Healthcare (Insurance)

vetoed · Oklahoma · House May 29, 2025

HB 1389: Mammography screening; coverage for low-dose mammography screening; examinations; definition; effective date.

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.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for mammograms without cost-sharing, expanding access to preventive breast cancer screening for specific age groups and high-risk cases.95% confidence

Sub-Topics Insurance

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in committee · Oklahoma · Senate Feb 10, 2025

SB 736: Income tax; creating the Health Care Sharing Ministry Tax Parity Act; stating certain deduction and procedures; requiring Oklahoma Tax Commission to create forms and guidelines. Effective date.

SB 736 creates the "Health Care Sharing Ministry Tax Parity Act," allowing Oklahoma residents who are active members of qualifying health care sharing ministries (HCSMs) to deduct their contributions from their state income tax starting in 2026. It directly affects Oklahoma residents who have been active HCSM members for at least one month during the tax year, treating their contributions like health insurance premiums for tax purposes. The bill requires the Oklahoma Tax Commission to develop forms for claiming the deduction, prohibits taxing reimbursements from HCSMs, and mandates annual reporting on the program's impact.

Topics ✓ Budget & TaxesSupports Budget & TaxesCreates tax deduction for HCSM contributions, reducing taxable income for qualifying residents - provides tax relief per SUPPORT indicators.90% confidence ✓ HealthcareSupports HealthcareAllows tax deductions for health care sharing ministry contributions, treating them like insurance premiums to expand coverage options for residents.95% confidence

Sub-Topics Income Tax Insurance

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in committee · Oklahoma · House Feb 4, 2025

HB 2270: Health insurance; terms; coverage of certain genetic testing and cancer imaging; terms of coverage; exclusions; effective date.

HB 2270 requires Oklahoma health insurance plans (including the Oklahoma Employees Insurance Plan) to cover two specific services without deductibles or copays: 1) Genetic testing for inherited cancer mutations when ordered by a provider following evidence-based guidelines (like NCCN Category 2A+ recommendations), for individuals with personal or family cancer history; 2) Evidence-based cancer imaging for high-risk individuals, also based on current medical guidelines. This applies to all plans renewed or issued on or after November 1, 2025, directly affecting patients seeking these preventive cancer services and insurers offering coverage in Oklahoma.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for genetic testing and cancer imaging without cost-sharing, expanding patient access to preventive care as per evidence-based guidelines.95% confidence

Sub-Topics Insurance

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in committee · Oklahoma · Senate Feb 26, 2025

SB 1064: Health insurance; establishing guidelines for step therapy protocol. Effective date,

SB 1064 requires health insurance plans in Oklahoma to use evidence-based clinical guidelines when creating step therapy protocols (where insurers mandate trying cheaper drugs first). It mandates that insurers provide a clear, accessible process for doctors and patients to request exceptions when step therapy blocks necessary medications, and they must grant exceptions if the doctor provides justification (e.g., prior drug failure, adverse reactions, or medical necessity). Insurers must respond to exception requests within 72 hours (24 hours for emergencies), and failure to respond on time automatically grants the exception. The bill directly affects insurers, healthcare providers, and patients using prescription drugs covered under step therapy protocols.

Topics ✓ HealthcareSupports HealthcareMandates evidence-based step therapy protocols and exception processes for necessary medications, improving patient access and protecting rights. Directly addresses insurance coverage within healthcare policy.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Oklahoma · Senate Feb 3, 2026

SB 1306: Prescription drugs; prohibiting insurer from modifying coverage under certain conditions; providing civil penalty; promulgating rules. Effective date.

This bill prevents health insurers from changing coverage for a prescription drug after it has been preapproved and the patient has already started taking it. It specifically prohibits insurers from increasing costs, denying coverage, moving the drug to a higher-cost tier, or switching to a generic without consent. Exceptions only apply if the FDA issues a safety warning or the drug manufacturer discontinues production. This directly protects patients with ongoing prescriptions who rely on specific medications.

Topics ✓ HealthcareSupports HealthcarePrevents insurers from changing coverage/costs for preapproved drugs, protecting patient access and rights to ongoing prescriptions without consent, aligning with healthcare protection indicators.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Oklahoma · Senate Mar 11, 2025

SB 1036: Ambulance service; requiring coverage for certain services. Effective date.

