OK
Oklahoma Senate Bill SB513

Oklahoma 2023 Regular Session

Oklahoma Senate Bill SB513 Compare Versions

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4-
5-An Act
6-ENROLLED SENATE
7-BILL NO. 513 By: Rosino and Garvin of the
28+ENGROSSED HOUSE AMENDME NT
29+ TO
30+ENGROSSED SENATE BILL NO . 513 By: Rosino and Garvin of the
831 Senate
932
1033 and
1134
12- Miller, Fugate, Stinson,
13-Sneed, Burns, Davis,
14-Newton, McEntire, Williams,
15-Cantrell, McCall, Bennett,
16-Hilbert, Stark, Randleman,
17-Marti, Roe, Tedford, Lowe
18-(Dick), Munson, Boles,
19-Manger, Roberts, and Baker
35+ Miller, Fugate, and Stinson
2036 of the House
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2644 An Act relating to biomarker testing; defining terms;
2745 requiring coverage of biomarker testing under certain
2846 conditions; requiring certain contract to be provided
2947 with policy; directing plan to limit disruptions in
3048 care with certain evidence; requiring plan to publish
3149 accessible process on certain website for certain
3250 requests; construing provision; amending 56 O.S.
3351 2021, Section 4002.6, as amended by Section 10,
3452 Chapter 395, O.S.L. 2022 (56 O.S. Supp. 2022, Section
3553 4002.6), which relates to the state Medicaid program;
3654 clarifying certain prio r authorization requirement;
3755 updating statutory language; defining terms;
3856 requiring certain coverage and provision of biomarker
3957 testing; stipulating prior au thorization requirements
4058 for biomarker testing; directing creation of process
4159 to request exceptions to certain coverage policies;
4260 providing for codification; and providing an
4361 effective date.
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66+AUTHOR: Add the following House Coauthor s: Sneed, Burns, Davis,
67+Newton, McEntire, Williams, Cantrell, McCall, Bennett,
68+Hilbert, Stark, Randleman, Marti, Roe, Tedford, Lowe
69+(Dick), Munson, Boles, Manger, Roberts, and Baker
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49-ENR. S. B. NO. 513 Page 2
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51-SUBJECT: Biomarker testing
72+AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill
73+and insert:
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101+"An Act relating to biomarker testing; defining
102+terms; requiring coverage of biomarker testing under
103+certain conditions; requiring certain contract to be
104+provided with policy; directing plan to limit
105+disruptions in care with certa in evidence; requiring
106+plan to publish accessible process on certain website
107+for certain requests; construing provision; amending
108+56 O.S. 2021, Section 4002.6, as amended by Section
109+10, Chapter 395, O.S.L. 2022 (56 O.S. Supp. 2022,
110+Section 4002.6), which relates to the state Medicaid
111+program; clarifying certain prio r authorization
112+requirement; updating statutory language; defining
113+terms; requiring certain coverage and provision of
114+biomarker testing; stipulating prior authorization
115+requirements for biomarke r testing; directing
116+creation of process to request exceptions to certain
117+coverage policies; providing for codification; and
118+providing an effective date.
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52122
53123 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
54-
55124 SECTION 1. NEW LAW A new section of law to be codified
56125 in the Oklahoma Statutes as Section 6060.5a of Title 36, unless
57126 there is created a duplication in numbering, reads as follows:
58-
59127 A. As used in this section:
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61128 1. "Biomarker" means a biological molecule found in blood,
62129 other body fluids, or tissues that is a sign of a normal or abnormal
63130 process, or of a condition or disease. A biomarker may be u sed to
64131 see how well the body responds to a treatment for a disease or
65132 condition or for other purposes . Biomarkers shall include but are
66133 not limited to gene m utation or protein expression;
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68134 2. "Biomarker testing" means the analysis of a patient’s
69135 tissue, blood, or other biospecimen for the presence of a biomarker.
