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. 74, § 1370. Flexible benefit allowance: Oklahoma State Employees Benefits Act – Oklahoma
Introduced: Status: Enacted
Subject to the requirement that a participant must elect the default benefits, the basic plan, or is a person who has retired from a branch of the United States military and has been provided with …
Download
Okla. Stat. tit. 74, § 1371. Election of benefit plans–Plans offered by health maintenance organizations–Default benefits: Oklahoma State Employees Benefits Act – Oklahoma
Introduced: Status: Enacted
All participants must purchase at least the basic plan unless, to the extent that it is consistent with federal law, the participant is a person who has retired from a branch of the United States …
Download
Okla. Stat. tit. 74, § 1372. Claims for flexible spending account benefits–Notice of denial–Hearing: Oklahoma State Employees Benefits Act – Oklahoma
Introduced: Status: Enacted
The Office of Management and Enterprise Services shall be responsible for making all determinations as to the rights of any participant or any beneficiary of a participant to receive amounts under the flexible spending account …
Download
Okla. Stat. tit. 74, § 1375. High deductible health plan: Oklahoma State Employees Benefits Act – Oklahoma
Introduced: Status: Enacted
The Oklahoma Employees Insurance and Benefits Board of the Office of Management and Enterprise Services shall make the pretax health savings account authorized by the provisions of the Health Savings Account Act established in Section …
Download
Okla. Stat. tit. 74, § 18b. Duties of Attorney General–Counsel of Corporation Commission as representative on appeal from Commission: Attorney General– General Provisions – Oklahoma
Introduced: Status: Enacted
The duties of the Attorney General as the chief law officer of the state shall be: to represent and protect the collective interests of insurance consumers in this state in rate-related proceedings before the Insurance …
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