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	3	+	ENGR. H. A. to ENGR. S. B. NO. 1703 Page 1 1
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	28	+	ENGROSSED HOUSE AMENDME NTS
	29	+	TO
	30	+	ENGROSSED SENATE BILL NO . 1703 By: Daniels of the Senate
	31	+
	32	+	and
	33	+
	34	+	McEntire of the House
1	35
2	36
3	37
4		-	An Act
5		-	ENROLLED SENATE
	38	+	An Act relating to the state Medicaid program;
	39	+	amending 63 O.S. 2021, Section 5051.2, which relates
	40	+	to recovery of expenses; prohibiting certain insurers
	41	+	and third-party administrators from denyin g claims on
	42	+	specified grounds; requiring acceptance of certain
	43	+	authorization; requiring response to certain inquiry
	44	+	within specified time frame; clarifying language; and
	45	+	declaring an emergency.
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	53	+
	54	+	AMENDMENT NO. 1. Page 1, Lines 6 through 9.5, strike title to read
	55	+
	56	+	"[ state Medicaid program – recovery of expenses –
	57	+	insurers – third-party administrators – denial of
	58	+	claims - acceptance of authorization – inquiry
	59	+	response –
	60	+	emergency ]"
	61	+	AMENDMENT NO. 2. Page 1, Line 12, strike the enacting clause
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	65	+	ENGR. H. A. to ENGR. S. B. NO. 1703 Page 2 1
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	90	+	Passed the House of Representatives the 25th day of April, 2024.
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	96	+	Presiding Officer of the House of
	97	+	Representatives
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	100	+	Passed the Senate the ____ day of _______ ___, 2024.
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	106	+	Presiding Officer of the Senate
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	108	+
	109	+	ENGR. S. B. NO. 1703 Page 1 1
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	134	+	ENGROSSED SENATE
6	135		BILL NO. 1703 By: Daniels of the Senate
7	136
8	137		and
9	138
10	139		McEntire of the House
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12	141
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15	144		An Act relating to the state Medicaid program;
16	145		amending 63 O.S. 2021, Section 5051.2, which relates
17	146		to recovery of expenses; prohibiting cer tain insurers
18	147		and third-party administrators from denying claims on
19	148		specified grounds; requiring acceptance of certain
20	149		authorization; requiring response to certain inquiry
21	150		within specified time frame; clarifying language; and
22	151		declaring an emergency .
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24	153
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26	155
27		-	SUBJECT: Medicaid
28		-
29	156		BE IT ENACTED BY THE PEO PLE OF THE STATE OF OKLAHOMA:
30		-
31	157		SECTION 1. AMENDATORY 63 O.S. 2021, Section 5051.2, is
32	158		amended to read as follows:
33		-
34	159		Section 5051.2. A. Whenever the Oklahoma Health Care Authority
35	160		pays for medical services or r enders medical service s, for or on
36	161		behalf of a person who has been injured or suffered an illness or
37	162		disease, the right of the provider of the services to reimbursement
38	163		shall be automatically assigned to the Oklahoma Health Care
39	164		Authority, upon noti ce to the insurer or other pa rty obligated as a
40	165		matter of law or agreement to reimburse the provider on behalf of
41	166		the patient.
42		-
43	167		B. Upon the assignment, the Authority, for purposes of the
44	168		claim for reimbursement, becomes a provider of medical services.
45	169
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46	194
47		-	ENR. S. B. NO. 1703 Page 2
48	195		C. The assignment of the right t o reimbursement shall be
49	196		applied and considered valid against any employer or insurer under
50	197		the Administrative Workers’ Compensation Act in this state.
51		-
52	198		D. Each insurer, upon receiving a claim from the Oklahoma
53	199		Health Care Authority, shall accept the state ’s right of recovery,
54	200		to process and, if appropriate, pay the claim to the same extent
55	201		that the plan would have been liable if it had been billed at the
56	202		point of sale or by the original provider of services. Insurer The
57	203		insurer shall not deny the Authorit y claims on the basis of the date
58	204		of submission, the format of the claim, or for failure to present
59	205		proper documentation of coverage at the point of sale.
60		-
61	206		E. An insurer or third-party administrator, except a Medicare
62	207		Advantage plan, shall not deny the Aut hority claims solely on the
63	208		basis that a claimed item or service did not receive prior
64	209		authorization under the rules or coverage policies of the insurer or
65	210		third-party administrator. The insurer or third -party administrator
66	211		shall accept an authorization p rovided by the Authority for an item
67	212		or service covered under the state Medicaid program or under a home -
68	213		and community-based services waiver for such individual as if such
69	214		authorization was made by the insurer or third-party administrator
70	215		for such item or service.
71		-
72	216		F. If the Authority submits an inquiry regarding a claim to an
73	217		insurer or third-party administrator not later than three (3) years
74	218		after the date of provision of the claimed item or service, the
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75	245		insurer or third-party administrator shall respond to the inquiry
76	246		within sixty (60) days of receiving the inquiry.
77		-
78	247		G. Insurer An insurer shall make appropriate payments to the
79	248		Authority as long as the claim is submitted for consideration within
80	249		three (3) years from the date t he service was furnished. An y action
81	250		by the Authority to enforce the payment of the claim shall be
82	251		commenced within six (6) years of the submission of the claim by the
83	252		Authority.
84		-
85	253		SECTION 2. It being immediately necessary for the preservation
86	254		of the public peace, heal th or safety, an emergency is hereby
87	255		declared to exist, by reason whereof this act shall take effect and
88	256		be in full force from and after its passage and approval.
89		-
90		-
91		-	ENR. S. B. NO. 1703 Page 3
92		-	Passed the Senate the 29th day of May, 2024.
	257	+	Passed the Senate the 12th day of March, 2024.
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96	261		Presiding Officer of the Senate
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99		-	Passed the House of Representatives the 30th day of May, 2024.
	264	+	Passed the House of Representatives the ____ day of __________,
	265	+	2024.
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103	269		Presiding Officer of the House
104	270		of Representatives
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106		-	OFFICE OF THE GOVERNOR
107		-	Received by the Office of the Governor this _______ _____________
108		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
109		-	By: _________________________________
110		-	Approved by the Governor of the State of Oklahoma this _______ __
111		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
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113		-	_________________________________
114		-	Governor of the State of Oklahoma
115		-
116		-
117		-	OFFICE OF THE SECRETARY OF STATE
118		-	Received by the Office of the Secretary of State this _______ ___
119		-	day of _________________ _, 20 _______, at _______ o'clock _______ M.
120		-	By: _________________________________

Oklahoma 2024 Regular Session

Oklahoma Senate Bill SB1703 Compare Versions