Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB1813

Introduced
2/7/22  

Caption

Surprise billing; requiring reimbursement at certain rate; establishing requirements and provisions for billing disputes. Effective date.

Impact

The introduction of SB1813 aims to protect consumers from surprise medical bills by prohibiting out-of-network providers from billing patients excessive amounts for care provided in emergencies or other specified circumstances. This would require insurance companies to reimburse out-of-network providers at usual and customary rates, thus aligning the reimbursement practices with the services rendered. Additionally, the bill establishes a framework for mediation and arbitration in disputes involving out-of-network care, potentially reducing legal conflicts and providing a more straightforward resolution process for payment discrepancies.

Summary

Senate Bill 1813 addresses the issue of surprise billing in healthcare, particularly focusing on out-of-network providers and ensuring that patients are not financially burdened by unexpected charges. This bill lays out clear definitions for various stakeholders in the healthcare process, such as 'administrator', 'emergency care', and 'arbitration', to facilitate understanding and compliance. Central to the bill is the requirement that if an enrollee receives emergency care from an out-of-network provider, they should not face financial responsibility for payment beyond their applicable copayment, coinsurance, and deductible under their health plan.

Contention

Discussion around SB1813 may center on the balance between protecting patients from surprise billing and the interests of healthcare providers and insurers. Critics might argue that imposing stringent reimbursement requirements could harm the operational viability of out-of-network providers, who often argue that they need flexibility in billing to cover their costs. Additionally, there may be debates about the adequacy of the mediation and arbitration provisions and whether they effectively safeguard the rights and financial interests of both patients and providers.

Companion Bills

No companion bills found.

Previously Filed As

OK HB2125

Insurance; health insurance; Oklahoma Surprise Billing Protection Act; effective date.

OK HB2807

Insurance; Oklahoma Out-of-Network Surprise Billing and Transparency Act; effective date.

OK SB881

Health insurance; creating the Surprise Billing Protection Act of 2023. Effective date.

OK SB881

Health insurance; creating the Surprise Billing Protection Act of 2023. Effective date.

OK SB00905

An Act Concerning Surprise Billing And Reimbursements For Emergency Services Provided By Out-of-network Facility-based Providers.

OK HB1284

Health Insurance Surprise Billing Protections

OK SB262

Provides relative to balance or "surprise" billing. (8/1/20)

OK SB7

Provides relative to surprise billing. (Item #37) (1/1/21) (EG INCREASE SG EX See Note)

OK HB286

Surprise Billing Consumer Protection Act; certain consumer protections against surprise billing for ambulance service; provide

OK HB61

Provides relative to surprise billing (Item #37) (OR INCREASE SG EX See Note)

Similar Bills

OK HB2125

Insurance; health insurance; Oklahoma Surprise Billing Protection Act; effective date.

TX SB1264

Relating to consumer protections against certain medical and health care billing by certain out-of-network providers.

TX HB3924

Relating to health benefits offered by certain nonprofit agricultural organizations.

TX HB4115

Relating to consumer protections against certain medical and health care billing by out-of-network ground ambulance service providers.

TX SB999

Relating to consumer protections against and county and municipal authority regarding certain medical and health care billing by ambulance service providers.

OK HB2807

Insurance; Oklahoma Out-of-Network Surprise Billing and Transparency Act; effective date.

TX SB2476

Relating to consumer protections against certain medical and health care billing by emergency medical services providers.

OK HB3508

Employee Group Insurance Division; transferring division to the Oklahoma Health Care Authority; effective date; emergency.