An Act
ENROLLED HOUSE
BILL NO. 1712 By: Marti and McDugle of the
House
and
Garvin of the Senate
An Act relating to health insurance; defining terms;
prohibiting insurers from refusing coverage to an
insured under certain circumst ances; providing for a n
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 dec laring 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 69 81 of Title 36, unless there
is created a duplication in numbering, reads as follows:
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 Medic aid
program;
ENR. H. B. NO. 1712 Page 2
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 car e 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 safet y, 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.
ENR. H. B. NO. 1712 Page 3
Passed the House of Representativ es the 23rd day of April, 2024.
Presiding Officer of the House
of Representatives
Passed the Senate the 19th day of March, 2024.
Presiding Officer of the Senate
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _____ ____
day of ___________________, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________