HB 2262 requires nursing homes, assisted living facilities, and other care providers marketing specialized dementia care to publicly disclose detailed information about their services. Facilities must submit a standardized form to Oklahoma's State Department of Health, covering staff ratios, care plans, facility design, activities, fees, and family involvement - ensuring transparency for residents and families considering placement. The bill mandates posting this disclosure online and in facilities, with the Department reviewing it during inspections. It directly affects dementia care providers and supports informed decisions by families seeking appropriate care.
HB 1576 requires Oklahoma Medicaid to cover rapid whole genome sequencing (RWGS) for eligible beneficiaries under age 21 with complex or acute illnesses of unknown cause while receiving critical care in a hospital. It mandates coverage only when specific medical criteria are met, such as symptoms suggesting broad genetic testing needs, timely diagnosis being critical for treatment, and conditions like congenital anomalies or abnormal test results. The bill also ensures genetic data used for diagnosis is protected under HIPAA, allows research use only with explicit patient or guardian consent (with opt-out rights), and requires the Oklahoma Health Care Authority to implement rules and seek federal approval for coverage. This policy directly affects Medicaid-covered children and teens in intensive care with undiagnosed conditions.
SB 804 requires Oklahoma assisted living centers to establish an internal quality assurance committee that meets quarterly. The committee must monitor incidents, resident satisfaction, and care quality - especially medication administration - and recommend policies, with membership including a registered nurse, administrator, direct care staff, and pharmacist as needed. The bill also updates existing rules to mandate monthly medication reviews by nurses/pharmacists, standardized resident screening, posting inspection results online, and individualized care plans. These changes directly affect all licensed assisted living centers in Oklahoma, effective November 1, 2025.
SB 574 expands the types of opioid-related projects eligible for state grant funding by allowing the Attorney General to allocate funds toward new prevention, treatment, and recovery initiatives. It directly affects state agencies and community organizations receiving opioid grants by broadening allowable uses beyond current restrictions. The bill authorizes the Attorney General to use grant funds for specific, previously ineligible activities, such as community-based support programs. This policy change modifies how opioid grant funds are distributed without altering the grant application process.
Oklahoma's SB 773 regulates pharmacy benefit managers (PBMs) by prohibiting unfair practices that affect independent pharmacies and patients. It requires PBMs to pay independent pharmacies the same reimbursement rate for identical drugs as they pay PBM-owned pharmacies, banning "spread pricing" where PBMs charge plans more than they pay pharmacies. The bill also prohibits PBMs from charging pharmacies fees for claim submission, network enrollment, or claims processing, and restricts retroactive payment reductions except for fraud or audit errors. These changes directly impact PBMs, pharmacies, and health plans operating in Oklahoma, aiming to ensure fairer payment practices. The bill was vetoed by the governor but overridden by the legislature on May 29, 2025.
This bill requires Oklahoma health insurance plans to cover low-dose mammography screenings for breast cancer without cost-sharing (such as deductibles or copays). It mandates coverage once every five years for women aged 35-39 and annually for women 40 and older. The law also requires coverage for necessary diagnostic and supplemental breast exams, including those for high-risk cases like dense breast tissue. The policy takes effect November 1, 2025.
HB 1808, now law in Oklahoma, reforms health insurance prior authorization and step-therapy rules to improve patient access to medications. It requires insurers to grant exceptions to step-therapy protocols (where patients must try cheaper drugs first) if a medication is contraindicated, ineffective based on medical history, or causes harm - covering specific scenarios like prior adverse reactions or stability on a current treatment. The bill mandates insurers respond to urgent prior authorization requests within 24 hours and non-urgent requests within 2 business days, with requests deemed approved if deadlines are missed. It also ensures continuity of coverage for stable treatments when switching plans (90-day protection) and requires insurers to cover at least one readily available asthma controller medication per class without prior authorization.
SB 1135 allocates $100,000 from Oklahoma's General Revenue Fund to the Oklahoma Health Care Authority for the 2025-2026 fiscal year to support its operations. The bill declares an emergency to allow immediate implementation upon approval. This legislation provides specific funding for the Authority's duties without altering existing health insurance or tax policies.
SB 1178 appropriates $100,000 from Oklahoma's General Revenue Fund to the Department of Human Services for fiscal year 2026 to support its existing mental health and substance abuse services duties. The bill directly affects state-funded mental health programs by providing dedicated funding for current operations. It includes an emergency clause, allowing it to take immediate effect without the governor's signature, which occurred on May 29, 2025. This is a procedural funding measure with no new policy requirements, solely allocating existing resources. The appropriation is limited to the specified amount and purpose as defined in the bill text.
SB 109 requires Oklahoma health insurance plans to cover genetic testing for inherited cancer risks and evidence-based cancer imaging for individuals with a personal or family history of cancer or increased cancer risk. This coverage must be provided without patient cost-sharing (such as deductibles or copays) when ordered by a healthcare provider following current medical guidelines, including those from the National Comprehensive Cancer Network. The law applies to all health benefit plans offered in Oklahoma starting November 1, 2025, ensuring these preventive services are accessible without financial barriers. It does not affect health savings account eligibility for non-preventive services but guarantees coverage for preventive care under federal guidelines.
