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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
HOUSE BILL 3508 By: Sneed
AS INTRODUCED
An Act relating to the Employee Group Insurance
Division; transferring the Employee Group Insurance
Division from the Office of Management and Enterprise
Services to the Oklahoma Public Employee Retirement
System; amending 36 O.S. 2021, Section 6802, which
relates to definitions for the Oklahoma Telemedicine
Act; transferring the Employee Group Insurance
Division from the Office of Managemen t and Enterprise
Services to the Oklahoma Public Employee Retirement
System; amending 63 O.S. 2021, Section 2-309I, as
amended by Section 1, Chapter 257, O.S.L. 2022 (63
O.S. Supp. 2023, Section 2-309I), which relates to
prescription requirements for opioi ds and
benzodiazepines; transferring the Employee Group
Insurance Division from the Office of Management and
Enterprise Services to the Oklahoma Public Employee
Retirement System; amending 74 O.S. 2021, Section
1304.1, which relates to Okla homa Employees Insurance
and Benefits Board; transferring the Employee Group
Insurance Division from the Office of Management and
Enterprise Services to the Oklahoma Public Employee
Retirement System; amending 85A O.S. 2021, Section
50, which relates to empl oyer required to provide
prompt medical treatment and fee schedule;
transferring the Employee Group Insurance Division
from the Office of Management and Enterprise Services
to the Oklahoma Public Employee Retirement System ;
providing for codification; providing an effec tive
date; and declaring an emergency .
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BE IT ENACTED BY THE PEOPL E OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1304.2 of Title 74, unless there
is created a duplication in numbering, reads as follows:
Effective July 1, 2024, the Employee Group Insurance Division of
the Office of Management and Enterprise Services shal l be
transferred to the Oklahoma Public Employees Retirement System. All
unexpended funds, property, records, personnel , and any outstanding
financial obligations or encumbrances of the Office of Management
and Enterprise Services which relate to the Emplo yee Group Division
Insurance Division are hereby transferred to the Oklahoma Publi c
Employees Retirement System.
SECTION 2. AMENDATORY 36 O.S. 2021, Section 6802, is
amended to read as follows:
Section 6802. As used in the Oklahoma Telemedicine Act:
1. "Distant site" means a site at which a health care
professional licensed to practice in this state is located while
providing health care services by means of telemedicine;
2. a. "Health benefits plan" means any plan or arrangement
that:
(1) provides benefits for medical or surgical
expenses incurred as a resu lt of a health
condition, accident or illness, and
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(2) is offered by any insurance company, group
hospital service corporation or health
maintenance organiza tion that delivers or issues
for delivery an individual, group, blanket or
franchise insurance poli cy or insurance
agreement, a group hospital service contract or
an evidence of coverage, or, to the extent
permitted by the Employee Retirement Income
Security Act of 1974, 29 U.S.C., Section 1001 et
seq., by a multiple employer welfare arrangement
as defined in Section 3 of the Employee
Retirement Income Security Act of 1974, or any
other analogous benefit arrangement, whether the
payment is fixed or by indem nity,
b. Health benefits plan shall not include:
(1) a plan that provides coverage:
(a) only for a specified disease or diseases or
under an individual limited benefit policy,
(b) only for accidental death or dismemb erment,
(c) only for dental or visi on care,
(d) for a hospital confinement indemnity policy,
(e) for disability income insurance or a
combination of accident-only and disability
income insurance, or
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(f) as a supplement to liability insurance,
(2) a Medicare supplemental policy as define d by
Section 1882(g)(1) of the Social Security Act (42
U.S.C., Section 1395ss),
(3) workers' compensation insurance coverage,
(4) medical payment insurance issued as part of a
motor vehicle insurance policy,
(5) a long-term care policy including a nursing home
fixed indemnity polic y, unless a determination is
made that the policy provides benefit coverage so
comprehensive that the policy meets the
definition of a healt h benefits plan,
(6) short-term health insurance issued on a
nonrenewable basis with a duration of six (6)
months or less, or
(7) a plan offered by the Employees Group Insurance
Division of the Office of Management and
Enterprise Services Oklahoma Public Emplo yees
Retirement System;
3. "Health care professional " means a physician or other health
care practitioner licensed, accredited or certified to perform
specified health care services consistent with state law;
4. "Insurer" means any entity providing an accident and health
insurance policy in this state including, but not limited to, a
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licensed insurance company, a not-for-profit hospital service and
medical indemnity corporation, a fraternal ben efit society, a
multiple employer welfare arrangement or any other entity subject to
regulation by the Insurance Commissioner;
5. "Originating site" means a site at which a patient is
located at the time health care services are provided to him or her
by means of telemedicine, which may include, but shall not be
restricted to, a patient 's home, workplace or school;
6. "Remote patient monitoring services " means the delivery of
home health services using telecommunications technology to enhance
the delivery of home health care including monitoring of clinical
patient data such as weight, blood pressure, pulse, pulse oximetry,
blood glucose and other condition -specific data, medication
adherence monitoring and interactive video conferencing with or
without digital image upload;
7. "Store and forward transfer " means the transmission of a
patient's medical information either to or from an originating site
or to or from the health care professional at the distant site, but
does not require the patient being pres ent nor must it be in real
time; and
8. "Telemedicine" or "telehealth" means technology-enabled
health and care management and delivery systems that extend capa city
and access, which includes:
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a. synchronous mechanisms, which may include live
audiovisual interaction between a patient and a health
care professional or real -time provider-to-provider
consultation through live interactive audiovisual
means,
b. asynchronous mechanisms, which include store and
forward transfers, online exchange of health
information between a patient and a health care
professional and online exchange of health information
between health care professionals, but shall not
include the use of automated text messages or
automated mobile applications that serve as the sole
interaction between a patient and a health care
professional,
c. remote patient monitoring, and
d. other electronic means that support clinical health
care, professional con sultation, patient and
professional health-related education, public health
and health administration.
