An Act
ENROLLED SENATE
BILL NO. 1752 By: Garvin of the Senate
and
McEntire of the House
An Act relating to the state Medicaid program;
amending Section 1, Chapter 309, O.S.L. 2022 (36 O.S.
Supp. 2023, Section 6012), which relates to health
care plan recognition; modifying certain authority of
the Insurance Department; requiring the Department to
recognize certain health care plans for specified
purpose; modifying conditions for recognition;
amending 56 O.S. 2021, Section 1010.1, as amended by
Section 2, Chapter 309, O.S.L. 2022 (56 O.S. Supp.
2023, Section 1010.1), which relates to premium
assistance program; modifying certain deadline and
conditions for participation by certain health care
plans; imposing additional conditions for
participation; updating statutory language; updating
statutory reference; providing an effective date; and
declaring an emergency .
SUBJECT: Medicaid
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY Section 1, Chapter 3 09, O.S.L.
2022 (36 O.S. Supp. 2023, Section 6012), is amended to read as
follows:
Section 6012. A health care plan recognized by the The
Insurance Department that participates shall recognize self -funded
or self-insured health care plans for the exclusi ve purpose of
participation in the premium assistance program created under
ENR. S. B. NO. 1752 Page 2
Section 1010.1 of Title 56 of the Oklahoma Statutes as of the
effective date of this act that at a later date becomes a self -
funded or self-insured health care plan may continue to be
recognized by the Insurance Department as a health care plan if such
plan meets if such plans meet the requirements under subsection J of
Section 1010.1 of Title 56 of the Oklahoma Statutes. The A self-
funded or self-insured health care plan recognized by the Department
under this section shall only be considered a health care plan for
the exclusive purposes of the premium assistance program created
under Section 1010.1 of Title 56 of the Oklahoma Statutes.
SECTION 2. AMENDATORY 56 O.S. 2021, Section 1010.1, as
amended by Section 2, Chapter 309, O.S.L. 2022 (56 O.S. Supp. 2023,
Section 1010.1), is amended to read as follows:
Section 1010.1. A. Section 1010.1 et seq. of this title shall
be known and may be cited as the “Oklahoma Medicaid Program Reform
Act of 2003”.
B. Recognizing that many Oklahomans do not have health care
benefits or health care coverage, that many small businesses cannot
afford to provide health care benefits to their employees, and that,
under federal law, barriers exist to providing Medicaid benefits to
the uninsured, the Legislature hereby establishes provisions to
lower the number of uninsured, assist businesses in their ability to
afford health care benefits and coverage for their employees, and
eliminate barriers to providing health coverage to eligible
enrollees under federal law.
C. Unless otherwise provided by law, the Oklahoma Health Care
Authority shall provide coverage under the state Medicaid program to
children under the age of eighteen (1 8) years whose family incomes
do not exceed one hundred eighty -five percent (185%) of the federal
poverty level.
D. 1. The Authority is directed to apply for a waiver or
waivers to the Centers for Medicare and Medicaid Services (CMS) that
will accomplish the purposes outlined in subsection B of this
section. The Authority is further directed to negotiate with CMS to
include in the waiver authority provisions to:
a. increase access to health care for Oklahomans,
ENR. S. B. NO. 1752 Page 3
b. reform the Oklahoma Medicaid Program to promote
personal responsibility for health care services and
appropriate utilization of health care benefits
through the use of public -private cost sharing,
c. enable small employers, and/or employed, uninsured
adults with or without children to purcha se employer-
sponsored, state-approved private, or state -sponsored
health care coverage through a state premium
assistance payment plan. If by January 1, 2012, the
Oklahoma Employer/Employee Partnership for Insurance
Coverage Premium Assistance Program premium assistance
program is not consuming more than seventy -five
percent (75%) of its dedicated source of funding, then
the program will be expanded to include parents of
children eligible for Medicaid, and
d. develop flexible health care benefit packages based
upon patient need and cost.
2. The Authority may phase in any waiver or waivers it receives
based upon available funding.
3. The Authority is authorized to develop and implement a
premium assistance plan to assist small businesses and/or their
eligible employees to purchase employer -sponsored insurance or “buy-
in” to a state-sponsored benefit plan.
4. a. The Authority is authorized to seek from the Centers
for Medicare and Medicaid Services any waivers or
amendments to existing waivers necessary to accomplish
an expansion of the premium assistance program to:
(1) include for-profit employers with two hundred
fifty employees or less up to any level supported
by existing funding resources, and
(2) include not-for-profit employers with five
hundred employees or less up to any level
supported by existing funding resources.
