Oklahoma 2024 Regular Session

Oklahoma Senate Bill SB1739 Compare Versions

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Version 2 (New)

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4		-	An Act
5		-	ENROLLED SENATE
	29	+	HOUSE OF REPRESENTATIVES - FLOOR VERSION
	30	+
	31	+	STATE OF OKLAHOMA
	32	+
	33	+	2nd Session of the 59th Legislature (2024)
	34	+
	35	+	ENGROSSED SENATE
6	36		BILL NO. 1739 By: Thompson (Kristen) of the
7	37		Senate
8	38
9	39		and
10	40
11	41		McEntire of the House
12	42
13	43
14	44
15	45		An Act relating to birthing centers; amending 3 6 O.S.
16	46		2021, Section 6060.3, which relates to maternity
17	47		benefits; modifying criteria for coverage of certain
18	48		benefits; conforming language; defining term;
19	49		amending 63 O.S. 2021, Section 1 -701, as amended by
20	50		Section 1, Chapter 117, O.S.L. 2023 (63 O.S. Supp .
21	51		2023, Section 1-701), which relates to hospitals;
22	52		modifying definitions; conforming language; amending
23	53		63 O.S. 2021, Section 1 -702a, which relates to
24	54		voluntary licensing of birthing centers; eliminating
25	55		license for birthing centers ; providing certain
26	56		construction; amending 63 O.S. 2021, Section 3129,
27	57		which relates to Lily ’s Law; defining term;
28	58		conforming language; updating statutory language;
29	59		directing the Oklahoma Health Care Authority to seek
30	60		certain federal approval ; providing for codification;
31	61		and providing an effective date .
32	62
33	63
34	64
35		-	~~SUBJECT: Birthing centers~~
	65	+
36	66
37	67		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
38		-
39	68		SECTION 1. AMENDATORY 36 O.S. 2021, Section 6060.3, is
40	69		amended to read as follows:
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41	96
42	97		Section 6060.3. A. Every health benefit plan issued, amended ,
43	98		renewed or delivered in this state on or after July 1, 1996, that
44	99		provides maternity benefits shall pro vide for coverage of:
45		-
46		-
47		-	ENR. S. B. NO. 1739 Page 2
48	100		1. A minimum of forty -eight (48) hours of inpatient care at a
49	101		hospital, or a birthing center licensed as a hospital, following a
50	102		vaginal delivery, for th e mother and newborn infant after
51	103		childbirth, except as otherwise provided in th is section;
52		-
53	104		2. A minimum of ninety -six (96) hours of inpatient care at a
54	105		hospital following a delivery by caesarean section for the mother
55	106		and newborn infant after childbirth, except as otherwise provided in
56	107		this section; and
57		-
58	108		3. a. Postpartum home care fo llowing a vaginal delivery if
59	109		childbirth occurs at home or in a birthing center
60	110		licensed as a birthing center that is not licensed as
61	111		a hospital but that is accredited as a freestanding
62	112		birth center by the Commission for the Accreditation
63	113		of Birth Centers. The coverage shall provide for one
64	114		home visit within forty -eight (48) hours of childbirth
65	115		by a licensed health care provider whose scope of
66	116		practice includes providing postpartum care. Visits
67	117		shall include, at a minimum:
68		-
69	118		(1) physical assessment of the m other and the newborn
70	119		infant,
71	120
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72	147		(2) parent education, to include, but not be limited
73	148		to:
74		-
75	149		(a) the recommended childhood immunization
76	150		schedule,
77		-
78	151		(b) the importance of childhood immu nizations,
79	152		and
80		-
81	153		(c) resources for obtaining childhood
82	154		immunizations,
83		-
84	155		(3) training or assistance with breast or bottle
85	156		feeding, and
86		-
87	157		(4) the performance of any medically necessary and
88	158		appropriate clinical tests.
89		-
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91		-	ENR. S. B. NO. 1739 Page 3
92	159		b. At the discretion of the mother, visits may occur at
93	160		the facility of the plan or the provider.