SECTION 3. AMENDATORY 63 O.S. 2021, Section 2-309I, as
amended by Section 1, Chapter 257, O.S.L. 2022 (63 O.S. Supp. 2023,
Section 2-309I), is amended to read as follows:
Section 2-309I. A. A practitioner shall not issue an initial
prescription for an opioid drug in a quantit y exceeding a seven-day
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supply for treatment of acute pain . Any opioid prescription for
acute pain shall be for th e lowest effective dose of an immed iate-
release drug.
B. Prior to issuing an initial prescription for an opioid drug
in a course of treatmen t for acute or chronic pain, a practitioner
shall:
1. Take and document the resul ts of a thorough medical histor y,
including the experience of the pa tient with nonopioid medication
and nonpharmacological pain-management approaches and substance
abuse history;
2. Conduct, as appropriate, and document the results of a
physical examination;
3. Develop a treatment plan with particular attention focused
on determining the cause of pain of the patient;
4. Access relevant prescription monitoring information fr om the
central repository pursuant to Section 2-309D of this title;
5. Limit the supply of any opioid drug prescribed for acute
pain to a duration of no more than seven (7) days as determined by
the directed dosage and frequency of dosage; provided, howev er, upon
issuing an initial prescription for acute pain pu rsuant to this
section, the practitioner may issue one (1) subsequent prescription
for an opioid drug in a quantity not to exceed seven (7) da ys if:
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a. the subsequent prescription is due to a major surgical
procedure or "confined to home" status as defined in
42 U.S.C., Section 1395n(a),
b. the practitioner provides the subsequent prescription
on the same day as the initial prescription,
c. the practitioner provides written instructions on the
subsequent prescription indicating the ea rliest date
on which the prescription may be filled, otherwise
known as a "do not fill until" date, and
d. the subsequent prescription is dispensed no more than
five (5) days after the "do not fill until" date
indicated on the prescription;
6. In the case of a patient under the age of eighteen (18)
years, enter into a patient-provider agreement with a parent or
guardian of the patient; and
7. In the case of a patien t who is a pregnant woman, enter into
a patient-provider agreement with the patient.
C. No less than seven (7) days after issuing the initial
prescription pursuant to subsection A of this section, the
practitioner, after consultation with the patient, may issue a
subsequent prescription for the drug to the patient in a quantity
not to exceed seven (7) days, provided that:
1. The subsequent prescripti on would not be deemed an initial
prescription under this section;
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2. The practitioner determines the pres cription is necessary
and appropriate to the treatm ent needs of the patient and documents
the rationale for the issuance of the subsequent prescripti on; and
3. The practitioner determines that issuance of the subsequent
prescription does not present an un due risk of abuse, addiction or
diversion and documents that determination.
D. Prior to issuing the initial prescription of an opioid drug
in a course of treatment for acute or chronic pain and again prior
to issuing the third prescription of the course o f treatment, a
practitioner shall discuss with th e patient or the parent or
guardian of the patient if the patient is under eighteen (18) years
of age and is not an emancipated minor, the risks associated w ith
the drugs being prescribed, including but not limited to:
1. The risks of addiction and overd ose associated with opioid
drugs and the dangers of taking opioid drugs with alcohol,
benzodiazepines and other central nervous system depressants;
2. The reasons why the prescription is necessary;
3. Alternative treatments that may be available; and
4. Risks associated with the use of the drugs being prescribed,
specifically that opioids are highly ad dictive, even when tak en as
prescribed, that there is a r isk of developing a physical or
psychological dependence on the controlled dangerous substance, and
that the risks of taking more opioids tha n prescribed or mixing
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sedatives, benzodiazepines or alcoh ol with opioids can re sult in
fatal respiratory depressio n.
The practitioner shall include a note in the me dical record of
the patient that the patient or the parent or guardian of the
patient, as applicable, has discussed with the practitioner the
risks of developing a physica l or psychological dependence on th e
controlled dangerous substance and alternative t reatments that may
be available. The applicable state licensing board of the
practitioner shall develop and make available to practitioners
guidelines for the discussion required pursuant to this subsectio n.
E. At the time of the issuance of the third pr escription for an
opioid drug, the practiti oner shall enter into a patient-provider
agreement with the patient.
