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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
HOUSE BILL 1890 By: Schreiber
AS INTRODUCED
An Act relating to medical price transparency;
amending 63 O.S. 2021, Section 1-725.3, which relates
to health care provider price transparency; creating
penalties; providing for the allocation of penalties ;
amending 63 O.S. 2021, Section 1-725.4, which relates
to health care facility price transparency; creating
penalties; providing for the allocation of penalties;
and providing an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Section 1-725.3, is
amended to read as follows :
Section 1-725.3
A. A health care provider shall make available to the public,
in a single document, either electronically or by posting
conspicuously on the provider 's website if one exists, the health
care prices for at least the twenty most common h ealth care services
the health care provider provides. If the health care provider, in
the normal course of his or her practice, regularly provides fewer
than twenty health care services, the health care provider shall
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make available the health care price s for the health care services
the provider most commonly provides.
B. The health care provider shall identify the services by:
1. A Current Procedural Terminology code or other coding system
commonly used by the health care provider and accepted as a na tional
standard for billing; and
2. A plain English description.
C. The health care provider shall update the document as
frequently as the health care provider deems appropriate, but at
least annually.
D. On a date on or after the effective date of this section, a
health care provider who is not in material compliance with th e
Transparency in Health Care Prices Act of the Ok lahoma Statutes on
the date that items or s ervices are purchased from or provided to a
patient by the health care provider , shall not initiate or pursue a
collection action against the patient or patient gu arantor for a
debt owed for the items or services.
E. If a patient believes that a health care provider was not in
material compliance with state laws, on a date on or after the
effective date of this section , that items or services were
purchased by or provided to the patient , and the health care
provider takes collection action against the patient or patient
guarantor, the patient or patien t guarantor may file suit to
determine if the hospital was mater ially out of compliance with the
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Transparency in Health Care Prices Act of the Oklahoma Statutes on
the date of service, and the noncompliance is related to the items
or services. The health care provider shall not take collection
action against the patient or patient guar antor while the lawsuit is
pending.
F. A health care provider that has been found by a judge or
jury, considering compliance standards issued by the federal centers
for Medicare and Medicaid services, to be materially out of
compliance with the Transparency in Health Care Prices A ct of the
Oklahoma Statutes:
1. Shall refund the payer any amount of the debt the payer has
paid and shall pay a penalty to the patient or patient guarantor in
an amount equal to the total amount of the debt;
2. Shall dismiss or cause to be dismissed any court action with
prejudice and pay any attorney fees and costs incurred by the
patient or patient guarantor re lating to the action ; and
3. Shall remove or cause to be removed from the patient's or
patient guarantor's credit report any report made to a consum er
reporting agency relating to the debt .
G. Nothing in this section:
1. Prohibits a health care provider from billing a patient ,
patient guarantor, or third-party payer, including health insurer ,
for items or services provided to the patient ; and
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2. Requires a health care provider to refund any payment made
to the health care provider for items or services provided to the
patient, so long as no collection action is taken in violation of
this section.
SECTION 2. AMENDATORY 63 O.S. 2021, Section 1-725.4, is
amended to read as follows :
Section 1-725.4
A. A health care facility shall make available to the public,
in a single document, either electronically or by posting
conspicuously on its web site if one exists, the health care pr ices
for at least:
1. The twenty most used dia gnosis-related group codes or other
codes for inpatient health care services per specialty s ervice line
used by the health care facility for billing; and
2. The twenty most used outpatient CPT codes or health care
services procedure codes per specialty se rvice line used for
billing.
B. A health care facility shall include with the health care
prices provided pursuant to subsection A of this section a plain
English description of the services for which the hea lth care prices
are provided.
C. The health care facility shall update the document as
frequently as it deems appropriate, but at least an nually.
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D. On a date on or after the effective date of t his section, a
health care facility that is not in material compliance with the
Transparency in Health Care Prices Act of th e Oklahoma Statutes on
the date that items or s ervices are purchased from or provided to a
patient by the health care facility, shall not initiate or pursue a
collection action against the pat ient or patient guarantor for a
debt owed for the items or servi ces.
E. If a patient believes that a health care facility was not in
material compliance with state laws , on a date on or after the
effective date of this se ction, that items or services were
purchased by or provided to the patient , and the health care
facility takes collection action against the patient or patient
guarantor, the patient or patient guarantor may file suit to
determine if the hospital was mater ially out of compliance with the
Transparency in Health Care Prices Act of the Oklahoma Statute s on
the date of service, and the noncompliance is related to the items
or services. The health care facility shall not take collection
action against the patie nt or patient guarantor while the lawsuit is
pending.
F. A health care facility that has been found by a judge or
jury, considering compliance standards issued by the feder al centers
for Medicare and Medicaid services, to be materially out of
compliance with the Transparency in Health Care Prices Act of the
Oklahoma Statutes:
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1. Shall refund the payer any amount of the debt the payer has
paid and shall pay a penalty to the patient or patient guarantor in
an amount equal to the total amount of the debt;
2. Shall dismiss or cause to be d ismissed any court action with
prejudice and pay any attorney fees and costs incurred by the
patient or patient guarantor re lating to the action; and
3. Shall remove or cause to be removed from the patient's or
patient guarantor's credit report any repor t made to a consumer
reporting agency relating to the debt .
G. Nothing in this section:
1. Prohibits a health care facility from billing a patient,
patient guarantor, or third-party payer, including health insurer ,
for items or services provided to the patient; and
2. Requires a health care facility to refund a ny payment made
to the health care facility for i tems or services provided to t he
patient, so long as no collection action is taken in violation of
this section.
SECTION 3. This act shall become effective November 1, 2023.
59-1-6870 TJ 01/17/23