94		-
95	161		B. Inpatient care shall incl ude, at a minimum:
96		-
97	162		1. Physical assessment of the mother and the newborn infant;
98		-
99	163		2. Parent education, to include, but not be limited to:
100		-
101	164		a. the recommended childhood immunizat ion schedule,
102		-
103	165		b. the importance of childhood immunizations, and
104		-
105	166		c. resources for obtaining childhood immunizations;
106		-
107	167		3. Training or assistance with breast or bottle feeding; and
108		-
109	168		4. The performance of any medically necessary and ap propriate
110	169		clinical tests.
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111	196
112	197		C. A plan may limit coverage to a shorter length of hospital
113	198		inpatient stay for services related to maternity and newborn infant
114	199		care provided that:
115		-
116	200		1. In the sole medical discretion or judgment of the attending
117	201		physician licensed by the Oklahoma State Board of Medical Licensure
118	202		and Supervision or the State Board of Osteopathic Exa miners or the
119	203		certified nurse midwife licensed by the Oklahoma Board of Nursing
120	204		providing care to the mother and to the newborn infant, it is
121	205		determined prior to discharge that an earlier discharge of the
122	206		mother and newborn infant is appropriate and meets medical criteria
123	207		contained in the most current treatment standards of the American
124	208		Academy of Pediatrics and the American College of Obstetricians and
125	209		Gynecologists that determ ine the appropriate length of stay based
126	210		upon:
127		-
128	211		a. evaluation of the antepartum, intrapartum and
129	212		postpartum course of the mother and newborn infant,
130		-
131	213		b. the gestational age, birth weight and clinical
132	214		condition of the newborn infant,
133		-
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135		-	ENR. S. B. NO. 1739 Page 4
136	215		c. the demonstrated ability of the mother to care for the
137	216		newborn infant postdischarge post-discharge, and
138		-
139	217		d. the availability of postdischarge post-discharge
140	218		follow-up to verify the condition of the newborn
141	219		infant in the first forty -eight (48) hours after
142	220		delivery.
143	221
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144	248		A plan shall adopt these guidelines by July 1, 1996; and
145		-
146	249		2. The plan covers one home visit, w ithin forty-eight (48)
147	250		hours of discharge, by a licensed health care provider whose scope
148	251		of practice includes providing postpartum care. The visits s hall
149	252		include, at a minimum:
150		-
151	253		a. physical assessment of the mother and the newborn
152	254		infant,
153		-
154	255		b. parent education, to include, but not be limited to:
155		-
156	256		(1) the recommended childhood immunization schedule,
157		-
158	257		(2) the importance of childhood immunizations, and
159		-
160	258		(3) resources for obtaining chil dhood immunizations,
161		-
162	259		c. training or assistance with breast or bottle feeding,
163	260		and
164		-
165	261		d. the performance of any medically necessary and
166	262		clinical tests.
167		-
168	263		At the mother’s discretion, visits may occur at the facility of
169	264		the plan or the provider.
170		-
171	265		D. The plan shall include, but is not limited to, notice of the
172	266		coverage required by this section in the evidence of coverage of the
173	267		plan, and shall provide additional written notice of the coverage to
174	268		the insured or an enrollee during the course o f the prenatal care of
175	269		the insured or enrollee.
176		-
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178		-	ENR. S. B. NO. 1739 Page 5
179	270		E. In the event the coverage required by this section is
180	271		provided under a contract that is subject to a capitated or global
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181	299		rate, the plan shall be required to provide supplementary
182	300		reimbursement to provider s for any additional services required by
183	301		that coverage if it is not included in the capitation or global
184	302		rate.
185		-
186	303		F. No health benefit plan subject to the provisions of this
187	304		section shall terminate the services of, reduce capitation payments
188	305		for, refuse payment for services, or oth erwise discipline a licensed
189	306		health care provider who orders care consistent wit h the provisions
190	307		of this section.
191		-
192	308		G. As used in this section , “health:
193		-
194	309		1. “Birthing center” has the same meaning as provided by
195	310		Section 1-701 of Title 63 of the Oklahoma Statutes ; and
196		-
197	311		2. “Health benefit plan” means any plan or arrangement as
198	312		defined in subsection C of Section 6060.4 of this title.
199		-
200	313		H. The Insurance Commissioner shall promulgate any rules
201	314		necessary to implement the provisions of this s ection.