F. When an opioid drug is continuo usly prescribed for thre e (3)
months or more for chronic pa in, the practitioner shall:
1. Review, at a minimum of every three (3) months, the course
of treatment, any new information about the etiolo gy of the pain,
and the progress of the patient toward treatment objectives and
document the results of that review ;
2. In the first year of the patient-provider agreement, assess
the patient prior to eve ry renewal to determine whether the patient
is experiencing problems associated with an opioid use disord er as
defined by the Ameri can Psychiatric Association and document the
results of that assessment. Following one (1) year of compliance
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with the patient-provider agreement, the practitioner shall asses s
the patient at a minimum of every six (6) months;
3. Periodically make reason able efforts, unless clinically
contraindicated, to either stop the use of the contro lled substance,
decrease the dosage, tr y other drugs or treatment modalities in an
effort to reduce the potential for abuse or the development o f an
opioid use disorder as defined by the American Psychiatri c
Association and document with specificity the ef forts undertaken;
4. Review the central repository information in accordance with
Section 2-309D of this title; and
5. Monitor compliance wi th the patient-provider agreement and
any recommendations that t he patient seek a referral.
G. 1. Any prescription for acute pain pursuant to this s ection
shall have the words "acute pain" notated on the face of the
prescription by the practitioner.
2. Any prescription for chronic pain pursuant to this section
shall have the words "chronic pain" notated on the face of the
prescription by the practit ioner.
H. This section shall not apply to a prescriptio n for a
patient:
1. Who has sickle cell disease;
2. Who is in treatment for cancer or receiving aftercare cancer
treatment;
3. Who is receiving hospice care from a licensed hospice;
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4. Who is receiving palliative care in conjunction with a
serious illness;
5. Who is a resident of a long-term care facility; or
6. For any medications that are being prescribed for u se in the
treatment of substance abuse or opioid d ependence.
I. Every policy, contract or plan delive red, issued, executed
or renewed in this state, or approved for issuance or renew al in
this state by the Insurance Commissioner, and every contract
purchased by the Employees Gr oup Insurance Division of t he Office of
Management and Enterprise Services Oklahoma Public Employees
Retirement System, on or after November 1, 2018, that provides
coverage for prescription drugs subject to a copayment, coinsurance
or deductible shall charge a copayment, coinsurance or deductible
for an initial prescription of an opioid drug prescribe d pursuant to
this section that is either:
1. Proportional between the cost sharing for a thirty-day
supply and the amount of drugs the patient was prescribed; or
2. Equivalent to the cost sharing for a full thirty-day supply
of the drug, provided that no additional cost shari ng may be charged
for any additional prescriptions for the remainder of the thirty-day
supply.
J. Any practitioner authorized to prescribe an opioid drug
shall adopt and maintain a written policy or policies that include
execution of a written agreement t o engage in an informed consent
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process between the prescribing practitioner and qualifying opioid
therapy patient. For the purposes of this section, "qualifying
opioid therapy patient" means:
1. A patient requiring opioid trea tment for more than three ( 3)
months;
2. A patient who is prescribed benzodiazepines and opioids
together for more than one twenty-four-hour period; or
3. A patient who is prescribed a dos e of opioids that exceeds
one hundred (100) morphine equivalent doses.
K. Nothing in the Anti-Drug Diversion Act shall be construed to
require a practitioner to limit or forcibly taper a patient on
opioid therapy. The standard of care requires effective and
individualized treatment for each patient as deemed appropr iate by
the prescribing practi tioner without an administrative or codified
limit on dose or quantity that is more restrictive than approved by
the Food and Drug Administration (FDA).
SECTION 4. AMENDATORY 74 O.S. 2021, Section 1304.1, is
amended to read as follows:
Section 1304.1 A. The State and Education Employees Group
Insurance Board and the Oklahoma State Employees Benefits Counc il
are hereby abolished. Wherever the State and Education Employees
Group Insurance Board and the Oklahoma State Employees Benefits
Council are referenced in la w, that reference shall be construed to
mean the Oklahoma Employees Insurance and Benefits Boar d.
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B. There is hereby created the Oklahoma Employees Insurance and
Benefits Board.
C. The chair and vice-chair shall be elected by the Board
members at the first meeting of the Board and shall preside over
meetings of the Board and perform other duties a s may be required by
the Board. Upon the resignation or expiration of the term of the
chair or vice-chair, the members shall elect a chair or vice -chair.
The Board shall elect one of its members to serve as secretary.
D. The Board shall consist of seven (7) members to be appointed
as follows:
1. The State Insurance Commissioner, or designee;
2. Four members shall be appointed by the Governor;
3. One member shall be appointed by the Speaker of the Oklahom a
House of Representatives; and
4. One member shall be appointed by the President Pro Tempore
of the State Senate.
E. The appointed members shall:
1. Have demonstrated professional experience in investment or
funds management, public funds management, p ublic or private group
health or pension fund ma nagement, or group health insuranc e
management;
2. Be licensed to practice law in this state and have
demonstrated professional experience in commercial matters ; or
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3. Be licensed by the Oklahoma Accountanc y Board to practice in
this state as a public ac countant or a certified public acc ountant.
In making appointments that conform to the requirements of this
subsection, at least one but not more than three membe rs shall be
appointed each from paragraphs 2 an d 3 of this subsection by the
combined appointing authorities.
F. Each member of the Board shall serve a term of four (4)
years from the date of appointment.
