HB 2797: Health Care Authority; prohibiting use of certain methodology; audits; fraud reporting; requiring joint collaboration between Department of Mental Health and Substance Abuse Services and Department of Human Services; duties; emergency. - Oklahoma

House Committee Substitute → Floor (House) · 3 edits

MINOR

The bill was reformatted from a committee substitute version to the House floor version, with minor adjustments to line spacing, indentation, and page headers. The substantive policy content regarding Medicaid auditing restrictions, fraud reporting, and program definitions remains unchanged.

TECHNICAL

Page headers were updated from 'Req. No. 13803' to 'HB2797 HFLR' to reflect the floor version status.

Line spacing and indentation were adjusted throughout the document for formatting consistency in the floor version.

The title page was updated to indicate 'HOUSE OF REPRESENTATIVES - FLOOR VERSION' instead of just 'COMMITTEE SUBSTITUTE'.

Proposed Committee Substitute (full committee) 1 → House Committee Substitute · 4 edits

MODERATE

The bill text was updated to reflect committee amendments, adding new sponsors (Hall and Haste of the Senate) and expanding the definition of health-related services to include additional care tasks like range of motion and supervision for activities of daily living. These changes clarify which services community services workers can provide under specific training and medical authorization requirements.

Scope change

The bill's scope was expanded to include additional health-related services under the Oklahoma Health Care Authority, specifically adding range of motion and supervision of activities of daily living to the list of services community services workers may provide with proper training and physician orders.

DEFINITION

Added new health-related service categories including range of motion and supervision or assistance with activities of daily living to the definition of services community services workers can provide.

REQUIREMENT

Added requirements for training, written agreements from personal support teams, and physician acknowledgment and orders for certain basic nursing care tasks.

TECHNICAL

Updated bill title and sponsor information to reflect committee amendments, adding Senate sponsors Hall and Haste.

Changed document title from 'PROPOSED COMMITTEE SUBSTITUTE' to 'COMMITTEE SUBSTITUTE' and updated request numbers.

Enrolled (final version) → Proposed Committee Substitute (full committee) 1 · 3 edits

MINOR

The bill was amended to replace the entire original text with a new version that maintains the same core purpose but updates the statutory citation from Section 1020 to Section 2020 and adds committee amendment metadata. The substantive policy provisions regarding audit methodology restrictions, fraud reporting, and program development remain unchanged in content.

Scope change

The bill's scope remains focused on Oklahoma Health Care Authority audit practices and Medicaid home and community-based services, with no changes to applicability or eligibility criteria.

TECHNICAL

Statutory citation in Section 2 was changed from 56 O.S. 2021, Section 1020 to Section 2020, though the actual content of the section remains the same.

Added committee amendment header, metadata, and formatting elements including Speaker/Chair designations and amendment submission details.

Removed original enrolled bill header and formatting elements including 'ENROLLED HOUSE' designation and original page numbering.

Engrossed → Enrolled (final version) · 3 edits · May 22, 2025

MINOR

The bill was converted from an Engrossed version to an Enrolled final version, with minor formatting adjustments and a technical addition to the definition of 'basic nursing care' that now requires a physician's specific order for certain tasks. The substantive policy content regarding audit methodology restrictions and fraud reporting remains unchanged.

Scope change

No substantive change in scope or applicability; the bill's core provisions regarding the Oklahoma Health Care Authority's audit restrictions remain the same.

TECHNICAL

Minor formatting changes from Engrossed to Enrolled version, including header updates and page numbering adjustments.

DEFINITION

Added requirement that basic nursing care tasks must include a primary care physician's specific order related to the task.

ENFORCEMENT

Core restrictions on audit extrapolation methods and nullification of prior audit results remain identical.

Introduced → Engrossed · 6 edits · May 22, 2025

MODERATE

This bill replaces a 2025 budget finance act with a new healthcare oversight law that restricts how the Oklahoma Health Care Authority audits Medicaid claims. The key change is prohibiting the use of statistical extrapolation methods that could require providers to repay more money than was actually audited. It also invalidates certain past audits and requires new training materials for providers.

Scope change

The bill's scope changed from a general budget finance act to a specific healthcare authority audit reform law with new definitions and restrictions on audit methodologies.

DEFINITION

New definitions for 'error rate', 'extrapolation', 'probability sample', 'sample', and 'universe' to clarify audit terminology.

REQUIREMENT

Prohibits the Oklahoma Health Care Authority from using extrapolation or statistical sampling methods that could result in repayment demands exceeding the audited claim amount.

Requires joint collaboration between the Oklahoma Health Care Authority and Department of Human Services to develop audit methodology and training materials for providers.

TIMELINE

Sets a timeline from January 27, 2020 through November 1, 2027 for claims subject to these new audit restrictions.

ENFORCEMENT

Declares certain past audits invalid and prevents the authority from demanding repayment or imposing penalties based on those invalidated audits.

SCOPE

Removed the original Budget and Finance Act of 2025 provisions and replaced them with healthcare-specific audit reform language.

Health Care Authority; prohibiting use of certain methodology; audits; fraud reporting; requiring joint collaboration between Department of Mental Health and Substance Abuse Services and Department of Human Services; duties; emergency.

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