Req. No. 364 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 58th Legislature (2021) SENATE BILL 378 By: Rosino AS INTRODUCED An Act relating to organ donation and anatomical gifts; creating Everett’s Law; providing short title; defining terms; specifying applicability of act; prohibiting certain acts by c overed entity; allowing covered entity to take disa bility into account under certain conditions; prohibiting covered entity from considering certain factor under specified condition; requiring covered entity to m ake certain modifications to policies, practices or procedures; requiring covered entity to ensure certain protections related to medical services; construing act; requiring certain c ompliance with federal law; providing for certain civil action ; requiring court to give certain priority and expedited review; authorizing court to grant certain relief; providing intent; defining terms; prohibiting certain actions by health carrier; specifying that certain ame ndment to collective bargaining agreement does not constitute termination; construing act; providing 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 Section 2200.28 of Title 63, unless there is created a duplication in numbering, reads as follows: This act shall be known and may be cited as “Everett’s Law”. Req. No. 364 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 2. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2200.29 of Title 63, unless there is created a duplication in numbering, reads as follows: As used in this act: 1. “Anatomical gift” means a donation of all or part of a human body to take effect after the donor ’s death for the purpose of transplantation or t ransfusion; 2. “Auxiliary aids or services” means an aid or service t hat is used to provide information to an individual with a cogniti ve, developmental, intellectual, neurological or physical disability and is available in a format or manner that allows the individual to better understand the information. An auxiliary aid or service may include: a. qualified interpreters or other effec tive methods of making aurally delivered materials available to persons with hearing impairments, b. qualified readers, taped texts, texts in accessible electronic format or other effective methods of making visually delivered materials available to persons with visual impairments, c. supported decision-making services, including: (1) the use of a support i ndividual to communicate information to the individual with a disability, Req. No. 364 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 ascertain the wishes of the individua l, or assist the individual in making dec isions, (2) the disclosure of information to a legal guardian, authorized represe ntative or another individual designated by the individual with a disability for such purpose, as long as th e disclosure is consistent with state and federal law including the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. 1320d et seq. and any regulations promulgated by the United States Department of Health and Human Services to implement the act, (3) if an individual has a court -appointed guardian or other individual responsible f or making medical decisions on behalf of the indivi dual, any measures used to ensure that the individual is included in decisions involving the individual’s health care and that medical decisions are in accordance with the i ndividual’s own expressed intere sts, or (4) any other aid or service that is used t o provide information in a format that is easily understandable and accessible to individuals with cognitive, neurological, development al or Req. No. 364 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 intellectual disabilities, inclu ding assistive communication technology; 3. “Covered entity” means: a. any licensed provider of health care services including licensed health care practitioners, hospitals, nursing facilities, laboratories, intermediate care facilities, psychiatric residential treatment facilities, ins titutions for individuals with intellectual or deve lopmental disabilities and prison health centers , or b. any entity responsible for matching anatomical gi ft donors to potential recipients ; 4. “Disability” has the meaning stated in the Americans with Disabilities Act of 1990, as amended by the ADA Amendments Act of 2008, 42 U.S.C. § 12102; 5. “Organ transplant” means the transplantation or transfusion of a part of a human body into the body of an other for the purpose of treating or curing a medical condi tion; and 6. “Qualified recipient” means an individual who has a disability and meets the essential eligibility requirements for the receipt of an anatomic al gift with or without any of the following: a. individuals or entities available to support and assist the individual with an anatomical gift or transplantation, Req. No. 364 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. auxiliary aids or services, or c. reasonable modification s to the policies, practices or procedures of a covered entity including modifications to allow for either or both of the following: (1) communication with one or more individuals or entities available to support or assist with the recipient’s care and medication after surgery or transplantation, or (2) consideration of support networks available to the individual including family, fri ends and home and community-based services including home and community-based services funded through Medicaid, Medicare, another health plan in which the individual is enrolled or any program or source of funding available to the individual, when determining whether the individual is able to comply with post-transplant medical requirements . SECTION 3. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2200.30 of Title 63, unless there is created a duplic ation in numbering, reads as follows: A. The provisions of this section shall apply to all s tages of the organ transplant process. B. A covered entity shall not, solely on the basis of an individual’s disability: Req. No. 364 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. Consider the individual ineligible to receive an anatomical gift or organ transplant ; 2. Deny medical services or other services re lated to organ transplantation including diagnostic services, evaluation, surgery, counseling, post-operative treatment and services; 3. Refuse to refer the ind ividual to a transplant center or other related specialist for the purpose of being evaluated f or or receiving an organ transplant ; 4. Refuse to place a qualified recipient on an organ transplant waiting list; 5. Place a qualified recipient on an organ t ransplant waiting list at a lower priority position than the position at which the individual would have been placed if the individual did not have a disability; or 6. Refuse to accept health insurance coverage for any procedure associated with being eval uated for or receiving an anatomical gift or organ transplant including post-transplantation and post - transfusion care. C. Notwithstanding subsection B of this section, a covered entity may take an individual ’s disability into account when making treatment or coverage recommendations or decisions, solely to the extent that the disability has been found by a physici an or surgeon, following an individualized evaluation of the individual, to be medically significant to the receipt of the anatomical gift. Req. No. 364 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 D. If an individual has the necessary support system t o assist the individual in complying with post -transplant medical requirements, a covered entity shall not consider the individual ’s inability to independently comply wit h post-transplant medical requirements to be medically significant for the purposes of subsection C of this section. E. A covered entity shall make reasonable modifications to its policies, practices or procedures to allow individuals with disabilities access to transplantation-related services including diagnostic services, surgery, cover age, post-operative treatment and counseling, unless t he entity can demonstrate that making such modifications would fundamentally alter the nature of such services. F. A covered entity shall take steps necessary to ensure that an individual with a disabi lity is not denied medical services or other services related to organ transplantation including diagnostic services, surgery, post -operative treatment or counseling, due to the absence of auxiliary aids or services, unless the covered entity demonstrates that taking the steps would fundamentally alter the nature of the medical services or other services related to organ transplantation or would result in an undue burd en for the covered entity. G. Nothing in this section shall be construed to require a covered entity to make a referral or recommendation for or perform a medically inappropriate organ transplant. Req. No. 364 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 H. A covered entity shall otherwise comply with the requirements of Titles II and III of the Americans with Disabilities Act of 1990, as amended by the ADA Amendments Act of 2008. SECTION 4. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2200.31 of Title 63, unless there is created a duplicatio n in numbering, reads as follows: A. Whenever it appears that a covered entity has violated or is in violation of any of the provisions of this act, the affected individual may commence a civil action for injunctive and other equitable relief against the covered entity for purposes of enforcing compliance with this act. The action may be brought in the district court for the county where the affected individual resides or resided or was denied the organ transplant or referral. B. In an action brought und er this act, the court shall give priority on its docket and expedited review, and may grant injunctive or other equitable relief including: 1. Requiring auxiliary aids or services to be made available for a qualified recipient; 2. Requiring the modific ation of a policy, practice or procedure of a covered entity; or 3. Requiring facilities be made readily accessible to and usable by a qualified recipient . Req. No. 364 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 C. Nothing in this act is intended to limit or replace available remedies under the Americans with Disabilities Act or any other applicable law. D. This act does not create a right to co mpensatory or punitive damages against a covered entity. SECTION 5. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Sec tion 2200.32 of Title 63, unless there is created a duplication in numbering, reads as follows: A. For purposes of this section: 1. “Covered person” means a policyholder, subscriber, enrollee, member or individual covered by a health benefit plan; 2. “Health benefit plan” means a policy, contract, certif icate, or agreement entered into, offered or issued by a health carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services. Health benefit plan shall not include a plan providing coverage for excepted benefits and short term policies that have a term of less than twelve (12) months; and 3. “Health carrier” means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdictio n of the Insurance Commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay fo r or reimburse any of the costs of health care services including through a health benef it plan as defined in this section, and shall include a s ickness and accident insurance company, a health mai ntenance organization, a Req. No. 364 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits. B. A health carrier that provides coverage fo r anatomical gifts, organ transplants or related treatment and services shall not: 1. Deny coverage to a covered person solely on the basis of the person’s disability; 2. Deny to a patient eligibility, or continued eligibility, to enroll or to renew cov erage under the terms of the health benefit plan, solely for the purpose of avoiding the requirements of this section; 3. Penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide monetary or nonmonetary incentives to an attending provider, to induce such provider to provid e care to an insured or enrollee in a manner inconsistent with this section; or 4. Reduce or limit coverage benefits to a patient for t he medical services or other services related to organ transplanta tion performed pursuant to this section as determined in consultation with the attending physician and patient. C. In the case of a hea lth benefit plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers, any plan amendment made pursuant to a collective bargaining agreement relating to the plan Req. No. 364 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 which amends the pla n solely to conform to any requirement imposed pursuant to this section shall not be treated as a termination of the collective bargaining agreement. D. Nothing in this section shall be construed to require a health carrier to provide coverage for a medically inappropriate organ transplant. E. The Insurance Commissioner shall promulgate rules to implement the provisio ns of this section. SECTION 6. This act shall become effective November 1, 2021. 58-1-364 DC 1/12/2021 5:53:51 PM