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70162 Biomarker testing shall include but not be limited to single-analyte
71163 tests, multiplex panel tests, gene or protein expression, and whole
72164 exome, whole genome, and whole transcriptome sequencing;
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74165 3. "Clinical utility" means the test result provides
75166 information that is used in the formulation of a treatment or
76167 monitoring strategy that informs a patient's outcome and impacts the
77168 clinical decision. Th e most appropriate test may include both
78169 information that is actionable and some information that cannot be
79170 immediately used in the formulation of a clinical decision ;
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81171 4. "Consensus statement" means a statement that:
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83172 a. is developed by an independent, multidisciplinary
84173 panel of experts that use a transparent methodolo gy
85174 and reporting structure that includes a conflict of
86175 interest policy,
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88176 b. is based on the best available evidence for the
89177 purpose of optimizing clinical care outcomes , and
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91178 c. is aimed at specific clinical circumstances;
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95179 5. "Health benefit plan" means a plan as defined pursuant to
96180 Section 6060.4 of Title 36 of the Oklahoma Statutes; and
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98181 6. "Nationally recognized clinical practice guidelines" means
99182 evidence-based clinical practice guidelines that:
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101183 a. are developed by independent organizations or medical
102184 professional societies using a transparent methodology
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103211 and reporting structure and a conflict of interest
104212 policy, and
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106213 b. establish standards of care that are informed by a
107214 systemic review of evi dence and an assessment of the
108215 benefits and costs of alternative care options that
109216 includes recommendations intended to optimize patient
110217 care.
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112218 B. Any health benefit pla n, including the Oklahoma Employees
113219 Insurance Plan, that is offered, issued, or renewed in this state on
114220 or after the effective date of this act shall provide coverage for
115221 biomarker testing. A contract provided with a health benefit plan
116222 under this section shall include biomarker testing for the purpose
117223 of diagnosis, treatment, appropriate management, or ongoing
118224 monitoring of an insured’s disease or condition to guide treatment
119225 decisions when the biomarker test provides clinical utility as
120226 demonstrated by medical and scientific evidence including, but not
121227 limited to:
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123228 1. Labeled indications for tests that are approved or cleared
124229 by the United States Food and D rug Administration;
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126230 2. Indicated tests for a drug that is approved by the United
127231 States Food and Drug Administration;
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129232 3. Warnings and precautions o n United States Food and Drug
130233 Administration-approved drug labels;
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132260 4. Centers for Medicare and Medicaid S ervices national coverage
133261 determinations or Medicare administrative contractor local coverage
134262 determinations; or
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138263 5. Nationally recognized clinical pr actice guidelines and
139264 consensus statements.
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141265 C. A health benefit plan shall ensure that coverage is provid ed
142266 in a manner that limits disruptions in care, including the need for
143267 multiple biopsies and biospeci men samples.
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145268 D. An insured and a prescribing practitioner shall have access
146269 to a clear, readily available, and convenient proc ess to request an
147270 exception to a coverage policy of a health benefit plan under this
148271 subsection. The process shall be readily accessible on the plan’s
149272 website. This subsection shall not be construed to require a
150273 separate process if the health benefit pla n’s existing process
151274 complies with this subsection.
152-
153275 SECTION 2. AMENDATORY 56 O.S. 2021, Section 4002.6, a s
154276 amended by Section 10, Chapter 395, O.S.L. 2022 (56 O.S. Supp. 2022,
155277 Section 4002.6), is amended to read as follows:
156-
157278 Section 4002.6 A. A contracted entity shall meet all
158279 requirements established by the Oklahoma Health Care Authority
159280 pertaining to prior authorizations. The Authority shall establish
160281 requirements that ensure timely determinations by contracted
161282 entities when prior authorizations are required including expedited
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162309 review in urgent and emergent cases that at a minimum meet the
163310 criteria of this section.
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165311 B. A contracted entity shall make a determination on a request
166312 for an authorization of the transfer of a hospital inpatient to a
167313 post-acute care or long-term acute care facility within twenty-four
168314 (24) hours of receipt of the request.
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170315 C. A contracted entity shall make a determination on a request
171316 for any member who is not hospitalized at the time of the request
172317 within seventy-two (72) hours of receipt of the request; provided,
173318 that if the request does not include sufficient or adequate
174319 documentation, the review and determination shall occur within a
175320 time frame and in accordance with a process established by the
176321 Authority. The process established by the Authority pursuant to
177322 this subsection shall include a time frame of at least forty-eight
178323 (48) hours within which a provider may submit the necessary
179324 documentation.
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183325 D. A contracted entity shall make a determination on a request
184326 for services for a hospitalized member including, but not limited
185327 to, acute care inpatient services or equipment necessary to
186328 discharge the member from an inpatient facility within one (1)
187329 business day of receipt of the request.
