Healthcare (Medicaid)

signed · Oklahoma · Senate May 5, 2026

SB 1645: Medicaid; establishing certain requirements and procedures for audits of providers; directing establishment of certain appeals. Effective date.

SB 1645 establishes new rules for auditing long-term care providers (like nursing homes and Medicaid home-care agencies) under Oklahoma's Medicaid program. It requires the Oklahoma Health Care Authority to give providers 1 week's notice before audits, limits audits to 50 claims or 0.25% of annual claims, and prohibits holding providers liable for simple clerical errors (like typos) as fraud. Providers must be allowed 60 days to correct claims after an audit, and recoupments (recovery of overpaid funds) can only apply to corrected claims, not original billing errors. The bill also creates a two-step appeals process, allowing providers to challenge audit results through the Authority and then to an administrative law judge.

Topics ✓ HealthcareSupports HealthcareBill reduces administrative burden on Medicaid providers by limiting audits, prohibiting liability for clerical errors, and allowing correction periods - protecting access to long-term care services under Medicaid.90% confidence

Sub-Topics Long-Term Care Medicaid Substance Abuse

died · Oklahoma · Senate Mar 2, 2026

SB 1566: Medicaid; modifying requirements and procedures related to applied behavior analysis treatment for autism spectrum disorder. Effective date.

This bill changes Oklahoma Medicaid rules for autism treatment coverage. It requires a diagnosis of autism spectrum disorder by specific licensed providers (like neurologists, developmental pediatricians, or psychologists) to qualify for applied behavior analysis (ABA) therapy. The bill prohibits Medicaid from requiring re-diagnoses after an initial diagnosis and mandates in-person ABA services while allowing remote supervision via telehealth. It directly affects Oklahoma Medicaid recipients with autism spectrum disorder seeking ABA therapy.

Topics ✓ HealthcareSupports HealthcareModifies Medicaid rules to require specific providers for autism diagnosis, prohibits re-diagnoses, and allows telehealth supervision, improving access to ABA therapy coverage for Medicaid recipients.95% confidence

Sub-Topics Medicaid Telehealth

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in committee · Oklahoma · Senate Feb 3, 2026

SB 1563: Nonopioid drugs; modifying certain restrictions on Medicaid drug formulary; prohibiting certain carriers from imposing specified utilization controls. Effective date.

SB 1563 prevents Oklahoma Medicaid and state employee health plans from applying stricter coverage rules to nonopioid pain medications than to opioids. It requires that FDA-approved nonopioid drugs for pain management cannot face more restrictive prior authorization or step therapy requirements than opioid options. The law applies to all Medicaid formularies and state flexible benefit plans, ensuring nonopioid drugs aren't disadvantaged in coverage decisions. It takes effect January 1, 2027.

Topics ✓ HealthcareSupports HealthcarePrevents Medicaid from imposing stricter coverage rules on nonopioid pain medications than opioids, ensuring equal access to alternatives and improving patient access to pain management options.95% confidence

Sub-Topics Medicaid Prescription Drugs Substance Abuse

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in committee · Oklahoma · Senate Feb 3, 2026

SB 1654: Mobile integrated healthcare; directing establishment of mobile integrated healthcare program; requiring certain reimbursement. Effective date.

SB 1654 requires health care benefit plans (like insurance companies) to reimburse mobile integrated healthcare (MIH) providers at specific rates. For non-transport treatments, plans must pay at least the state Medicaid program's minimum rate. For MIH providers who transport patients to alternative destinations (e.g., clinics instead of hospitals), reimbursement must match basic or advanced life support rates based on patient needs. This applies to all MIH suppliers and affects how health plans cover these services in Oklahoma. The bill directs the Oklahoma Health Care Authority to establish the reimbursement methodology.

Topics ✓ HealthcareSupports HealthcareMandates specific reimbursement rates for MIH providers, ensuring coverage access and strengthening healthcare funding for mobile services.95% confidence

Sub-Topics Medicaid

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in committee · Oklahoma · House Feb 3, 2026

HB 3597: State welfare benefits; eligibility; immigrants; food stamps; Medicaid; effective date.

HB 3597 prohibits unauthorized immigrants (defined as individuals without proper legal documentation, including those who entered without inspection or overstayed visas) from receiving food stamp benefits or Medicaid/SooonerCare coverage in Oklahoma. The bill amends state statutes to explicitly ban these benefits for such individuals under all circumstances, with penalties for knowingly assisting them. It aligns Medicaid eligibility requirements with federal SNAP work rules but excludes Insure Oklahoma and specific exempt populations. The law takes effect November 1, 2026.