G. Members of the Board shall be subject to the f ollowing:
1. The appointed members shall each receive compensation of
Five Hundred Dollars ($5 00.00) per month. Appointed membe rs who
fail to attend a regularly scheduled m eeting of the Board shall not
receive the related compensation;
2. The appointed members shall be reimbursed for their
expenses, according to the State Travel Reimbursement Act , as are
incurred in the performan ce of their duties, which shall be paid
from the Health Insurance Reserve Fund;
3. In the event an appointed member does not a ttend at least
seventy-five percent (75%) of th e regularly scheduled meetings of
the Board during a calendar year, the appointing authority may
remove the member;
4. A member may also be removed for any other cause as provided
by law;
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5. No Board member shall be individually or personally liable
for any action of the Board; and
6. Participation on the Board is contingent upon mai ntaining
all necessary annual training as may be required through the Health
Insurance Portability and Accountability Act of 19 96, Medicare
contracting requirements or other statutory or regulatory
guidelines.
H. The Board shall meet as often as necessary to conduct
business but shall meet no less t han four times a year, with an
organizational meeting to be held prior to December 1, 2012. The
organizational meeting shall be called by the Insurance
Commissioner. A majorit y of the members of the Board shal l
constitute a quorum for the transaction of business, and any
official action of the Board must have a favorable vote by a
majority of the members of the Board present.
I. Except as otherwise provided in this subsection, no member
of the Board shall be a lobbyist registered in this state as
provided by law, or be employed directly or indirectly by any firm
or health care provide r under contract to the State and Education
Employees Group Insurance Board, the Oklahoma State Employees
Benefits Council, or th e Oklahoma Employees Insurance and Benefits
Board, or any benefit program under its jurisdiction, for any goods
or services whatsoever. Any physician member of the Board sha ll not
be subject to the provisions of this subs ection.
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J. Any vacancy occurring on the Board shall be filled for the
unexpired term of office in the same manner as provided for in
subsection D of this sectio n.
K. The Board shall act in accordance with t he provisions of the
Oklahoma Open Meeting Act, the Oklahoma Open Records Act and the
Administrative Procedures Act.
L. The Administrative Director of the Courts shall designate
grievance panel members as sha ll be necessary. The members of the
grievance panel shall consist of two attorneys licensed to practice
law in this state and on e state licensed health care professional or
health care administrator who has at least three (3) years practical
experience, has had or has admitting privileges to a hospita l in
this state, has a working knowledge of pres cription medication, or
has worked in an administrative capacity at some point in their
career. The state health care professional shall be appointed by
the Governor. At the Governor 's discretion, one or mo re qualified
individuals may also be appointed a s an alternate to serve on the
grievance panel in the event the Governor 's primary appointee
becomes unable to serve.
M. The Office of Management and Enterprise Services Oklahoma
Public Employees Retirement System shall have the following duties,
responsibilities and authority with respec t to the administration of
the flexible benefits plan authorized pursuant to the State
Employees Flexible Benefits Act:
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1. To construe and interpret the plan, and decide all questions
of eligibility in accordance with the Oklahoma State Employees
Benefits Act and 26 U.S.C.A., Section 1 et seq.;
2. To select those benefits which shall be made availa ble to
participants under the p lan, according to the Oklahoma State
Employees Benefits Act, and other applicable laws and rule s;
3. To prescribe procedures to be followed by participants in
making elections and filing claims under the plan;
4. Beginning with the plan year which begins on January 1,
2013, to select and contract wit h one or more providers to offer a
group TRICARE Supplement product to eligible em ployees who are
eligible TRICARE beneficiarie s. Any membership dues required to
participate in a group TRICARE Supplement prod uct offered pursuant
to this paragraph shall be paid by the employee. As used in this
paragraph, "TRICARE" means the Department of Defense health care
program for active dut y and retired service members and their
families;
5. To prepare and distribute in formation communicating and
explaining the plan to participating employers and participants.
Health Maintenance Organizations or other third-party insurance
vendors may be directly or indirectly involved in the distribution
of communicated information to p articipating state agency employers
and state employee participants subject to the following co ndition:
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the Board shall verify a ll marketing and communications information
for factual accuracy prior to distribution;
6. To receive from participating emplo yers and participants
such information as shall be necessary for the proper administration
of the plan, and any of the benefits o ffered thereunder;
7. To furnish the partici pating employers and participants such
annual reports with respect to the administ ration of the plan as are
reasonable and approp riate;
8. To keep reports of benefit elections, claims and
disbursements for clai ms under the plan;
9. To negotiate for best and final offer through competitive
negotiation with the assistance and through th e purchasing
procedures adopted by the Office of Management and Enterprise
Services Oklahoma Public Employees Retirement System and contract
with federally qualified health m aintenance organizations under the
provisions of 42 U.S.C., Section 300e et seq., or with Health
Maintenance Organizations grante d a certificate of authority by the
Insurance Commissioner pursuant to the Health Maintenance Reform Act
of 2003 for considerat ion by participants as an alternative to the
health plans offered by the Oklahoma Employees Insurance and
Benefits Board, and to transfer to the health maintenance
organizations such funds as may be approved for a participant
electing health maintenance or ganization alternative services. The
Board may also select and contract with a ve ndor to offer a point-
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of-service plan. An HMO may offer coverage through a point -of-
service plan, subject to the guidelines esta blished by the Board.