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189330 E. Notwithstanding the provisions of subsection C of this
190331 section, a contracted entity shall make a determination on a request
191332 as expeditiously as necessary and, in any event, within twenty-four
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192359 (24) hours of receipt of the request for service if adhering to the
193360 provisions of subsection C or D of this section could jeopardize the
194361 member’s life, health or ability to attain, maintain or regain
195362 maximum function. In the event of a medically emergent matter, the
196363 contracted entity shall not impose limitations on providers in
197364 coordination of post-emergent stabilization health care including
198365 pre-certification or prior authorization.
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200366 F. Notwithstanding any other provision of this section, a
201367 contracted entity shall make a determination on a request for
202368 inpatient behavioral health s ervices within twenty-four (24) hours
203369 of receipt of the request.
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205370 G. A contracted entity shall make a determination on a request
206371 for covered prescription drugs that are required to be prior
207372 authorized by the Authority within twenty-four (24) hours of receipt
208373 of the request. The contracted entity shall not require prior
209374 authorization on any covered prescription drug for which the
210375 Authority does not require prior authorization.
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212376 H. A contracted entity shall make a dete rmination on a request
213377 for coverage of biomarker testing in accordan ce with Section 3 of
214378 this act.
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216379 I. Upon issuance of an adverse determination on a prior
217380 authorization request under subsection B of this section, the
218381 contracted entity shall provide the requesting provider, within
219382 seventy-two (72) hours of receipt of suc h issuance, with reasonable
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220409 opportunity to participate in a peer-to-peer review process with a
221410 provider who practices in the same specialty, but not necessarily
222411 the same sub-specialty, and who has experience treating the same
223412 population as the patient on w hose behalf the request is submitted;
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226413 provided, however, if the requesting provider determin es the
227414 services to be clinically urgent, the contracted entity shall
228415 provide such opportunity within twenty-four (24) hours of receipt of
229416 such issuance. Services not covered under the state Medicaid
230417 program for the particular patient shall not be subject to peer-to-
231418 peer review.
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233419 I. J. The Authority shall ensure that a provider offers to
234420 provide to an enrollee a member in a timely manner services
235421 authorized by a contracted entity.
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237422 J. K. The Authority shall establish requirements for both
238423 internal and external reviews and appeals of adverse determinations
239424 on prior authorization requests or claims that, at a minimum:
240-
241425 1. Require contracted entities to provide a detailed
242426 explanation of denials to Medicaid providers and members;
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244427 2. Require contracted entities to provide a prompt opportunity
245428 for peer-to-peer conversations with licensed clinical staff of the
246429 same or similar specialty which shall include, but not be limited
247430 to, Oklahoma-licensed clinical staff upon adverse determination; and
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249431 3. Establish uniform rules for Medicaid provider or member
250432 appeals across all contracted entities.
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251458
252459 SECTION 3. NEW LAW A new section of law to be codified
253460 in the Oklahoma Statutes as Section 4003 of Title 56, unless there
254461 is created a duplication in numb ering, reads as follows:
255-
256462 A. As used in this section:
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258463 1. "Biomarker", "biomarker testing", "consensus statement", and
259464 "nationally recognized clinical practice guidelines" shall have the
260465 same meaning as provided by Section 1 of this act; and
261-
262466 2. "Contracted entity" shall have the same meaning as provided
263467 by Section 4002.2 of Title 56 of the Oklahoma Statutes.
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265468 B. The state Medicaid program s hall cover biomarker testing in
266469 accordance with the requirements provided by this section.
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270470 C. Biomarker testing shall be cove red for the purposes of
271471 diagnosis, treatment, approp riate management, or ongoing monitoring
272472 of a member’s disease or condition whe n the test is supported by
273473 medical and scientific evidence, including, but not limited to:
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275474 1. Labeled indications for a United States Food and Drug
276475 Administration (FDA)-approved or -cleared test;
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278476 2. Indicated tests for an FDA-approved drug;
279-
280477 3. Warnings and precautions on FDA-approved drug labels;
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282478 4. Centers for Medicare and Medicaid Services (CMS) national
283479 coverage determinations or Medicare Administrative Contrac tor (MAC)
284480 local coverage determinations; or
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286481 5. Nationally recognized clinical pra ctice guidelines and
287482 consensus statements.
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289509 D. Contracted entities under the state Medicaid program shall
290510 provide biomarker testing at the same sc ope, duration, and frequency
291511 as the Medicaid program otherwise provides to members.
