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.
HB 2048, the "340B Nondiscrimination Act," prohibits health insurers, pharmacy benefits managers (PBMs), and third-party payors from discriminating against healthcare providers participating in the federal 340B drug discount program. It specifically bans lower reimbursement rates for 340B drugs, extra fees or administrative burdens for 340B entities, exclusion from provider networks based on 340B status, and requirements to disclose 340B-specific billing details. The law applies to all 340B entities - such as community health centers and hospitals participating in the federal program - and ensures they receive equal treatment in billing, reimbursement, and network access. Enforcement is handled by the Attorney General, with the Oklahoma Medicaid program excluded from these provisions.
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 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.
SB 1136 allocates $100,000 from Oklahoma's General Revenue Fund to the Oklahoma Health Care Authority (OHCA) for unspecified duties required by law. The bill directly affects the OHCA, which administers state health care programs, by providing dedicated funding for its operations. It requires the agency to use these specific funds for purposes outlined in existing law, though the bill does not detail the exact programs or services. The funding is effective immediately upon the bill's passage, declared an emergency for public health and safety reasons. This is a routine appropriations measure with no new policy requirements or beneficiary changes.
HB 2782 creates a "Rate Preservation Fund" within Oklahoma's Health Care Authority to prevent cuts to Medicaid reimbursement rates for healthcare providers when the state's federal Medicaid funding percentage decreases. The bill allows the Authority to use fund monies to maintain these rates and permits temporary transfers of up to one-third of the fund's balance to other Medicaid program accounts for cash flow needs - provided the funds are fully repaid to the preservation fund by year-end. This directly affects hospitals, clinics, and other Medicaid providers who rely on stable reimbursement rates. The law also declares an emergency to take immediate effect.