202		-
203	315		SECTION 2. AMENDATORY 63 O.S. 2021, Section 1 -701, as
204	316		amended by Section 1, Chapter 117, O.S.L. 2023 (63 O.S. Supp. 2023,
205	317		Section 1-701), is amended to read as follows:
206		-
207	318		Section 1-701. For the purposes of Section 1 -701 et seq. of
208	319		this title:
209		-
210	320		1. “Hospital” means any institution, place, building or agency,
211	321		public or private, w hether organized for profit or not, primarily
212	322		engaged in the maintenance and operation of facilities for the
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213	350		diagnosis, treatment or care of patients a dmitted for overnight sta y
214	351		or longer in order to obtain medical care, surgical care,
215	352		obstetrical care, or nursing care for illness, disease, injury,
216	353		infirmity, or deformity. Except as otherwise provided by paragraph
217	354		7 of this section, places where pregnant females are admitted and
218	355		receive care incident to pregnancy, abortion or delivery shall be
219	356		considered to be a “hospital” hospital within the meaning of this
220	357		article, regardless of the number of patients received or the
221		-
222		-	ENR. S. B. NO. 1739 Page 6
223	358		duration of their stay. The term “hospital” hospital includes
224	359		general medical surgical hospitals, specialized hospitals, critical
225	360		access hospitals, emergency hospitals, and rural emergency
226	361		hospitals, and but does not include birthing centers except to the
227	362		extent a birthing center is licens ed as a hospital;
228		-
229	363		2. “General medical surgical hospital ” means a hospital
230	364		maintained for the purpose of providing hospital care in a broad
231	365		category of illness and injury;
232		-
233	366		3. “Specialized hospital ” means a hospital maintained for the
234	367		purpose of providing hospital care in a certai n category, or
235	368		categories, of illness and injury;
236		-
237	369		4. “Critical access hospital ” means a hospital determined by
238	370		the State Department of Health to be a necessary provider of health
239	371		care services to residents of a rural community;
240		-
241	372		5. “Emergency hospital” means a hospital that provides
242	373		emergency treatment and stabilization services on a twenty-four-hour
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243	401		basis that has the ability to admit and treat patients for short
244	402		periods of time;
245		-
246	403		6. “Rural emergency hospital ” means a hospital tha t provides
247	404		emergency treatment and stabilization services for an average length
248	405		of stay of twenty-four (24) hours or less;
249		-
250	406		7. “Birthing center” means any facility, place or institution ,
251	407		which that is maintained or established primarily for the purpose of
252	408		providing services of a certified midwife or licensed medical doctor
253	409		to assist or attend a woman in deliv ery and birth, and where a woman
254	410		is scheduled in advance to give birth following a normal,
255	411		uncomplicated, low-risk pregnancy. Such services are perfor med by:
256		-
257	412		a. a licensed Advanced Practice Registered Nurse
258	413		recognized by the Oklahoma Board of Nursing as a
259	414		Certified Nurse-Midwife,
260		-
261	415		b. a Certified Professional Midwife or Certified Midwife
262	416		licensed under Section 3040.6 of Title 59 of the
263	417		Oklahoma Statutes, or
264		-
265		-
266		-	ENR. S. B. NO. 1739 Page 7
267	418		c. a licensed allopathic or osteopathic physician .
268		-
269	419		Provided, however, licensure for a birthing center shall not be
270	420		compulsory available or required for birthing centers unless the
271	421		birthing center is a hospital, in which case the hospital shall be
272	422		licensed as a hospital under Se ction 1-702 of this title;
273		-
274	423		8. “Day treatment program ” means nonresidential, par tial
275	424		hospitalization programs, day treatment programs, and day hospital
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276	452		programs as defined by subsection A of Section 175.20 of Title 10 of
277	453		the Oklahoma Statutes; and
278		-
279	454		9. a. “Primarily engaged” means a hospital shall be
280	455		primarily engaged, defined by this section and as
281	456		determined by the State Department of Health, in
282	457		providing to inpatients the following care by or under
283	458		the supervision of physicians:
284		-
285	459		(1) diagnostic services a nd therapeutic services for
286	460		medical diagnosis, treatment and care of injured,
287	461		disabled or sick persons, or
288		-
289	462		(2) rehabilitation services for the rehabilitation of
290	463		injured, disabled or sick persons.
