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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
SENATE BILL 1817 By: Dahm
AS INTRODUCED
An Act relating to hospitals; defining terms;
requiring facilities to make public certain file and
list; stating requirements for list of standard
charges; requiring certain digital publication of
specified information; requiring certain online
display of list; stipulating requirements related to
accessibility and formatting of list; requiring
development of certain formatting template; requiring
annual update of list; stating requirements for list
of standard charges and selection of shoppable
services; requiring list to include certain
information; directing certain display and
availability of list; requiring facility to submit
certain updates to the State Department of Health;
requiring certain compliance monitoring by the
Department; directing certain actions for
noncompliance; requiring the Department to create and
update certain list of violations; making certain
information subject to public disclosure; stipulating
certain licensing consideration; defining materia l
violation; requiring issuance of cert ain notice upon
certain determination; specifying certain
requirements for correcti ve action plans; directing
imposition of certain administrative penalties;
establishing minimum penalties; requiring certain
considerations by the Department; repealing 63 O.S.
2021, Sections 1-725.1, 1-725.2, 1-725.3, 1-725.4,
and 1-725.5, which relate to the Transparency in
Health Care Prices Act ; providing for codification;
and providing an 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 1-725.11 of Title 63, unless
there is created a duplication in numbering, reads as follows:
As used in this act:
1. “Ancillary service” means a facility item or service that a
facility customarily provides as part of a shoppable service;
2. “Chargemaster” means the list of all facility items or
services maintained by a facility for which the facility has
established a charge ;
3. “De-identified maximum negotiated charge ” means the highest
charge that a facility has negotiated with all third -party payors
for a facility item or se rvice;
4. “De-identified minimum negotiated charge ” means the lowest
charge that a facility has negotiated with all third -party payors
for a facility item or service ;
5. “Department” means the State Depar tment of Health;
6. “Discounted cash pric e” means the charge that applies to an
individual who pays cash, or a cash equivalent, for a facility item
or service;
7. “Facility” means a hospital licensed under Section 1-702 of
Title 63 of the Oklahoma Statutes ;
8. “Facility items or services ” means all items and services,
including individual items and services and service packages, that
may be provided by a facility to a pati ent in connection with an
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inpatient admission or an outpatient department visit, as
applicable, for which the facility has es tablished a standard
charge, including:
a. supplies and procedures ,
b. room and board,
c. use of the facility and other areas, the charges for
which are generally referred to as facility fees ,
d. services of physicians and non -physician
practitioners, employed by the facility, the charges
for which are generally referred to as professional
charges, and
e. any other item or service for which a facility has
established a standard charge ;
9. “Gross charge” means the charge for a facility item or
service that is reflected on a facility’s chargemaster, absent any
discounts;
10. “Machine-readable format” means a digital representation of
information in a file that can be imported or read into a computer
system for further processing. The term includes Extensible Markup
Language (.XML), JavaScript Object Notation (.JSON), and Comma-
Separated Values (.CSV) formats;
11. “Payor-specific negotiated charge ” means the charge that a
facility has negotiated with a third -party payor for a facility item
or service;
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12. “Service package” means an aggregation of individual
facility items or services into a single service with a single
charge;
13. “Shoppable service” means a service that may be scheduled
by a health care consumer in advance ;
14. “Standard charge” means the regular rate established by the
facility for a facility item or service provided to a specific group
of paying patients. The term includes all of the following, as
defined under this section:
a. the gross charge,
b. the payor-specific negotiated charge ,
c. the de-identified minimum negotiated charge ,
d. the de-identified maximum negoti ated charge, and
e. the discounted cash price ; and
15. “Third-party payor” means an entity that is, by statute,
contract, or agreement, legally responsible for payment of a claim
for a facility item or service.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.12 of Title 63, unless
there is created a duplication in numbering, reads as follows:
Notwithstanding any other law, a facility shall make public:
1. A digital file in a machine -readable format that contains a
list of all standard charges fo r all facility items or services as
described by Section 3 of this act; and
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2. A consumer-friendly list of standard c harges for a limited
set of shoppable services as provided in Section 4 of this act.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.13 of Title 63, unless
there is created a duplicat ion in numbering, reads as follows:
A. A facility shall:
1. Maintain a list of all standard charges for all facility
items or services in accordance with this section; and
2. Ensure the list required under paragraph 1 of this
subsection is available at all times to the public, including by
posting the list electronically in the manner pro vided by this
section.
