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SENATE FLOOR VERSION
February 28, 2022
SENATE BILL NO. 1369 By: McCortney
An Act relating to health insurance; creating the
Oklahoma Healthcare Transparency Initiative Act of
2022; providing legislative intent; d efining terms;
directing Initiative to establish all-payer claims
database; establishing governance of Ini tiative;
providing Oklahoma State Health Information Network
and Exchange authority as administ rator of
Initiative; requiring Exchange to establish
procedures, identify areas for improvement under
Initiative, and provide biennial report to
Legislature; requiring submitting entity submit
certain claims data quarterly; exemptin g certain data
from Oklahoma Open Records Act under certain
circumstances; permitting data disclosed pursuant to
act be available to certain parties in certain
circumstances; providing for complia nce with federal
law; establishing penalty schedule; requiring
submission of data for integration into Initiative;
amending 51 O.S. 2021, Section 24A. 3, which relates
to Oklahoma Open Records Act; omitting certain data
under Oklahoma Healthcare Transparency Initiat ive Act
of 2022 from definition of record; prov iding for
codification; and providing an effective date .
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 Se ction 6971 of Title 36, unless there
is created a duplication in numbering, reads as follows:
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This act shall be known and may be cited as the “Oklahoma
Healthcare Transparency Initiative Act of 20 22”.
SECTION 2. NEW LAW A new sectio n of law to be codified
in the Oklahoma Statutes as S ection 6972 of Title 36, unless there
is created a duplication in numbering, read s as follows:
A. It is the intent of the Legislature to create and maintain
an informative source of healthcare information to support
consumers, researchers, and policymakers in healthcare decisions
within this state including decisions by the Insurance Department to
regulate the business of insurance in this state.
B. The purpose of this act is to:
1. Create the Oklahoma Healthcare Transparency Initiative;
2. Establish governance of the Oklahoma Healthcare Transparency
Initiative;
3. Provide authority to collect healthcare information from
insurance carriers and other entities; and
4. Establish appropriate methods for collecting, maintaining,
and reporting healthcare information including privacy and security
safeguards.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6973 of Title 36, unless there
is created a duplication in numbering, reads as follows:
As used in the “Oklahoma Healthcare Transparency Initiative Act
of 2022”:
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1. “Oklahoma Healthcare Transparency Initiative” means an
initiative to create a database including ongoing all-payer claims
database projects that receive and store data from a submitting
entity relating to medical, dental, pharmaceutical, and other
insurance claims information, unique identifiers, and geographic and
demographic information for covered individuals as permitted in this
act, and provider files, for the purposes of this act;
2. “Oklahoma resident” means an individual for whom the
submitting entity has identified an Oklahoma address as the primary
place of residence of the individual;
3. “Claims data” means information included in an
institutional, professional, or pharmacy claim or equivalent
information transaction for a covered individual including the
amount paid to a provider of healthcare services plus any amount
owed by the covered individual;
4. “Covered individual” means a natural person who is an
Oklahoma resident and is eligible to receive medical, dental, or
pharmaceutical benefits under any policy, contract, certificate,
evidence of coverage, rider, binder, or endorsement that provides
for or describes coverage;
5. “Direct personal identifiers” means information relating to
a covered individual that contains primary or obvious identifiers,
such as the individual’s name, street address, e-mail address,
telephone number, and Social Security number. Direct personal
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identifiers shall not include geographic or demographic information
that would not allow the identification of a covered individual;
6. “Enrollment data” means demographic information and other
identifying information relating to covered individuals including
direct personal identifiers;
7. “Exchange” means the Oklahoma State Health Information
Network and Exchange.
8. “Protected health information” means health information as
protected by the Health Insurance Portability and Accountability Act
of 1996, Pub. L. No. 104-191;
9. “Provider” means an individual or entity licensed by the
state to provide healthcare services;
10. “Submitting entity” means:
a. an entity that provides health or dental insurance or
a health or dental benefit plan in the state including
without limitation an insurance company, medical
services plan, managed care organization, hospital
plan, hospital medical service corporation, health
maintenance organization, or fraternal benefit
society, provided that the entity has covered
individuals and the entity had at least two thousand
(2,000) covered individuals in the previous calendar
year,
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b. a health benefit plan offered or administered by or on
behalf of the state or an agency or instrumentality of
the state including without limitation benefits
administered by a managed care organization,
notwithstanding the number of covered individuals in
the previous year,
c. a health benefit plan offered or administered by or on
behalf of the federal government with the agreement of
the federal government,
d. the Workers’ Compensation Commission,
e. any other entity providing a plan of health insurance
or health benefits subject to state insurance
regulation, a third-party administrator, or a pharmacy
benefits manager; provided, that the entity has
covered individuals and the entity had at least two
thousand (2,000) covered individuals in the previous
calendar year,
f. a health benefit plan subject to the Employee
Retirement Income Security Act of 1974, Pub. L. No.