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293512 E. If prior authorization is required for biomar ker testing,
294513 the contracted entity shall approve or deny a prior authorization
295514 request and notify the member, the member’s provider, and any entity
296515 requesting authorization of th e service within seventy-two (72)
297516 hours for non-urgent requests or within twenty-four (24) hours for
298517 urgent requests.
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300518 F. The member and t he member’s provider shall have access to
301519 clear, readily access ible, and convenient process es to request an
302520 exception to a coverage policy for biomarker testing of the state
303521 Medicaid program. The process shall be made readily accessible to
304522 all participating providers and members online.
523+SECTION 4. This act shall become effective January 1, 2024."
305524
306-SECTION 4. This act shall become effective January 1, 2024.
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550+Passed the House of Representat ives the 20th day of April, 2023.
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310-Passed the Senate the 19th day of May, 2023.
553+
554+
555+
556+Presiding Officer of the House of
557+ Representatives
558+
559+
560+Passed the Senate the ____ day of __________, 2023.
561+
562+
311563
312564
313565
314566 Presiding Officer of the Senate
315567
316568
317-Passed the House of Representatives the 20th day of April, 2023.
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594+ENGROSSED SENATE
595+BILL NO. 513 By: Rosino and Garvin of the
596+Senate
597+
598+ and
599+
600+ Miller, Fugate, and Stinson
601+of the House
602+
603+
604+
605+
606+An Act relating to biomarker testing; defining terms;
607+requiring coverage of biomarker testing under certain
608+conditions; requiring certain contract to be provided
609+with policy; directing plan to limit disruptions in
610+care with certain evidence; requiring plan to publish
611+accessible process on certain website for certain
612+requests; construing provision; amending 56 O.S.
613+2021, Section 4002.6, as amended by Section 10,
614+Chapter 395, O.S.L. 2022 (56 O.S. Supp. 2022, Section
615+4002.6), which relates to the state Medicaid program;
616+clarifying certain prio r authorization requirement;
617+updating statutory language; defining terms;
618+requiring certain coverage and provision of biomarker
619+testing; stipulating prior au thorization requirements
620+for biomarker testing; directing creation of process
621+to request exceptions to certain coverage policies;
622+providing for codification; and providing an
623+effective date.
624+
625+
626+
627+
628+BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
629+SECTION 5. NEW LAW A new section of law to be codified
630+in the Oklahoma Statutes as Section 6060.5a of Title 36, unless
631+there is created a duplication in numbering, reads as follows:
632+A. As used in this section:
633+1. “Biomarker” means a biological molecule found in blood,
634+other body fluids, or tissues that is a sign of a normal or abnormal
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661+process, or of a condition or disease. A biomarker may be u sed to
662+see how well the body responds to a treatment for a disease or
663+condition or for other purposes . Biomarkers shall include but are
664+not limited to gene m utation or protein expression;
665+2. “Biomarker testing” means the analysis of a patient’s
666+tissue, blood, or other biospecimen for the presence of a biomarker.
667+Biomarker testing shall include but not be limited to single-analyte
668+tests, multiplex panel tests, gene or protein expression, and whole
669+exome, whole genome, and whole transcriptome sequencing;
670+3. “Consensus statement” means a statement that:
671+a. is developed by an independent, multidisciplinary
672+panel of experts that use a transparent methodolo gy
673+and reporting structure that includes a conflict of
674+interest policy,
675+b. is based on the best available evidence for the
676+purpose of optimizing clinical care outcomes , and
677+c. is aimed at specific clinical circumstances;
678+4. “Health benefit plan” means a plan as defined pursuant to
679+Section 6060.4 of Title 36 of the Oklahoma Statutes; and
680+5. “Nationally recognized clinical practice guidelines” means
681+evidence-based clinical practice guidelines that:
682+a. are developed by independent organizations or medical
683+professional societies using a transparent methodology
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710+and reporting structure an d a conflict of interest
711+policy, and
712+b. establish standards of care that are informed by a
713+systemic review of evidence and an assessment of the
714+benefits and costs of alternative care options that
715+includes recommendations intended to optimize patient
716+care.
