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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
COMMITTEE SUBSTITUTE
FOR
HOUSE BILL NO. 1890 By: Schreiber
COMMITTEE SUBSTITUTE
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 do cument, 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 norma l course of his or her practice, regularly
provides fewer than twenty health care services, the health care
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provider shall 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 provide r shall update the document as
frequently as the health care provider deems appropriate, but at
least annually.
D. On or after the effective date of this act, a health care
provider who is not in material compliance with Section 2718(e) of
the Public Health Service Act, P.L. 78-410, as amended, and rules
adopted by the United States Department of Health and Human Services
implementing Section 2718(e), with respect to "items of services" or
"items or services" as defined in 45 CFR 180.20, on the date that
items or services 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 guarantor f or a debt owed for
the items or services.
E. If a patient can demonstrate that a health care provider was
not in material compliance with state laws, on a date on or after
the effective date of this act, that items or services were
purchased by or provided to the patient, and the health care
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provider takes collection action against the patient or patient
guarantor, the patient or patien t guarantor may file suit to
determine if the health care provider was materially out of
compliance with the Transparency in Health Care Prices Act, Section
1-725.1 et seq. of this title, 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 guarantor while the lawsuit is pending.
F. A health care provider who has been found by a judge or
jury, considering compliance standards issued by the Centers for
Medicare and Medicaid Services, to be materially out of compliance
with the Transparency in Health Care Prices Act, Section 1-725.1 et
seq. of this title:
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 consumer
reporting agency relating to the debt .
G. Nothing in this section shall:
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1. Prohibit a health care provider from billing a patient ,
patient guarantor, or third-party payer, including a health insurer,
for items or services provided to the patient; and
2. Require 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
prices 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 health care prices
are provided.
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C. The health care facility shall update the document as
frequently as it deems appropriate, but at least an nually.
D. On or after the effective date of t his act, a health care
facility that is not in material compliance with the Transparency in
Health Care Prices Act , Section 1-725.1 et seq. of this title, on
the date that items or s ervices are purchased by or provided to a
patient by the health care facility, shall not initiate or pursue a
collection action against the patient or patient guarantor for a
debt owed for the items or servi ces.
E. If a patient can demonstrate that a health care facility was
not in material compliance with federal laws, on or after the
effective date of this act, 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
health care facility was materially out of compliance with Section
2718(e) of the Public Health Service Act, P.L. 78-410, as amended,
and rules adopted by the United States Department of Health and
Human Services implementing Section 2718(e), with respect to "items
of services" or "items or services" as defined in 45 CFR 180.20, 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 i s
pending.
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F. A health care facility that has been found by a judge or
jury, considering compliance standards issued by the Centers for
Medicare and Medicaid Services, to be materially out of compliance
with the Transparency in Health Care Prices Act, Section 1-725.1 et
seq. of this title:
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 actio n 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 consumer
reporting agency relating to the debt.
G. Nothing in this section shall:
1. Prohibit a health care facility from billing a patient,
patient guarantor, or third-party payer, including a health insurer,
for items or services provided to the patient ; and
2. Require a health care facility to refund any 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.
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SECTION 3. This act shall become effective November 1, 2023.
59-1-7897 TJ 03/02/23