93-406, and that is fully insured,
g. a risk-based provider organization licensed by the
Insurance Department, and
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h. any entity that contracts with the Department of
Corrections to provide medical, dental, or
pharmaceutical care to inmates.
A submitting entity shall not include an entity that provides
health insurance or a health benefit plan that is accident-only,
specified disease, hospital indemnity, long-term care, disability
income, or other supplemental benefit coverage, an employee of a
welfare benefit plan as defined by federal law that is also a trust
established pursuant to collective bargaining subject to the Labor
Management Relations Act, 1947, Pub. L. No. 80-101, or a health
benefit plan subject to the Employee Retirement Income Security Act
of 1974, Pub. L. No. 93-406, that is self-funded; and
11. “Unique identifier” means any identifier that is guaranteed
to be unique among all identifiers for covered individuals but does
not include direct personal identifiers.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6974 of Title 36, unless there
is created a duplication in numbering, rea ds as follows:
A. The Oklahoma Healthcare Transparency Initiative shall be
governed by the Oklahoma State Health Information Network and
Exchange.
B. The Exchange shall be the administrator of the Oklahoma
Healthcare Transparency Initiative, and shall be responsible for
development and implementation of a sustainability plan subject to
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data use and disclosure requirements of this act and any rules
promulgated therein. The Exchange shall have the authority to:
1. Collect, validate, analyze, and present health data
including claims data; and
2. Assess penalties for noncompliance with this section.
C. The Exchange shall exercise its powers and duties under this
section to:
1. Establish policies and procedures necessary for the
administration and oversight of the Oklahoma Healthcare Transparency
Initiative including procedures for the collection, processing,
storage, analysis, us e, and release of data;
2. Identify and explore the key healthcare issues, questions,
and problems that may be improv ed through more transparent
information including without limitation data require d to be
disclosed to patients related to provider relatio nships or
affiliations with payers and providers , financial interests in
healthcare businesses, and payments or items of any value given to
providers from pharmaceutical or medical device manufacture rs or
agents thereof; and
3. Provide a biennial report t o the Legislature on the
operations of the Oklah oma Healthcare Transparency Initiative.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Sect ion 6975 of Title 36, unless there
is created a duplicati on in numbering, reads as follows:
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A. No later than January 1, 2023, and every quarter thereafter,
a submitting entity shall sub mit health and dental claims data,
unique identifiers, and geog raphic and demographic information for
covered individuals as pe rmitted in this act, and provider files to
the Oklahoma Healthcare Transparency Initiative in accordance with
standards and procedures adopted by the Oklahoma State Health
Information Network and Exchange.
B. Data submitted under this section shall be treated as
confidential and shall be exempt from disclosure as a record under
the Oklahoma Open Records Act as defined pursuant to Section 24A.3
of Title 51 of the Oklahoma Statutes and are not subject to subpoena
except to the extent provided in the Oklahoma Insurance Code.
C. The collection, storag e, and release of data and other
information under this section is subject to applicab le state and
federal data privacy and security law.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6976 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. Data in the Oklahoma Healthcare Transparency Initiative
shall, to the extent authorized by the Oklahoma State Health
Information Network and Exchange, be available:
1. When disclosed in a form and manner that ensures the privacy
and security of protected health information as required by state
and federal laws, as a resource to insurers, employers, purchasers
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of health care, researchers, state agencies, and healthcare
providers to allow for assessment of healthcare utilization,
expenditures, and performance in this state including without
limitation as a resource for hospital community health needs
assessments; and
2. To state programs regarding healthcare quality and costs for
use in improving health care in the state, subject to rules
prescribed by the Exchange conforming to state and federal privacy
laws or limiting access to limited-use data sets.
B. Data in the Oklahoma Healthcare Transparency Initiative
shall not be used to disclose trade secrets of submitting entities,
reidentify or attempt to reidentify an individual who is the subject
of any submitted data without obtaining the individual’s consent, or
create or augment data contained in a national claims database.
C. Notwithstanding any other section of law, the Oklahoma
Healthcare Transparency Initiative shall not publicly disclose any
data that contains direct personal identifiers.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6977 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. Except for state or federal agencies that are submitting
entities, a submitting entity that fails to submit data as required
by this act or the rules of the Oklahoma State Health Information
Network and Exchange may be subject to a penalty.
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B. The Exchange shall adopt a schedule of penalties not to
exceed One Thousand Dollars ($1,000.00) per day for each day the
violation occurs, determined by the severity of the violation.
C. A penalty imposed under this section may be remitted or
mitigated upon such terms and conditions as the Exchange considers
proper and consistent with the public health and safety.
