Healthcare (Medicare)

This is a resolution (not a bill) introduced by Oklahoma's House of Representatives. It requests the Centers for Medicare and Medicaid Services (CMS) to require equal reimbursement rates for healthcare providers treating Medicare Advantage Plan (Part C) patients as those provided for traditional Medicare (Parts A/B) patients. The resolution specifically addresses Oklahoma's 800,000 Medicare beneficiaries and aims to correct current rate disparities that affect providers serving these patients. As a non-binding request, it does not change law but asks CMS to adjust its payment policies.

HB 1974 requires Medicare to cover annual preventative diagnostic screenings and advanced imaging services at no cost for Medicare-eligible Oklahomans. It specifically mandates coverage for cardiovascular, diabetes, and endocrinology testing (such as HbA1c, TSH, and lipid panels), plus MRI when medically necessary. The Oklahoma State Department of Health will administer the program in partnership with healthcare providers, including targeted outreach to rural and underserved communities. The bill also requires an annual report to the Legislature detailing program participation, health impacts, and cost savings.

SB 787 establishes the Oklahoma Health Care Cost Containment and Affordability Act, setting strict limits on how much health insurance plans must pay hospitals and providers for inpatient or outpatient services. It prohibits payments exceeding 200% of Medicare rates (or Medicaid rates if Medicare doesn't cover the service) or the median rate paid by health plans for the same service. This directly affects hospitals, health systems, and providers billing health insurance plans, while exempting critical access hospitals, federally qualified health centers, and rural clinics. The bill also requires providers to report pricing data to the State Department of Health and insurers to monitor compliance, with strict confidentiality rules for shared information.