291		-
292	464		b. In reaching a determination as t o whether an entity is
293	465		primarily engaged in providing inpatient hospital
294	466		services to inpatients of a hosp ital, the Department
295	467		shall evaluate the total facility operations and
296	468		consider multiple factors as provided in subparagraphs
297	469		c and d of this subsection paragraph.
298		-
299	470		c. In evaluating the total facility operations, the
300	471		Department shall review the actual provis ion of care
301	472		and services to two or more inpatients, and the
302	473		effects of that care, to assess whether the care
303	474		provided meets the needs of individual pat ients by way
304	475		of patient outcomes.
305	476
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306	503		d. The factors that the Department shall consider for
307	504		determination of whether an entity meets the
308		-
309		-	ENR. S. B. NO. 1739 Page 8
310	505		definition of primarily engaged include, but are not
311	506		limited to:
312		-
313	507		(1) a minimum of four inpatient beds,
314		-
315	508		(2) the entity’s average daily census (ADC),
316		-
317	509		(3) the average length of stay (ALOS),
318		-
319	510		(4) the number of off-site campus outpatient
320	511		locations,
321		-
322	512		(5) the number of provider -based emergency
323	513		departments for the entity,
324		-
325	514		(6) the number of inpatient beds related to the size
326	515		of the entity and the scope of the services
327	516		offered,
328		-
329	517		(7) the volume of outpatient surgical procedures
330	518		compared to the inpatient surgical procedures, if
331	519		surgical services are provided,
332		-
333	520		(8) staffing patterns, and
334		-
335	521		(9) patterns of ADC by day of the week.
336		-
337	522		e. Notwithstanding any other provision of this section,
338	523		an entity shall be considered primarily engaged in
339	524		providing inpatient hospital services to inpatients if
340	525		the hospital has had an ADC of at least two (2) and an
341	526		ALOS of at least two (2) midnights over the past
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342	554		twelve (12) months. A critical access hospital shall
343	555		be exempt from the ADC and ALOS determination. ADC
344	556		shall be calculated by adding the midnight daily
345	557		census for each day of the twelve -month period and
346	558		then dividing the total number by days in the year. A
347	559		facility that has been oper ating for less than (12)
348	560		months at the time of the survey shall calculate its
349	561		ADC based on the number of months the facility has
350	562		been operational, but not less than three (3) months.
351	563		If a first survey finds noncompliance with the ADC and
352		-
353		-	ENR. S. B. NO. 1739 Page 9
354	564		ALOS, a second survey may be required by the
355	565		Department to demonstrate compliance with state
356	566		licensure.
357		-
358	567		SECTION 3. AMENDATORY 63 O.S. 2021, Section 1 -702a, is
359	568		amended to read as follows:
360		-
361	569		Section 1-702a. A. By January 1, 1992, the State Board of
362	570		Health shall promulgate and adopt rules for the voluntary licensing
363	571		of birthing centers On and after the effective date of this act, the
364	572		State Department of Health shall cease licensing birthing centers.
365	573		No new license shall be is sued, and no current license shall be
366	574		renewed upon expiration. Provided, however, this subsection shall
367	575		not be construed to exempt a hospital that operates a birthing
368	576		center from the requirement to obtain a hospital license under
369	577		Section 1-702 of this title.
370	578
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371	605		B. The State Board Commissioner of Health shall promulgate
372	606		rules establishing standards for day trea tment programs other than
373	607		those operated by community mental health centers.
374		-
375	608		SECTION 4. AMENDATORY 63 O.S. 2021, Section 3129 , is
376	609		amended to read as follows:
377		-
378	610		Section 3129. A. This section shall be known and may be cited
379	611		as “Lily’s Law”.