However, if the Board chooses to offer a point -of-service plan, then
a vendor that offers both an HMO pl an and a point-of-service plan
may choose to offer only its point-of-service plan in lieu of
offering its HMO plan. The Board ma y, however, renegotiate rates
with successful bidders after contracts have been awarded if there
is an extraordinary circumstan ce. An extraordinary circumstance
shall be limited to insolvency of a participating health mai ntenance
organization or point -of-service plan, dissolution of a
participating health maintenance organization or point -of-service
plan or withdrawal of another participating health maintenance
organization or point-of-service plan at any time during the
calendar year. Nothing in this sec tion of law shall be construed to
permit either party to unilaterally alter the terms of the contract;
10. To retain as confid ential information the initial Request
For Proposal offers as well as any subsequent bid offers made by the
health plans prior to final contract awards as a part of the best
and final offer negotiations process for the benefit plan;
11. To promulgate admi nistrative rules for the competitive
negotiation process;
12. To require vendors offering cove rage to provide such
enrollment and claims data as is determined by the Board. The Board
shall be authorized to retain as confidential any proprietary
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information submitted in response to the Board 's Request For
Proposal. Provided, however, that any such information requested by
the Board from the vendors shall only be subject to t he
confidentiality provision of this paragraph if it is clearly
designated in the Request For Proposal as being protected under t his
provision. All requested information lackin g such a designation in
the Request For Proposal shall be subject to Section 24 A.1 et seq.
of Title 51 of the Oklahoma Statutes. From health maintenance
organizations, data provided shall include the current Health Plan
Employer Data and Information Set ( HEDIS);
13. To authorize the purc hase of any insurance deemed necessary
for providing benefits under the plan including indemnity dental
plans, provided that th e only indemnity health plan selected by the
Board shall be the indemnity plan offered by the B oard, and to
transfer to the Board such funds as may be approved for a
participant electing a benefit plan offered by the Board. All
indemnity dental plans shal l meet or exceed the following
requirements:
a. they shall have a statewide provider network,
b. they shall provide benefits whic h shall reimburse the
expense for the followi ng types of dental procedures:
(1) diagnostic,
(2) preventative,
(3) restorative,
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(4) endodontic,
(5) periodontic,
(6) prosthodontics,
(7) oral surgery,
(8) dental implants,
(9) dental prosthetics, and
(10) orthodontics, and
c. they shall provide an annual benefit of not less than
One Thousand Five Hundred Dollars ($1,500.00) for all
services other than orthodontic services, and a
lifetime benefit of not less than One Thousand Fi ve
Hundred Dollars ($1,500.00) for orthodontic services;
14. To communicate de ferred compensation programs as provided
in Section 1701 of Title 74 of the Oklaho ma Statutes;
15. To assess and collect reasona ble fees from contracted
health maintenance orga nizations and third-party insurance vendors
to offset the costs of administrati on;
16. To accept, modify or reject elections under the plan in
accordance with the Oklahoma State Employees Benefits Act and 26
U.S.C.A., Section 1 et seq.;
17. To promulgate election and claim forms to be us ed by
participants;
18. To adopt rules requi ring payment for medical and dental
services and treatment rendered by duly licens ed hospitals,
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physicians and dentists. Unless the Board has otherwise contracted
with the out-of-state health care provider, the Board shall
reimburse for medical services a nd treatment rendered and charged by
an out-of-state health care provider at least at the same percentage
level as the network pe rcentage level of the fee schedule
established by the Oklahoma Employees Insurance and Benefits Board
if the insured employee w as referred to the out -of-state health care
provider by a physician or it was an e mergency situation and the
out-of-state provider was the closest in proximity to the place of
residence of the employee which off ers the type of health care
services needed. For purposes of this paragraph, health care
providers shall include, but not be l imited to, physicians,
dentists, hospitals and special care facilities;
19. To enter into a co ntract with out-of-state providers in
connection with any PPO or hospital or me dical network plan which
shall include, but not be limited to, special care facili ties and
hospitals outside the borders of the S tate of Oklahoma. The
contract for out-of-state providers shall be identical to t he in-
state provider contracts. The Board ma y negotiate for discounts
from billed charges when the out -of-state provider is no t a network
provider and the member sought serv ices in an emergency situation,
when the services were not otherwise available in the State of
Oklahoma or when the Administrat or appointed by the Board approved
the service as an exceptional circumstance;
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20. To create the establishment of a grievance pr ocedure by
which a three-member grievance panel shall act as an appeals body
for complaints by insured employees regarding the allowance and
payment of claims, eligibility, and other matters. Except for
grievances settled to the satisfaction of both parti es prior to a
hearing, any person who requests i n writing a hearing before the
grievance panel shall receive a hearing before t he panel. The
grievance procedure provided by this paragraph shall be the
exclusive remedy available to insured employees having complaints
against the insurer. Such grievance procedure shall be subject to
the Oklahoma Administrative Procedures Act, incl uding provisions
thereof for review of agency decisions by the district court. Th e
grievance panel shall schedule a hearing rega rding the allowance and
payment of claims, elig ibility and other matters within s ixty (60)
days from the date the grievance pa nel receives a written request
for a hearing unless the panel orders a continuance for good cause
shown. Upon written request by the insured employee to the
grievance panel and received not less than ten (10) d ays before the
hearing date, the grievance pa nel shall cause a full stenographic
record of the proceedings to be made by a comp etent court reporter
at the insured employee 's expense; and
21. To intercept monies owing to p lan participants from other
state agencies, when those participants in turn owe money to the
Office of Management and Enterprise Services Oklahoma Public
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Employees Retirement System , and to ensure that the pa rticipants are
afforded due process of law.