B. The standard charges contained in the list required to be
maintained by a facility under subsection A of this section shall
reflect the standard charges applicable to that locati on of the
facility, regardless of wheth er the facility operates in more than
one location or operates under the same license as another facility.
C. The list required under subsection A of this section shall
include the following items, as applicable:
1. A description of each facility item or service pro vided by
the facility;
2. The following charges for each individual facility item or
service when provided in either an inpatient setting or an
outpatient department se tting, as applicable:
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a. the gross charge,
b. the de-identified minimum neg otiated charge,
c. the de-identified maximum negotiated charge ,
d. the discounted cash price , and
e. the payor-specific negotiated charge, listed by the
name of the third-party payor and plan associated with
the charge and displayed in a manner that clearly
associates the charge with each third -party payor and
plan; and
3. Any code used by the facility for purposes of accounting or
billing for the facility item or service, including the Current
Procedural Terminology (CPT) code, the Healthcare Common Proce dure
Coding System (HCPCS) code, the Diagnosis Related Group (DRG) code,
the National Drug Code (NDC), or other common identifier.
D. The information contained in the list required under
subsection A of this section shall be published in a single digital
file that is in a machine -readable format.
E. The list required under subsection A of this section shall
be displayed in a prominent location on the home page of the
facility’s publicly accessible Internet website or accessible by
selecting a dedicated li nk that is prominently displayed on the home
page of the facility’s publicly accessible Internet website. If the
facility operates multiple locations and maintains a single Interne t
website, the list required under subsection A of this section shall
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be posted for each location the facility operates in a manner that
clearly associates the list with the applicable location of the
facility.
F. The list required under subsection A of this section shall:
1. Be available:
a. free of charge,
b. without having to establish a user account or
password,
c. without having to submit personal identifying
information, and
d. without having to overcome any other impediment,
including entering a co de to access the list;
2. Be accessible to a common commercial operator of an Internet
search engine to the extent necessary for the search engine to index
the list and display the list as a result in response to a search
query of a user of the search eng ine;
3. Be formatted in a manner prescribed by the State Department
of Health;
4. Be digitally searchable; and
5. Use the following naming convention specified by the Centers
for Medicare and Medicaid Services :
“<ein>_<facility-name>_standardcharges.[js onxmlcsv]”.
G. In prescribing the format of the list under paragraph 3 of
subsection F of this section, the Department shall:
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1. Develop a template that each facility shall use in
formatting the list; and
2. In developing the template under paragraph 1 of this
subsection:
a. consider any applicable federal guidelines for
formatting similar lists required by federal law or
rule and ensure that the design of the template
enables health care researchers to compare the charges
contained in the lists maintain ed by each facility,
and
b. design the template to be substantially similar to the
template used by the Centers for Medicare and Medicaid
Services for purposes similar to those of this act, if
the Department determines that designing the template
in that manner serves the purposes of subparagraph a
of this paragraph and that the Department benefits
from developing and requiring that s ubstantially
similar design.
H. The facility shall update the list required under subsection
A of this section at least once each year. The facility shall
clearly indicate the date on which the list was most recently
updated, either on the list or in a manner that is clearly
associated with the list.
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SECTION 4. NEW LAW A new section of law to be codifie d
in the Oklahoma Statutes as Section 1-725.14 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Except as provided by subsection C of this section, a
facility shall maintain and make publicly available a list of the
standard charges described by subparagraphs b through e of paragraph
2 of subsection C of Section 3 of this act for each of at least
three hundred shoppable services provided by the facility. The
facility may select the shoppable services to be included in the
list, except that the list shall include:
1. The seventy services specified as shoppable services by the
Centers for Medicare and Medicaid Services; or
2. If the facility does not provide all of the shoppable
services described by paragraph 1 of this subsection, as many of
those shoppable services the facility does provide.