D. A penalty remitted under this section shall be used to fund
Oklahoma Healthcare Transparency Initiative operations.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6978 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. The State Department of Health shall submit data collected
under Section 1-115 et seq. of Title 63 of the Oklahoma Statutes to
the Oklahoma Healthcare Transparency Initiative for integration into
the Initiative.
B. The data submitted under subsection A of this section shall
be assigned a unique identifier as defined in Section 3 of this act
and may be used in accordance with the purposes of the Oklahoma
Healthcare Transparency Initiative and the rules promulgated
pursuant to this act.
SECTION 9. NEW LAW A new section of l aw to be codified
in the Oklahoma Statutes as Section 6979 of Title 36, unless there
is created a duplication in numbering, reads as follows:
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A. The State Department of Health shall submit data collected
regarding hospital discharge and emergency department records for
the uninsured, birth and death records, and disease registry data
under Sections 1-115 et seq. and 1-323 et seq. of Title 63 of the
Oklahoma Statutes, and Rule 310:567-1-1 et seq. of the Oklahoma
Administrative Code, to the Oklahoma Healthcare Transparency
Initiative Board for integration into the Initiative database
created under Section 4 of this act.
B. The data submitted under subsection A of this section shall
be assigned a unique identifier as defined in Section 3 of this act
and may be used in accordance with the purposes of the Oklahoma
Healthcare Transparency Initiative and the rules promulgated under
this act.
SECTION 10. AMENDATORY 51 O.S. 2021, Section 24A.3, is
amended to read as follows:
Section 24A.3. As used in the Oklahoma Open Records Act:
1. “Record” means all documents, including, but not limited to,
any book, paper, photograph, microfilm, data files created by or
used with computer software, computer tape, disk, record , sound
recording, film reco rding, video record or other material regardless
of physical form or characteristic, created by, received by, under
the authority of, or coming into the custody, control or possessio n
of public officials, public bodies, or their representatives in
connection with the transaction of public business, the expenditure
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of public funds or the a dministering of public property . “Record”
Record does not mean:
a. computer software,
b. nongovernment personal effects,
c. unless public disclosure i s required by other laws or
regulations, vehicle movement records of the Oklahoma
Transportation Authority obtai ned in connection with
the Authority’s electronic toll collection system,
d. personal financial in formation, credit reports or
other financial data obtained by or submitted to a
public body for the purpose of evaluating credit
worthiness, obtaining a licen se, permit, or for the
purpose of becoming qualified to contract with a
public body,
e. any digital audio/video recordings of the toll
collection and safeguarding activities of the Oklahoma
Transportation Authority,
f. any personal information provided by a guest at any
facility owned or operated by the Oklahoma Tourism and
Recreation Department or the Board of Trustees of the
Quartz Mountain Arts and Conference Center and Nature
Park to obtain any service at the facility or by a
purchaser of a product sold by or through the Oklahoma
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Tourism and Recreation Department or the Quartz
Mountain Arts and Conf erence Center and Nature Park,
g. a Department of Defense Form 214 (DD Form 214) filed
with a county clerk, including any DD Form 214 filed
before July 1, 2002, or
h. except as provided for in Section 2-110 of Title 47 of
the Oklahoma Statutes,
(1) any record in connection with a Motor Vehicle
Report issued by the Department of Public Safety,
as prescribed in Section 6 -117 of Title 47 of the
Oklahoma Statutes, or
(2) personal information wit hin driver records, as
defined by the Driver ’s Privacy Protection A ct,
18 United States Code, Sections 2721 throu gh
2725, which are stored and maintained by the
Department of Public Safety , or
i. data submitted pursuant to Section 5 of the Oklahoma
Healthcare Transparency Initiative Act of 20 22;
2. “Public body” shall include, but not be limited to, any
office, department, board, bureau, commission, agency, trusteeship,
authority, council, committee, trust or any entity cr eated by a
trust, county, city, village, town, township, district, school
district, fair board, cou rt, executive office, advisory group, task
force, study group, or any subdivision thereof, supported in whole
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or in part by public funds or entrusted with th e expenditure of
public funds or administering or operating public property, and all
committees, or subcommittees thereof. Except for the records
required by Section 24A.4 of this title, “public body” public body
does not mean judges, justices, the Council on Judicia l Complaints,
the Legislature, or legislators;
3. “Public office” means the physical location wher e public
bodies conduct business or keep records ;
4. “Public official” means any official or employee of any
public body as defined herein; and
5. “Law enforcement agency” means any public body charged with
enforcing state or local criminal laws and init iating criminal
prosecutions, including, but not limited to, police departments,
county sheriffs, the Department of Public Safety, the Oklahoma State
Bureau of Narcotics and Dangerous Drugs Control, the Alcoholic
Beverage Laws Enforcement Commission, and t he Oklahoma State Bureau
of Investigation.
SECTION 11. This act shall become effective November 1, 2022.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
February 28, 2022 - DO PASS