Health care services; terms; documentation; prohibiting certain billing; deductible; codification; effective date.

Added Senate sponsor Frix to the list of bill sponsors

Updated header to indicate this is the Floor version of the bill

Reformatted page headers and footers to match Floor version standards

All original text of the bill was deleted and replaced with entirely new content

New bill text was inserted with different structure and language throughout all sections

The bill format changed from 'Engrossed House' to 'Proposed Oversight Committee Substitute' indicating it went through committee review and amendment

Expanded the definition of 'health care service' to explicitly include mental health and substance use disorder services, ensuring these are covered under the out-of-pocket payment program.

Added 'durable medical equipment' to the definition of health care services, broadening what qualifies for the program.

Clarified that the program applies to licensed health care providers and requires services to be medically necessary and covered under the enrollee's health benefit plan.

Expanded the list of excluded insurance plans to include Medicare supplemental policies, workers' compensation, medical payment insurance, long-term care policies, and short-term health insurance with six-month or less duration.

Added a new requirement that health care providers must accept out-of-pocket payments as payment in full and cannot bill the patient or insurer for any balance.

Revised documentation requirements to specify that providers must not bill for balances between collected payments and their billed charges when accepting negotiated out-of-pocket payments.

Document title and header information changed from 'Proposed Policy Committee Substitute' to 'Committee Substitute' with updated page numbering and formatting.

Page breaks and reference numbers were updated throughout the document to reflect the new committee substitute format.

Added explicit reference to Section 6060.50 and 6060.51 codification in the new committee substitute format.

Definition sections were reorganized; the 'Health care service' definition now appears earlier in the document, and mental health/substance use disorder services are included in the definition.

The definitions of 'health benefit plan' and 'health care service' were reorganized and expanded to include mental health and substance use disorder services, while clarifying exclusions for limited benefit policies.

Added a new definition for 'health care provider' to clarify who is licensed under specific Oklahoma Statutes titles.

Added specific immunization requirements for children, including diphtheria, hepatitis B, measles, mumps, pertussis, polio, rubella, tetanus, varicella, haemophilus influenzae type B, and hepatitis A.

Clarified that benefits required for children must not be subject to deductibles, co-payments, or coinsurance requirements.

Reorganized the document structure and moved definitions to a new subsection for better clarity and readability.

The definition of 'health benefit plan' was expanded to include any insurance company or health maintenance organization issuing coverage to Oklahoma residents, replacing the previous narrower list of specific plan types.

New exclusions were added specifying that the term does not include plans covering only specified diseases, accidental death/dismemberment, dental/vision care, hospital confinement indemnity, disability income insurance, liability insurance supplements, Medicare supplements, workers' compensation, or short-term nonrenewable insurance of six months or less.

The bill title was changed from 'PROPOSED OVERSIGHT' to 'PROPOSED POLICY' and document reference numbers were updated from Req. No. 13220 to Req. No. 12268.

The bill header was updated from 'Suzanne Schreiber-TKR' dated 3/5/2025 to 'Suzanne Schreiber-TJ' dated 2/4/2025, reflecting committee assignment and revision date changes.

Expanded the definition of 'health benefit plan' to include group hospital coverage, individual and group medical insurance, not-for-profit hospital or medical service plans, prepaid health plans, health maintenance organization plans, preferred provider organization plans, and the State and Education Employees Group Health Insurance Plan.

Added Multiple Employer Welfare Arrangement to the list of plans that are explicitly excluded from the health benefit plan definition.

Changed the language requiring enrollees to negotiate for a lower price from a licensed health care provider than the average allowed amount established by the enrollee's health benefit plan for covered health care services.

Modified how out-of-pocket payments are counted, now applying to both the enrollee's deductible and annual maximum out-of-pocket expense, with specific conditions for covered services and negotiated lower costs.

Added a new provision requiring health care providers to accept the enrollee's payment as payment in full and prohibiting billing for any balance between the amount collected from the enrollee and the provider's billed charge for the service.

Updated document reference numbers from Req. No. 12954 to Req. No. 13220 and changed the committee version identifier from FULLPCS1 to FULLPCS2 with updated timestamp.