019 Status: Enacted
HB2191, as introduced, requires the disclosure of insurers’ corporate governance structures, policies, and practices to the Insurance Commissioner. HB2191 establishes an annual deadline of June 1 to submit to the Commissioner a Corporate Governance Annual …
HB 2632 – Oklahoma
Introduced: 2019 Status: Enacted
[Enforcement suspended pending litigation] An Act relating to insurance; creating the Patient’s Right to Pharmacy Choice Act; declaring purpose; defining terms; providing for compliance standards for retail pharmacy networks; providing for review of retail pharmacy …
Okla. Stat. tit. 15, § 219A. Noncompetition agreements: Unlawful Contracts – Oklahoma
Introduced: Status: Enacted
Prohibits noncompete contracts except those written to protect the sale of goodwill of a business, dissolution of a partnership or those that prohibit only the direct solicitation of established customers of the former employer.
Download
Okla. Stat. tit. 15, § 777.4. Maximum permitted price or rate for sale, rent, or lease of goods, services, dwelling units, or storage space–Application of section: Emergency Price Stabilization Act – Oklahoma
Introduced: Status: Enacted
Prohibits price gouging in emergency situations.
Download
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