HEALTH INSURANCE
OKLAHOMA 2024 SESSION LAW SERVICE Fifty-Ninth Legislature, 2024 Second Regular Session
2024 Okla. Sess. Law Serv. Ch. 359 (H.B. 1712) (WEST)
SEE VETO INFORMATION AT END OF DOCUMENTOKLAHOMA 2024 SESSION LAW SERVICE
Fifty-Ninth Legislature, 2024 Second Regular Session
CHAPTER 359
H.B. No. 1712
HEALTH INSURANCE
An Act relating to health insurance; defining terms; prohibiting insurers from refusing coverage to an insured under certain circumstances; providing for an insured to seek care from an out-of-network provider under certain circumstances; requiring out-of-network providers to be reimbursed for covered services at the same rate as in-network providers; providing for codification; and declaring an emergency.
SUBJECT: Health insurance
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 6981 of Title 36, unless there is created a duplication in numbering, reads as follows:
<< OK ST T. 36 § 6981 >>
A. As used in this section:
1. “Durable medical equipment” means equipment as defined pursuant to Section 375.2 of Title 59 of the Oklahoma Statutes;
2. “Health benefit plan” means a health benefit plan as defined pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes, but shall not include any health benefit plan offered by a contracted entity as defined in Section 4002.2 of Title 56 of the Oklahoma Statutes that provides coverage to members of the state Medicaid program;
3. “Health care provider” means a provider as defined pursuant to Section 6571 of Title 36 of the Oklahoma Statutes;
4. “Health maintenance organization” or “HMO” means a health maintenance organization as defined pursuant to Section 6902 of Title 36 of the Oklahoma Statutes, but shall not include any health benefit plan offered by a contracted entity as defined in Section 4002.2 of Title 56 of the Oklahoma Statutes that provides coverage to members of the state Medicaid program; and
5. “Preferred provider organization” or “PPO” means a preferred provider organization as defined pursuant to Section 6054 of Title 36 of the Oklahoma Statutes.
B. No health benefit plan, HMO, PPO, or other provider network authorized to administer health care coverage in this state shall refuse coverage to an insured for durable medical equipment and supplies as prescribed by a health care provider, regardless of whether they are in-network or out-of-network, unless there is an Oklahoma-licensed in-network provider within a fifteen-mile radius of the patient's home address that can provide in-person evaluation for durable medical equipment, supplies, and related services.
C. If a health care provider deems it necessary that an insured receive covered durable medical equipment or supplies within twenty-four (24) hours, the insured shall not be subject to drop-shipped orders and may seek such equipment and supplies from any health care provider who can provide the necessary services and supplies within the requested time frame.
D. When an insured utilizes an out-of-network health care provider, as described in subsection B of this section, the out-of-network provider shall be reimbursed at the same rate and benefit level for the provided services as an in-network provider for the health benefit plan, HMO, PPO, or other provider network authorized to administer health care coverage in this state.
SECTION 2. It being immediately necessary for the preservation of the public peace, health or safety, an emergency is hereby declared to exist, by reason whereof this act shall take effect and be in full force from and after its passage and approval.
Governor’s veto overridden by both houses of the Legislature and filed with the Secretary of State May 30, 2024.
MESSAGE
FROM THE
HOUSE OF REPRESENTATIVES
5/30/2024
TO HONORABLE
SECRETARY OF STATE
By order of the House of Representatives of the State of Oklahoma, this Message is sent:
Transmitting herewith Enrolled HB 1712 together with the Governor’s veto message thereon, and advising that under the provisions of Article V, Section 58, of the Constitution of the State of Oklahoma, the House of Representatives has reconsidered and passed said measure, over the Governor's veto, by a three-fourths vote of all members elected to and constituting the House, said votes being as follows:
House of Representatives: | Ayes: 82, Nays: 13 |
Senate: | Ayes: 37, Nays: 6 |
Respectfully,
EMILY GILES
______________________________
Chief Clerk
Received May 30, 2024, Oklahoma Secretary of State
OFFICE OF
THE GOVERNOR
STATE OF OKLAHOMA
OKLAHOMA CITY, OKLA., April 29, 2024
No. HB 1712
TIME SIGNED:
TO THE HONORABLE SPEAKER OF THE HOUSE
AND MEMBERS OF THE OKLAHOMA HOUSE OF REPRESENTATIVES
SECOND REGULAR SESSION OF THE
FIFTY-NINTH OKLAHOMA LEGISLATURE
ENROLLED HOUSE BILL NO. 1712:
Pursuant to the authority vested in me by Section 11 of Article VI of the Oklahoma Constitution, I have vetoed Enrolled House Bill 1712.
House Bill 1712 would mandate health insurers to cover an insured for durable medical equipment and supplies as prescribed by a health care provider, regardless of whether they are in-network or out-of-network. This requirement is in place even if the health care provider determines that the durable medical equipments is not medically necessary. The result is unquestionably an increase in the cost of health insurance for all Oklahomans.
For these reasons, I have vetoed Enrolled House Bill 1712.
BY THE GOVERNOR OF THE STATE OF OKLAHOMA
Kevin Stitt
Received May 6, 2024, Oklahoma Secretary of State
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