717+B. Any health benefit pla n, including the Okla homa Employees
718+Insurance Plan, that is offered, issued, or renewed in this stat e on
719+or after the effective date of this act shall provide coverage for
720+biomarker testing. A contract provided with a health benefit plan
721+under this section shall include bioma rker testing for the purpose
722+of diagnosis, treatment, appropriate management, or ongoing
723+monitoring of an insured’s disease or condition to guide treatment
724+decisions when the biomarker test is supported by medical and
725+scientific evidence including, but not limited to:
726+1. Labeled indications for tests that are approved or cleared
727+by the United States Food and D rug Administration;
728+2. Indicated tests for a drug that is approved by the United
729+States Food and Drug Administration;
730+3. Warnings and precautions o n United States Food and Drug
731+Administration approved d rug labels;
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758+4. Centers for Medicare and Medicaid S ervices national coverage
759+determinations or Medicare admini strative contractor local coverage
760+determinations; or
761+5. Nationally recognized clinical pr actice guidelines and
762+consensus statements.
763+C. A health benefit plan shall ensure that coverage is provid ed
764+in a manner that limits disruptions in care, including the need for
765+multiple biopsies and biospeci men samples.
766+D. An insured and a prescribing practitioner shall have access
767+to a clear, readily available, and convenient proc ess to request an
768+exception to a coverage policy of a health benefit plan under this
769+subsection. The process shall be readily accessible on the plan’s
770+website. This subsection shall not be construed to require a
771+separate process if the health benefit pla n’s existing process
772+complies with this subsection.
773+SECTION 6. AMENDATORY 56 O.S. 2021, Section 4002.6, a s
774+amended by Section 10, Chapter 395, O.S.L. 2022 (56 O.S. Supp. 2022,
775+Section 4002.6), is amended to read as follows:
776+Section 4002.6. A. A contracted entity shall meet all
777+requirements established by the Oklah oma Health Care Authority
778+pertaining to prior authorizations. The Authority shall establish
779+requirements that ensure timely determinations by contracted
780+entities when prior authorizations are required including expedited
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807+review in urgent and emergent case s that at a minimum meet the
808+criteria of this section.
809+B. A contracted entity shall make a determination on a request
810+for an authorization of the transfer of a hospital inpatient to a
811+post-acute care or long-term acute care facility within twenty-four
812+(24) hours of receipt of the request.
813+C. A contracted entity shall make a determination on a request
814+for any member who is not hospitalized at the time of the request
815+within seventy-two (72) hours of receipt of the request; provided,
816+that if the request does not include sufficient or adequate
817+documentation, the review and determination shall occur within a
818+time frame and in accordance with a process established by the
819+Authority. The process established by the Authority pursuant to
820+this subsection shall include a time frame of at least forty-eight
821+(48) hours within which a provider may submit the necessary
822+documentation.
823+D. A contracted entity shall make a determination on a request
824+for services for a hospitalized member including, but not limited
825+to, acute care inpatient services or equipment necessary to
826+discharge the member from an inpatient facility within one (1)
827+business day of receipt of the request.
828+E. Notwithstanding the provisions of subsection C of this
829+section, a contracted entity shall make a determination on a request
830+as expeditiously as necessary and, in any eve nt, within twenty-four
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857+(24) hours of receipt of the request for service if adhering to the
858+provisions of subsection C or D of this section could jeopardize the
859+member’s life, health or ability to attain, maintain or regain
860+maximum function. In the event of a medically emergent matter, the
861+contracted entity shall not impose limitations on providers in
862+coordination of post-emergent stabilization health care including
863+pre-certification or prior authorization.
864+F. Notwithstanding any other provision of this section, a
865+contracted entity shall make a determination on a request for
866+inpatient behavioral health s ervices within twenty-four (24) hours
867+of receipt of the request.
868+G. A contracted entity shall make a determination on a request
869+for covered prescription dr ugs that are required to be prior
870+authorized by the Authority within twenty-four (24) hours of receipt
871+of the request. The contracted entity shall not require prior
872+authorization on any covered prescription drug for which the
873+Authority does not require prior authorization.
874+H. A contracted entity shall make a determination on a re quest
875+for coverage of biomarker testing in accordan ce with Section 3 of
876+this act.