N. Except for a breach of fiduciary o bligation, a Board member
shall not be individually or personally responsible for any action
of the Board.
O. The Board shall operate in an advisory capacity to the
Office of Management and Enterprise Services Oklahoma Public
Employees Retirement System .
P. The members of the Board shall not accept gifts or
gratuities from an individual organization with a value in excess of
Ten Dollars ($10.00) per year. The provisions of this section shall
not be construed to prevent t he members of the Board from atten ding
educational seminars, conferences, meeti ngs or similar functions.
SECTION 5. AMENDATORY 85A O.S. 2021, Section 50, is
amended to read as follow s:
Section 50. A. The employer shall promptly provide an in jured
employee with medical, surgical, hospital, optometric, podiatric,
chiropractic and nursing services, along with any medicine,
crutches, ambulatory devices, artificial limbs, eyeglasses, con tact
lenses, hearing aids, and other apparatus as may be reas onably
necessary in connection with the injury r eceived by the employee.
The employer shall have the right to ch oose the treating physician
or chiropractor.
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B. If the employer fails or neglects to provide medical
treatment within five (5) days after actu al knowledge is recei ved of
an injury, the injur ed employee may select a physician or
chiropractor to provide med ical treatment at the expense of the
employer; provided, however, that the injured employee, or another
in the employee's behalf, may obtain em ergency treatment at the
expense of the employer where such emergency treatment is not
provided by the employer.
C. Diagnostic tests shall not be repeated sooner than six (6)
months from the date of the test unless agreed to by the parties or
ordered by the Commission for goo d cause shown.
D. Unless recommended by the treating doctor or chiropractor at
the time claimant reaches maximum medical improvement or by an
independent medical examiner, c ontinuing medical maintenan ce shall
not be awarded by the Com mission. The employe r or insurance carrier
shall not be responsible for continuing medical maintenance or pain
management treatment that is outside the parameters established by
the Physician Advisory Committee or ODG. T he employer or insurance
carrier shall not be responsib le for continuing medical m aintenance
or pain management treatment not previously ordered by the
Commission or approved in advance by the employer or insurance
carrier.
E. An employee claiming or enti tled to benefits under the
Administrative Workers' Compensation Act, shall, if ord ered by the
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Commission or requested by the employer or insurance carrier, submit
himself or herself for medical examination. If an employee refuse s
to submit himself or hers elf to examination, his or her rig ht to
prosecute any proceeding under the Adminis trative Workers'
Compensation Act shall be suspended, and no comp ensation shall be
payable for the period of such refusal.
F. For compensable inju ries resulting in the use o f a medical
device, ongoing servic e for the medical device shall be provided in
situations including, but not limited to, medical device battery
replacement, ongoing medication refills related to the medical
device, medical devic e repair, or medical device replacement.
G. The employer sha ll reimburse the empl oyee for the actual
mileage in excess of twenty (20) miles round trip to and from the
employee's home to the location of a medical service provider for
all reasonable and nec essary treatment, for an ev aluation of an
independent medical examiner and for any evaluation made at the
request of the employer or insurance carrier. The rate of
reimbursement for such travel expense shall be the official
reimbursement rate as establish ed by the State Travel Reim bursement
Act. In no event shall the reimbursement of travel for medical
treatment or evaluation exceed six hundred (600) miles round trip.
H. Fee Schedule.
1. The Commission shall conduct a review and update of the
Current Procedural Terminology (CPT) in the Fee Schedule every two
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(2) years pursuant to the provisions of paragraph 14 of this
subsection. The Fee Schedule shall establish the maximu m rates that
medical providers shall be reimbursed for medical care provided to
injured employees including, but not limited to, charges by
physicians, chiropractor s, dentists, counselors, ho spitals,
ambulatory and outpatient facilities, clinical laborator y services,
diagnostic testing services, and ambulance services, and charges for
durable medical equipment, p rosthetics, orthotics, and supplie s.
The most current Fee Schedule established by the Administrator of
the Workers' Compensation Court prior to Fe bruary 1, 2014, shall
remain in effect, unless or until the Legislature approves t he
Commission's proposed Fee Schedule.
