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.
In 2024, the state passed a law creating the Ensuring Transparency in Prior Authorization Act, requiring disclosure and review of prior authorization. The state also enacted legislation establishing new requirements for collecting medical debt in civil actions in Oklahoma.
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, § 1141. Prohibited Conduct: Advisory Organizations – Insurance Code – Oklahoma
Introduced: Status: Enacted
Advisory organizations are prohibited from attempting to monopolize or advising an insurance company to monopolize. They are forbidden from conspiring with an insurance company.
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Okla. Stat. tit. 36, § 1201. Declaration of purpose: Unfair Practices and Frauds – Oklahoma
Introduced: Status: Enacted
The purpose of this article is to regulate trade practices in the business of insurance in accordance with the intent of Congress as expressed in the Act of Congress of March 9, 1945 (Public Law […]
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Okla. Stat. tit. 36, § 1202. Definitions: Unfair Practices and Frauds – Oklahoma
Introduced: Status: Enacted
Definitions related to OK’s Unfair Practices and Frauds.
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Okla. Stat. tit. 36, § 1203. Unfair methods of competition or unfair and deceptive acts or practices prohibited: Unfair Practices and Frauds – Oklahoma
Introduced: Status: Enacted
No person shall engage in this state in any trade practice which is defined in this article as, or determined pursuant to this article to be, an unfair method of competition or an unfair or […]
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Okla. Stat. tit. 36, § 1204. Unfair methods of competition and unfair or deceptive acts or practices defined: Unfair Practices and Frauds – Oklahoma
Introduced: Status: Enacted
This law outlines what constitutes an unfair or deceptive act/practice
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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. State agencies submit their budget requests to the governor by October 1. The governor submits the proposed budget to the state legislature in February. The legislature typically adopts a budget in May. The governor is constitutionally required to submit a balanced budget proposal, and the legislature is required to pass a balanced budget.
STATE LEGISLATURE
There are 101 members of the State House of Representatives, each serving a two-year term, and 48 state senators, who serve staggered four-year terms. Regular legislative sessions begin at twelve o’clock noon on the first Monday in February of each year and end not later than five o’clock p.m. on the last Friday in May of each year.