877+I. Upon issuance of an adverse determination on a prior
878+authorization request under subsection B of this section, the
879+contracted entity shall provide the requesting provider, within
880+seventy-two (72) hours of receipt of suc h issuance, with reasonable
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907+opportunity to participate in a peer-to-peer review process with a
908+provider who practices in the same specialty, but not necessarily
909+the same sub-specialty, and who has experience treating the same
910+population as the patient on w hose behalf the request is submitted;
911+provided, however, if the requesting provider determin es the
912+services to be clinically urgent, the contracted entity shall
913+provide such opportunity within twenty-four (24) hours of receipt of
914+such issuance. Services not covered under the state Medicaid
915+program for the particular patient shall not be subject to peer-to-
916+peer review.
917+I. J. The Authority shall ensure that a provider offers to
918+provide to an enrollee a member in a timely manner services
919+authorized by a contracted entity.
920+J. K. The Authority shall establish requirements for both
921+internal and external reviews and appeals of adverse determinations
922+on prior authorization requests or claims that, at a minimum:
923+1. Require contracted entities to provide a detailed
924+explanation of denials to Medicaid providers and members;
925+2. Require contracted entities to provide a prompt opportunity
926+for peer-to-peer conversations with licensed clinical staff of the
927+same or similar specialty which shall include, but not be limited
928+to, Oklahoma-licensed clinical staff upon adverse determination; and
929+3. Establish uniform rules for Medicaid provider or member
930+appeals across all contracted entities.
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957+SECTION 7. NEW LAW A new section of law to be codified
958+in the Oklahoma Statutes as Se ction 4003 of Title 56, unless there
959+is created a duplication in numb ering, reads as follows:
960+A. As used in this section:
961+1. “Biomarker”, “biomarker testing”, “consensus statement”, and
962+“nationally recognized clinical practice guidelines” shall have the
963+same meaning as provided by Section 1 of this act; and
964+2. “Contracted entity” shall have the same meaning as provided
965+by Section 4002.2 of Title 56 of the Oklahoma Statutes.
966+B. The state Medicaid program s hall cover biomarker testing in
967+accordance with the requirements p rovided by this secti on.
968+C. Biomarker testing shall be cove red for the purposes of
969+diagnosis, treatment, approp riate management, or ongoing monitoring
970+of a member’s disease or condition whe n the test is supported by
971+medical and scientific evidence, includ ing, but not limited to:
972+1. Labeled indications for a Food and Drug Administration
973+(FDA)-approved or -cleared test;
974+2. Indicated tests for an FDA-approved drug;
975+3. Warnings and precautions on FDA-approved drug labels;
976+4. Centers for Medicare and Medicaid Services (CMS) national
977+coverage determinations or Medicare Administrative Contractor (MAC)
978+local coverage determinations; or
979+5. Nationally recognized clinical pra ctice guidelines and
980+consensus statements.
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1007+D. Contracted entities under the sta te Medicaid program shall
1008+provide biomarker testing at the same scope, dur ation, and frequency
1009+as the Medicaid program otherwise provides to members.
1010+E. If prior authorization is required for biomar ker testing,
1011+the contracted entity shall approve or deny a prior authorization
1012+request and notify the member, the member’s provider, and any entity
1013+requesting authorization of th e service within seventy-two (72)
1014+hours for non-urgent requests or within twenty-four (24) hours for
1015+urgent requests.
1016+F. The member and the mem ber’s provider shall have access to
1017+clear, readily accessible, an d convenient processes to request an
1018+exception to a coverage policy for biomarker testing of the state
1019+Medicaid program. The process shall be made readily accessible to
1020+all participating providers and members on line.
1021+SECTION 8. This act shall become effective January 1, 2024.
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1048+Passed the Senate the 6th day of March, 2023.
1049+
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1052+ Presiding Officer of the Senate
1053+
1054+
1055+Passed the House of Representatives the ____ day of __________,
1056+2023.
3181057
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3201059
3211060 Presiding Officer of the House
3221061 of Representatives
3231062
324-OFFICE OF THE GOVERNOR
325-Received by the Office of the Governor this _______ _____________
326-day of _________________ __, 20_______, at _______ o'clock ____ ___ M.
327-By: _______________________________ __
328-Approved by the Governor of the State of Oklahoma this _____ ____
329-day of ___________________, 20_______, at _______ o'clock _______ M.
3301063
331- _________________________________
332- Governor of the State of Oklahoma
333-
334-
335-OFFICE OF THE SECRETARY OF STATE
336-Received by the Office of the Secretary of State this _______ ___
337-day of __________________, 20 _______, at _______ o'clock _______ M.
338-By: _______________________________ __