380		-
381	612		B. As used in this section:
382		-
383	613		1. “Birthing center” has the same meaning as provided by
384	614		Section 1-701 of this title;
385		-
386	615		2. “Fetal death” means:
387		-
388	616		a. spontaneous death prior to the complete expulsion or
389	617		extraction from its mother of an unborn child,
390	618		irrespective of gestational age. The death is
391	619		indicated by the fact that, after such expulsion or
392	620		extraction, the unborn child does not breathe or show
393	621		any other evidence of life such as beating of the
394	622		heart, pulsation of the umbilical cord or definite
395	623		movement of voluntary muscles,
396		-
397		-	ENR. S. B. NO. 1739 Page 10
398		-
399	624		b. death that occurs as the result of accidental trauma
400	625		or a criminal assault on the pregnant female or her
401	626		unborn child, irrespective of gestational age, or
402		-
403	627		c. death that occurs, irrespective of gestational age,
404	628		from the use or prescription of any instrument,
	629	+
	630	+	SB1739 HFLR Page 13
	631	+	BOLD FACE denotes Committee Amendments. 1
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405	656		medicine, drug or any other substance or device to
406	657		remove an ectopic pregnancy; and
407		-
408	658		2. 3. “Stillbirth” shall have the same meaning as provided by
409	659		subparagraph a of paragraph 1 of this subsection.
410		-
411	660		C. Every licensed hospital, birthing center, or licensed
412	661		medical facility in this state shall maintain a written policy for
413	662		the disposition of the remains of a child from a still birth or fetal
414	663		death event at such hospital, birthing center or medical facility.
415	664		A parent of the child shall have the right to direct the disposition
416	665		of the remains, except that disposition may be made by the hospital,
417	666		birthing center or medical facility if no direction is given by a
418	667		parent within fourteen (14) days following the delivery of the
419	668		remains. The policy and the disposition shall comply with all
420	669		applicable provisions of state and federal law. Upon the delivery
421	670		of a child from a stillbirth or a fetal death event, the hospital,
422	671		birthing center or medical facility shall notify at least one (1)
423	672		parent of the parents’ right to direct the disposition of the
424	673		remains of the child and shall provide at least (1) one parent with
425	674		a copy of its policy with respect to disposition.
426		-
427	675		D. Except as otherwise provided by law, nothing in this section
428	676		shall be interpreted to prohibit any hospital, birthing center or
429	677		medical facility from providing additional notification and
430	678		assistance to the parent of a child deli vered as a stillbirth or a
	679	+
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431	706		fetal death event at the hospital, birthing center or medical
432	707		facility relating to the disposition of the remains of the child.
433		-
434	708		SECTION 5. NEW LAW A new section of law to be codified
435	709		in the Oklahoma Statut es as Section 5029.1 of Title 63, unless there
436	710		is created a duplication in numbering, reads as follows:
437		-
438		-
439		-	ENR. S. B. NO. 1739 Page 11
440	711		A. As used in this section, “birthing center” has the same
441	712		meaning as provided by Section 1 -701 of Title 63 of the Oklahoma
442	713		Statutes.
443		-
444	714		B. The Oklahoma Health Care Authority sha ll seek federal
445	715		approval to allow a birthing center that is not licensed by the
446	716		state but has been accredited as a freestanding birth center by the
447	717		Commission for the Accreditation of Birth Centers to receive
448	718		reimbursement under th e state Medicaid program for services
449	719		provided.
450		-
451	720		SECTION 6. This act shall become effecti ve November 1, 2024.
452	721
453		-
454		-	ENR. S. B. NO. 1739 Page 12
455		-	Passed the Senate the 4th day of March, 2024.
456		-
457		-
458		-
459		-	Presiding Officer of the Senate
460		-
461		-
462		-	Passed the House of Representati ves the 17th day of April, 2024.
463		-
464		-
465		-
466		-	Presiding Officer of the House
467		-	of Representatives
468		-
469		-	OFFICE OF THE GOVERNOR
470		-	Received by the Office of the Governor this _______ _____________
471		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
472		-	By: _________________________________
473		-	Approved by the Governor of the State of Oklahoma this _______ __
474		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
475		-
476		-	_________________________________
477		-	Governor of the State of Oklahoma
478		-
479		-
480		-	OFFICE OF THE SECRET ARY OF STATE
481		-	Received by the Office of the Secretary of State this _______ ___
482		-	day of _________________ _, 20 _______, at _______ o'clock _______ M.
483		-	By: _________________________________
	722	+	COMMITTEE REPORT BY: COMMITTEE ON PUBLIC HEALTH, dated 03/27/2024 -
	723	+	DO PASS.