2. Reimbursement for medical care shall be prescribed and
limited by the Fee Schedule. The director of the Employees Group
Insurance Division of the Office of Management and Enterprise
Services Oklahoma Public Emplo yees Retirement System shall provide
the Commission such info rmation as may be rel evant for the
development of the Fee Schedule. The Commission shall develop the
Fee Schedule in a manner in which quality of medical ca re is assured
and maintained for injur ed employees. The Commissi on shall give due
consideration to additional requireme nts for physicians treating an
injured worker under the Administrative Workers ' Compensation Act,
including, but not limited to, communi cation with claims
representatives, case managers, attorneys, and representatives of
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employers, and the additional time required to complete forms for
the Commission, insurance carriers, and employers.
3. In making adjustments to the Fee Schedule, the Com mission
shall use, as a benchmark, the reimbursement rate for eac h Current
Procedural Terminology ( CPT) code provided fo r in the fee schedule
published by the Centers for Medicare and Medicaid Services of the
U.S. Department of Health and Human Services fo r use in Oklahoma
(Medicare Fee Schedu le) on the effective date o f this section,
workers' compensation fee schedules emp loyed by neighboring states ,
the latest edition of "Relative Values for Physicians " (RVP), usual,
customary and reasonable medical payme nts to workers' compensation
health care providers in the same tr ade area for comparable
treatment of a person with simi lar injuries, and all other data the
Commission deems relevant. For services not valued by CMS, the
Commission shall establish values b ased on the usual, customary and
reasonable medical payments to h ealth care providers in the same
trade area for compara ble treatment of a person w ith similar
injuries.
a. No reimbursement shall be allowed for any magnetic
resonance imaging (MRI) unless th e MRI is provided by
an entity that meets Medicare requirements f or the
payment of MRI services or is accredited by the
American College of Radiolo gy, the Intersocietal
Accreditation Commission or the Joint Commission on
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Accreditation of Healthcare Organiz ations. For all
other radiology proce dures, the reimbursement ra te
shall be the lesser of the reim bursement rate allowe d
by the 2010 Oklahoma Fee Schedule and two hundred
seven percent (207%) of the Medicare Fee Schedule.
b. For reimbursement of medical s ervices for Evaluation
and Management of injured employees as def ined in the
Fee Schedule adopted b y the Commission, the
reimbursement rate shall n ot be less than one hundred
fifty percent (150%) of the Medicare Fee Schedule.
c. Any entity providing durabl e medical equipment,
prosthetics, orthotics or supplies shall be accredited
by a CMS-approved accreditation organization . If a
physician provides durable medical equipment,
prosthetics, orthotics, prescription drugs, or
supplies to a patient ancillary to the patient's
visit, reimbursement sha ll be no more than ten perc ent
(10%) above cost.
d. The Commission shall develop a reasonable stop-loss
provision of the Fee Schedule to provide for adequate
reimbursement for treatment for major burns, severe
head and neurological injuries, multiple syste m
injuries, and other catas trophic injuries requiring
extended periods of intensive care. An employer or
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insurance carrier shall have the right to audit the
charges and question the reasonableness and necessity
of medical treatment contained in a bill for treatment
covered by the stop-loss provision.
4. The right to recover charges fo r every type of medical car e
for injuries arising out of and in the course of covered employment
as defined in the Administrative Worker s' Compensation Act shall lie
solely with the Commission. When a medical care provider has
brought a claim to the Commi ssion to obtain payment for services, a
party who prevails in full on the claim shall be entitled to
reasonable attorney fees.
5. Nothing in this section shall prevent an em ployer, insurance
carrier, group self-insurance association, or certified workplac e
medical plan from contrac ting with a provider of medical care for a
reimbursement rate that is greater than or less than limits
established by the Fee Schedule.
6. A treating physician may not charg e more than Four Hundred
Dollars ($400.00) per hour for preparation for or testimo ny at a
deposition or appearance before the Commission in connection with a
claim covered by the Administrati ve Workers' Compensation Act.
7. The Commission's review of medical and treatment charges
pursuant to this section shal l be conducted pursuant to the Fee
Schedule in existence at the time the medical care or treatment was
provided. The judgment approving the medical and treatment charges
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pursuant to this section shall be enforceable by the Commission in
the same manner as provided in the Administra tive Workers'
Compensation Act for the enforcement of other compensation payments.
8. Charges for prescripti on drugs dispensed by a pharmacy shall
be limited to ninety perce nt (90%) of the average wholesale price of
the prescription, plus a dispensing fee of Five Dollars ($5.00) per
prescription. "Average wholesale price " means the amount determined
from the latest publication designated by the Com mission.
Physicians shall prescribe and pharmacies shall dis pense generic
equivalent drugs when available. If the National Drug Code, or
"NDC", for the drug product dispensed is for a repackaged drug, then
the maximum reimbursement shall be the lesser of the original
labeler's NDC and the lowest-cost therapeutic equivalent drug
product. Compounded medications shall be billed by the compounding
pharmacy at the ingredient level, with each ingredient identified
using the applicable NDC of the drug product, and the corresponding
quantity. Ingredients with no NDC area are not separately
reimbursable. Payment shall be based on a sum of the allowable fee
for each ingredient plus a dispensing fee of Five Dollars ($5.00)
per prescription.
9. When medical care i ncludes prescription drugs dispensed by a
physician or other medical care provider and the NDC for the drug
product dispensed is for a repackaged drug, then the maximum
reimbursement shall be the lesser of the original labeler's NDC and
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the lowest-cost therapeutic equivalent drug pr oduct. Payment shall
be based upon a sum of the allowable fee for each ingredient plus a
dispensing fee of Five Dollars ($5.00) per prescription. Compounded
medications shall be billed by t he compounding pharmacy.