Topics ✗ HealthcareOpposes HealthcareRestricts Medicaid access for unauthorized immigrants, directly limiting healthcare coverage under public health programs.95% confidence ✗ ImmigrationOpposes ImmigrationProhibits unauthorized immigrants from state welfare benefits (food stamps/Medicaid), restricting access to essential services per bill's explicit ban and penalties.95% confidence

Sub-Topics Medicaid Work Authorization

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in committee · Oklahoma · House Feb 3, 2026

HB 3911: Medicaid; Oklahoma Health Care Authority; 1915(c) waiver; postsecondary support; Home and Community-Based Services waiver; effective date.

HB 3911 directs Oklahoma's Medicaid agency to amend its federal 1915(c) waiver with CMS to expand coverage for postsecondary support (such as job training or education programs) under Home and Community-Based Services (HCBS) waivers. This change would directly affect Oklahomans receiving HCBS through Medicaid who need postsecondary support to maintain independence in community settings. The bill requires the Oklahoma Health Care Authority to formally update the waiver agreement with federal authorities. The amendment would take effect November 1, 2026.

Topics ✓ EducationSupports EducationExpands Medicaid coverage for postsecondary education programs under HCBS waivers, directly enhancing educational access for HCBS recipients.85% confidence ✓ HealthcareSupports HealthcareExpands Medicaid HCBS waiver to include postsecondary support, enhancing community-based care access for beneficiaries through federal waiver amendment.95% confidence

Sub-Topics Medicaid

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in committee · Oklahoma · Senate Feb 3, 2026

SB 1648: Medicaid; creating the Healthy Moms, Healthy Babies Act; requiring coverage and reimbursement of specified services; requiring certain reimbursement methodology. Effective date.

SB 1648, the "Healthy Moms, Healthy Babies Act," requires Oklahoma Medicaid to cover specific maternal health services for pregnant and postpartum women. It mandates separate reimbursement for prenatal, delivery, and postpartum care (including office visits, lab work, remote monitoring, and gestational diabetes management) instead of bundled payments, and adds coverage for depression screening, self-measured blood pressure monitoring, remote ultrasounds, and doulas/community health workers for home visits. The bill also establishes presumptive eligibility for pregnant applicants to access immediate prenatal care while processing full applications. These changes take effect November 1, 2026, and require the Oklahoma Health Care Authority to seek necessary federal approvals.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid coverage for expanded maternal health services including depression screening, remote monitoring, and doulas, strengthening access and funding for critical healthcare needs.95% confidence

Sub-Topics Medicaid Telehealth Women's Health

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signed · Oklahoma · Senate May 6, 2026

SB 1565: Medicaid; establishing powers and duties related to Transforming Maternal Health (TMaH) Model; requiring inclusion of nutrition support services. Effective date. Emergency.

SB 1565 requires Oklahoma's Medicaid program to include nutrition support services for pregnant and postpartum women with diet-related conditions or high-risk pregnancy factors. It mandates medically tailored home-delivered meals designed by dietitians to meet specific medical needs, along with optional nutritional counseling, to improve maternal health outcomes. The bill authorizes Oklahoma Health Care Authority to use federal funds from the CMS Transforming Maternal Health (TMaH) Model exclusively for these services. The law takes effect July 1, 2026, and is designated as an emergency measure.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid inclusion of nutrition support services for high-risk maternal health, expanding coverage and improving access to medically tailored care.95% confidence

Sub-Topics Medicaid Women's Health

signed · Oklahoma · Senate Apr 28, 2026

SB 1847: Medicaid home- and community-based services; modifying eligibility criteria for the ADvantage Waiver Program. Effective date. Emergency.

SB 1847 modifies Oklahoma's ADvantage Waiver Program, which provides Medicaid home- and community-based services. It creates an exception allowing individuals with cognitive impairments to qualify if they were already residing in an assisted living center contracted with the state when their impairment developed, and the center has a specific accommodation plan. This change directly affects adults with cognitive impairments who live in state-contracted assisted living facilities and developed their condition after moving in. The bill does not alter financial or age requirements but adjusts eligibility for this specific group. The exception applies to those meeting all three conditions outlined in the bill's new subsection B.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for cognitive impairment patients in state-contracted facilities, increasing access to home-based care services under ADvantage Waiver Program.95% confidence

Sub-Topics Long-Term Care Medicaid

in committee · Oklahoma · House Feb 3, 2026

HB 3359: Medicaid coverage; biomarker testing coverage; discretionary; effective date.

HB 3359 requires Oklahoma's Medicaid program to cover biomarker testing for Medicaid members when supported by medical evidence, such as FDA approvals, clinical guidelines, or CMS coverage policies. It directly affects Medicaid recipients needing these tests, healthcare providers ordering them, and Medicaid contractors managing coverage. Key provisions mandate that contractors cover testing at the same scope as other services, approve/deny prior authorizations within 24-72 hours, and provide clear online processes for coverage exceptions. The bill takes effect November 1, 2026, with no changes to existing Medicaid coverage standards beyond this specific requirement.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid coverage for biomarker testing, expanding access to essential diagnostic services for beneficiaries per medical evidence standards.95% confidence

Sub-Topics Medicaid

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