SB 1036, the "Oklahoma Triage, Treat, and Transport to Alternative Destination Act," requires health insurers in Oklahoma to cover specific ambulance services starting January 1, 2026. It mandates coverage for ambulance providers treating patients in place, triaging/treating/transporting to lower-acuity facilities (like urgent care or mental health centers), or for encounters resulting in no transport. This affects insurers, ambulance services, and people covered by health insurance plans. The law excludes hospitals, dialysis centers, and residential settings from "alternative destinations" and sets minimum reimbursement rates for ambulance services. It applies to all new or renewed health insurance contracts on or after the effective date.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for non-transport ambulance services including mental health centers, expanding access to lower-acuity care without hospital transport.95% confidence

Sub-Topics Insurance Mental Health

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passed · Oklahoma · House Apr 1, 2025

HB 1769: Insurance; purchase of benefits by school district employees; enrollment period; effective date.

HB 1769 modifies Oklahoma school district health insurance benefits for employees. It sets minimum monthly flexible benefit allowances: $69.71 for certified staff (like teachers) and $189.69 for support staff (like aides) if they opt out of the district’s health plan. Employees who don’t use their full allowance to cover health benefits receive the excess as taxable cash payments. The bill requires annual enrollment between November 1 and December 15, with specific rules for mid-year terminations and unused allowances.

Topics ✓ HealthcareSupports HealthcareMandates minimum health benefit allowances for school employees, ensuring baseline coverage under district plans and preventing benefit reduction.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentSets minimum health benefit allowances for school employees, allowing unused portions as taxable cash, expanding employee benefits under employment standards.95% confidence

Sub-Topics Insurance

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in committee · Oklahoma · House Feb 4, 2025

HB 1473: Revenue and taxation; Health Care Sharing Ministry Tax Parity Act; definitions; income tax deduction; effective date.

HB 1473, the "Health Care Sharing Ministry Tax Parity Act," allows Oklahoma residents who are active members of qualifying health care sharing ministries (HCSMs) to deduct their membership contributions from their state income taxes starting in 2026. It treats these deductions similarly to health insurance premiums, applying to self-employed individuals, employer contributions (as nontaxable benefits), and individuals covering themselves or dependents. To claim the deduction, members must provide documentation of contributions and membership, and false claims could result in $500 penalties per offense and three years of ineligibility. Funds received from HCSMs for medical expenses will not be considered taxable income under Oklahoma law.

Topics ✓ Budget & TaxesSupports Budget & TaxesAllows tax deduction for health care sharing ministry memberships, providing tax relief similar to health insurance premiums, directly impacting state taxation policy.95% confidence ✓ HealthcareSupports HealthcareAllows tax deductions for health care sharing ministry memberships, treating them like insurance premiums to expand coverage alternatives and improve access to health coverage options.85% confidence

Sub-Topics Income Tax Insurance

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died · Oklahoma · House Feb 11, 2026

HB 2931: Insurance; Oklahoma Life and Health Insurance Guaranty Association coverage; annuities; effective date.

This bill clarifies eligibility for Oklahoma's Life and Health Insurance Guaranty Association coverage when an insurer fails. It ensures Oklahoma residents automatically receive coverage for life, health, and annuity policies, while non-residents may qualify only if the insurer was based in Oklahoma and no other state provides coverage. The bill specifically excludes structured settlement annuities from certain coverage rules and prevents duplicate coverage across states. It does not create new benefits but defines who qualifies under existing law, excluding reinsurance, self-funded employer plans, and certain policy features like dividends or marketing claims.

Topics ✓ HealthcareSupports HealthcareEnsures automatic health insurance coverage for Oklahoma residents when insurers fail, protecting access to health coverage without restrictions or defunding.95% confidence

Sub-Topics Insurance

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died · Oklahoma · House Feb 5, 2025

HB 1119: Oklahoma Right to Shop Act; definitions; shared savings incentive program and insurance carrier obligations; effective date.

HB 1119 creates an optional "shared savings incentive program" for Oklahoma health insurance carriers, allowing them to offer financial rewards to people with health insurance who choose providers charging less than the average rate paid by the insurer for comparable services. The bill requires carriers to provide incentives of at least 25% of the savings generated when enrollees use out-of-network providers who agree to accept rates below the average allowed amount, calculated as a cash payment or credit toward deductibles. Carriers must disclose program details, publish provider rates and incentives online, and report participation data annually to the Insurance Department. The law takes effect November 1, 2025, and applies to all health benefit plans offered by Oklahoma-licensed insurance carriers.

Topics ✓ HealthcareSupports HealthcareCreates shared savings incentives (25% cash rewards) for lower-cost provider use, promoting affordable access and cost reduction in healthcare services.85% confidence

Sub-Topics Insurance

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