10. Implantables are paid in addition t o procedural
reimbursement paid fo r medical or surgical services. A
manufacturer's invoice for the actual cost to a physician, hospital
or other entity of an implantable device shall be adju sted by the
physician, hospital or oth er entity to reflect, at th e time
implanted, all applicable d iscounts, rebates, co nsiderations and
product replacement programs and shall be provided to the payer by
the physician or hospital as a condition of payment for the
implantable device. If the ph ysician, or an entity in wh ich the
physician has a financial interest other than a n ownership interest
of less than five percent (5%) in a publically traded company,
provides implantable devices, this relationship shal l be disclosed
to patient, employer, i nsurance company, third -party commission,
certified workplace medical plan, case m anagers, and attorneys
representing claimant and defendant. If the physician, or an entity
in which the physician has a financial inter est other than an
ownership interest o f less than five percent (5 %) in a publicly
traded company, buys and resells impla ntable devices to a hospita l
or another physician, the markup shall be limited to ten percent
(10%) above cost.
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11. Payment for medical care as required by the Administrativ e
Workers' Compensation Act shall be due within forty -five (45) days
of the receipt by the employer or insura nce carrier of a complete
and accurate invoice, unless the employer or insurance carrier has a
good-faith reason to request additional information about such
invoice. Thereafter, the Commission may assess a penalty up to
twenty-five percent (25%) for any amount due under the Fee Schedule
that remains unpaid on the finding by the Commission that no good -
faith reason existed for the delay in payment. If the Commission
finds a pattern of an employer or insuranc e carrier willfully and
knowingly delaying payme nts for medical care, the Commission may
assess a civil penalty of not more than Five Thousand Dollars
($5,000.00) per occurrence.
12. If an employee fails to appear for a s cheduled appointment
with a physician or chiropractor, the employer or insurance c ompany
shall pay to the physician or chiropractor a reasonable charge, to
be determined by the Commission, fo r the missed appointment. In the
absence of a good-faith reason for missing the appointment, the
Commission shall order the employee to reimburse the employer or
insurance company for the charge.
13. Physicians or chiropractors providing treatment under the
Administrative Workers ' Compensation Act shall disclose under
penalty of perjury to the Commiss ion, on a form prescr ibed by the
Commission, any ownership or interest in any health care facility,
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business, or diagnostic center that is not the physician 's or
chiropractor's primary place of b usiness. The disclosure sh all
include any employee leasing a rrangement between th e physician or
chiropractor and any health care facility that is not the
physician's or chiropractor's primary place of business. A
physician's or chiropractor's failure to disclose as required by
this section shall be grounds for the Commission to disqua lify the
physician or chiropractor from providing treatment under the
Administrative Workers ' Compensation Act.
14. a. Beginning on May 28, 2019, the Commission shall
conduct an evaluation of the Fee S chedule, which shall
include an update of the list of C urrent Procedural
Terminology (CPT) codes, a line item adjustment or
renewal of all rates, and amendment as needed to the
rules applicable to the Fee Schedule.
b. The Commission shall contract with an external
consultant with knowledge of workers' compensation fee
schedules to review regional and nationwide
comparisons of Oklahoma 's Fee Schedule rates and date
and market for medical servic es. The consultant shall
receive written and oral comment from e mployers,
workers' compensation medical service and ins urance
providers, self-insureds, group self-insurance
associations of this state and the public. The
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consultant shall submit a report o f its findings and a
proposed amended Fee Schedule to the Commiss ion.
c. The Commission shall adopt the proposed amended Fee
Schedule in whole or i n part and make any additional
updates or adjustments. The Commission shall submit a
proposed updated and ad justed Fee Schedule to the
President Pro Tempore of the Senate, t he Speaker of
the House of Represe ntatives and the Gove rnor. The
proposed Fee Schedule shall become effective on July 1
following the legislative session, if approved by
Joint Resolution of the Legislature during the session
in which a proposed Fee Schedu le is submitted.
d. Beginning on May 28, 2019, an exter nal evaluation
shall be conducted and a proposed amended Fee Schedule
shall be submitted to the Legislature for approval
during the 2020 legislative session. Thereafter, an
external evaluation shall b e conducted and a proposed
amended Fee Schedule shall b e submitted to the
Legislature for approval every two (2) years.
I. Formulary. The Commission by rule shall adopt a closed
formulary. Rules adopted by the Commission shall allow an appeals
process for claims in which a treating doct or determines and
documents that a drug not incl uded in the formulary is necessary to
treat an injured employee 's compensable injury. The Commission by
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rule shall require the use of generic phar maceutical medications and
clinically appropriate over -the-counter alternatives to prescription
medications unless otherwise specified by the prescribing doctor, in
accordance with applicable state law.
SECTION 6. This act shall become eff ective July 1, 2024.
SECTION 7. It being immediately necessary fo r the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof thi s act shall take effect and
be in full force from and after its passage and approval.
59-2-9553 TJ 01/04/24