ENR. S. B. NO. 1752 Page 4
b. Foster parents employed by employers with greater than
two hundred fifty employees shall be exempt from the
qualifying employer requirement provided for in this
paragraph and shall be eligible to qualify for the
premium assistance program provided for in this
section if supported by existing funding.
E. For purposes of this paragraph, “for-profit employer” shall
mean an entity which is not exempt from taxation pursuant to the
provisions of Section 501(c)(3) of the Internal Revenue Code and
“not-for-profit employer” shall mean an entity which is exempt from
taxation pursuant to the provisions of Section 501(c)(3) of the
Internal Revenue Code.
F. The Authority is authorized to seek from the Centers for
Medicare and Medicaid Services any waivers or amendments to existing
waivers necessary to accomplish an extension of the premium
assistance program to include qualified employees whose family
income does not exceed two hundred fif ty percent (250%) of the
federal poverty level, subject to the limit of federal financial
participation.
G. The Authority is authorized to create as part of the premium
assistance program an option to purchase a high -deductible health
insurance plan that is compatible with a health savings account.
H. 1. There is hereby created in the State Treasury a
revolving fund to be designated the “Health Employee and Economy
Improvement Act (HEEIA) Revolving Fund ”.
2. The fund shall be a continuing fund, not s ubject to fiscal
year limitations, and shall consist of:
a. all monies received by the Authority pursuant to this
section and otherwise specified or authorized by law,
b. monies received by the Authority due to federal
financial participation pursuant to Title XIX of the
Social Security Act, and
c. interest attributable to investment of money in the
fund.
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3. All monies accruing to the credit of the fund are hereby
appropriated and shall be budgeted and expended by the Authority to
implement a premium a ssistance plan and to fund the state share for
the Oklahoma Medicaid program Program on or after July 1, 2020,
unless otherwise provided by law.
I. 1. The Authority shall establish a procedure for verifying
an applicant’s individual income by utilizing available Oklahoma Tax
Commission records, new hire report data collected by the Oklahoma
Employment Security Commission, and child support payment data
collected by the Department of Human Services in accordance with
federal and state law.
2. The Oklahoma Tax Commission, Oklahoma Employment Security
Commission, and Department of Human Services shall cooperate in
accordance with federal and state law with the Authority to
establish procedures for the secure electronic transmission of an
applicant’s individual income data to the Authority.
3. The Department of Public Safety shall cooperate in
accordance with federal and state law with the Authority to
establish procedures for the secure electronic transmission of an
applicant’s individual identification d ata to the Authority.
J. A health care plan An employer participating in the premium
assistance program created under this section as of the effective
date of this act that at a later date becomes May 1, 2024, may
utilize a self-funded or self-insured health care plan may continue
to participate in the premium assistance program as a participating
health care plan if:
1. The health care plan has continuously participated in the
premium assistance program without interruption up to the date it
becomes a self-funded or self-insured health care plan;
2. The self-funded or self-insured health care plan continues
to be recognized as a health care plan is recognized by the
Insurance Department under Section 1 of this act Section 6012 of
Title 36 of the Oklah oma Statutes;
ENR. S. B. NO. 1752 Page 6
3. 2. The self-funded or self-insured health care plan
continues to cover covers all essential health benefits as required
by the Centers for Medicare and Medicaid Services Authority and all
other health benefits required under applicable f ederal laws;
3. The self-funded or self-insured health care plan otherwise
complies with all applicable federal laws including but not limited
to the Employee Retirement Income Security Act of 1974 (ERISA);
4. The self-funded or self-insured health care plan assesses a
monthly premium on members and maintains a rate schedule for
provider reimbursement;
5. The self-funded or self-insured health care plan meets
actuarial standards for the premium assistance program as determined
by the Authority and the employer submits an attestation to the
Insurance Department that the self -funded or self-insured health
care plan meets such actuarial standards ; and
4. 6. The Authority receives the necessary federal approval for
self-funded or self-insured health care plans to participate in the
premium assistance program.
SECTION 3. This act shall become effective July 1, 2024.
SECTION 4. It being immediately necessary for the preservation
of the public peace, health or safety, an e mergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and after its passage and approval.
ENR. S. B. NO. 1752 Page 7
Passed the Senate the 1 4th day of March, 2024.
Presiding Officer of the Senate
Passed the House of Repr esentatives the 17th day of April, 2024.
Presiding Officer of the House
of Representatives
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this _______ _____________
day of _________________ __, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _______ __
day of _________________ __, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this _______ ___
day of _________________ _, 20 _______, at _______ o'clock _______ M.
By: _________________________________