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ENGROSSED HOUSE AMENDME NT
TO
ENGROSSED SENATE BILL NO . 1264 By: Stanley of the Senate
and
Miller of the House
[ health insurance - coverage - exclusions -
codification - effective date ]
AUTHOR: Add the following House Coauthors: Provenzano, Munson,
Townley, Baker, and West (Tammy)
AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill
and insert:
"[ health insurance - genetic testing - cancer
imaging - coverage – exclusions – codification -
effective date ]
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6060.5b of Title 36, un less
there is created a duplication in numbering, reads as follo ws:
A. For the purposes of this section:
1. “Clinical utility” means clinical utility as defined
pursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes;
2. “Evidence-based cancer imaging” means appropriate
preventative screening and imagi ng supported by evidence;
3. “Genetic testing for an inherited mutation ” means multi-gene
testing for an inherited mutation associated with an increased risk
of cancer;
4. “Health benefit plan” means a health benefit plan as defined
pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; and
5. “Health care provider ” means any physician, hospital, or
other entity or person that is l icensed or otherwise authorized in
this state to furnish health care services.
B. Any health benefit plan includin g the Oklahoma Employees
Insurance Plan that is o ffered, issued, or renewed in this state on
or after the effective date of this act shall pr ovide coverage for:
1. Clinical genetic testing for an inherited gene mutation for
individuals with a personal or famil y history of cancer when such
test provides clinical utility and when orde red or recommended by a
health care provider in accordance with medical and scientific
evidence including, but not lim ited to:
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a. the most recent version of the National Compreh ensive
Cancer Network (NCCN) clinical practice
recommendations that are level 2 a or higher,
b. Centers for Medicare and Medicaid Services nat ional
coverage determinations or Medicare administrative
contractor local coverage determinations, or
c. nationally recognized clinical practice guidelines;
and
2. Evidence-based cancer imaging for individuals with an
increased risk of cancer when such te st provides clinical utility
and when ordered or recomme nded by a health care provider in
accordance with the most recent version of the NCCN clinical
practice recommendations that are level 2a or higher, or in
accordance with other nationally recognized c linical practice
guidelines.
C. Coverage under this sec tion shall not be subject to any
annual deductibles, copayments, or coinsurance limits as established
for all covered benefits under the h ealth benefit plan.
D. If application of this section would r esult in health
savings account ineligibility under Sect ion 223 of the federal
Internal Revenue Code, as amended, the provisions of this section
shall only apply to health savings accounts with qualified high
deductible health plans with respect to the ded uctible of such a
plan after the enrollee has satisfied the minimum deductible.
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Provided, however, the provisions of th is section shall apply to
items or services that are preventive care pursu ant to Section
223(c)(2)(C) of the federal Internal Revenue Co de, as amended,
regardless of whether the minimum deduct ible has been satisfied.
SECTION 2. This act shall become effective November 1, 2024. "
Passed the House of Representatives the 17th day of April, 2024.
Presiding Officer of the House of
Representatives
Passed the Senate the ____ day of _______ ___, 2024.
Presiding Officer of the Senate
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ENGROSSED SENATE
BILL NO. 1264 By: Stanley of the Senate
and
Miller of the House
[ health insurance - coverage - exclusions -
codification - effective date ]
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6060.5b of Title 36, unless
there is created a duplication in numbering, reads as follows:
A. For the purposes of this section:
1. “Clinical utility” means clinical utility as defined
pursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes;
2. “Evidence-based cancer imaging ” means appropriate
preventative screening and imagi ng supported by evidence;
3. “Genetic testing for an inherited mutation ” means multi-gene
testing for an inherited mutation associated with an increased risk
of cancer;
4. “Health benefit plan” means a health benefit plan as defined
pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; and
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5. “Health care provider ” means any physician, hospital, or
other entity or person that is licensed or otherwise authorized in
this state to furnish health care services.
B. Any health benefit plan includin g the Oklahoma Employees
Insurance Plan that is offered, issued, or renewed in this stat e on
or after the effective date of this act shall provide coverage for:
1. Clinical genetic testing for an inherited gene mutation for
individuals with a personal or family history of cancer when such
test provides clinical utility and when ordered or re commended by a
health care provider in accordance with medical and scientific
evidence including, but not limited to:
a. the most recent version of the National Compreh ensive
Cancer Network (NCCN) clinical practice
recommendations that are level 2a or high er,
b. Centers for Medicare and Medicaid Services national
coverage determinations or Medicare administrative
contractor local coverage determinations, and
c. nationally recognized clinical practice guidelines;
and
2. Evidence-based cancer imaging for ind ividuals with an
increased risk of cancer when such test provides clinical utility
and when ordered or recommended by a health care provider in
accordance with the most recent version of the NCCN clinical
practice recommendations that are level 2a or highe r, or in
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accordance with other nationally recognized clinical practice
guidelines.
C. Coverage under this section shall not be subject to any
annual deductibles, copayments, or coinsurance limits as established
for all covered benefits under the health be nefit plan.
D. If application of this section would result in health
savings account ineligibility under Section 223 of the federal
Internal Revenue Code, as amended, the provisions of this section
shall only apply to health savings accounts with qualifie d high
deductible health plans with respect to the deductible of such a
plan after the enrollee has satisfied the minimum deductible.
Provided, however, the provisions of this section shall apply to
items or services that are preventive care pursuant to S ection
223(c)(2)(C) of the federal Internal Revenue Code, as amended,
regardless of whether the minimum deductible has been satisfied.
SECTION 4. This act shall become effective November 1, 2024.
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Passed the Senate the 14th day of March, 2024.
Presiding Officer of the Senate
Passed the House of Representatives the ____ day of __________,
2024.
Presiding Officer of the House
of Representatives