B. In selecting a shoppable service for purposes of inclusion
in the list required under subsection A of this section, a facility
shall:
1. Consider how frequently the facility p rovides the service
and the facility’s billing rate for that service; and
2. Prioritize the selection of services that are among t he
services most frequently provided by the facility.
C. If a facility does not provide three hundred shoppable
services, the facility shall maintain a list of the total number of
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shoppable services that the facility provides in a manner that
otherwise complies with the requirements of subsection A of this
section.
D. The list required under subsection A or C of this section,
as applicable, shall:
1. Include:
a. a plain-language description of each shoppable service
included on the list ,
b. the payor-specific negotiated charge that applies to
each shoppable service included on the list and any
ancillary service, listed by the name of the third-
party payor and plan associated with the charge and
displayed in a manner that clearly associates the
charge with the third -party payor and plan ,
c. the discounted cash price that applies to each
shoppable service included on the list and any
ancillary service or, if the fac ility does not offer a
discounted cash price for one or more of the shoppable
or ancillary services on the list, the gross charge
for the shoppable service or ancillary service, as
applicable,
d. the de-identified minimum negotiated charge that
applies to each shoppable service included on the list
and any ancillary service ,
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e. the de-identified maximum negot iated charge that
applies to each shoppable service included on the list
and any ancillary service , and
f. any code used by the facility for purposes o f
accounting or billing for each shopp able service
included on the list and any ancillary serv ice,
including the Current Procedural Terminology (CPT)
code, the Healthcare Common Procedure Coding System
(HCPCS) code, the Diagnosis Related Group (DRG) code,
the National Drug Code (NDC), or other common
identifier; and
2. If applicable:
a. state each location at which the facility provides the
shoppable service and whether the standard charges
included in the list apply at that location to the
provision of that shoppable service in an inpatient
setting, an outpatient department setting, or in both
of those settings, as applicable , and
b. indicate if one or more of the shoppable services
specified by the Centers for Medicare and Medicaid
Services is not provided by the facility.
E. The list required under subsection A or C of this section,
as applicable, shall be:
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1. Displayed in the manner prescribed by subsection E of
Section 3 of this act for the list required under that section;
2. Available:
a. free of charge,
b. without having to register o r establish a user account
or password,
c. without having to submit personal identifying
information, and
d. without having to overcome any other impediment,
including entering a co de to access the lis t;
3. Searchable by service description, billing code, and payor;
4. Updated in the manner prescribed by subsection H of Section
3 of this act for the list required under that section;
5. Accessible to a common commercial operator of an Internet
search engine to the ext ent necessary for the search engine to index
the list and display the list as a result in response to a search
query of a user of the search engine; and
6. Formatted in a manner that is consistent with the format
prescribed by the State Department of Health under paragraph 3 of
subsection F of Section 3 of this act .
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.15 of Title 63, unless
there is created a duplication in numbering, reads as follows:
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Each time a facility upd ates a list as required under subsection
H of Section 3 of this act and paragraph 4 of subsection E of
Section 4 of this act , the facility shall submit the updated list to
the State Department of Health. The Department shall prescribe the
form in which the updated list shall be submitted to the Department.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.16 of Title 63, unless
there is created a duplication in numbering, reads as follo ws:
A. The State Department of Health shall monitor each facility ’s
compliance with the requirements of this act using any of the
following methods:
1. Evaluating complaints made by persons to the Department
regarding noncompliance with this act;
2. Reviewing any analysis prepared regarding noncompliance with
this act;
3. Auditing the Internet websites of facilities for compliance
with this act; and
4. Confirming that each facil ity submitted the lists required
under Section 5 of this act.
B. If the Department determines that a facility is not in
compliance with a pro vision of this act, the Department shall take
the following actions:
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1. Provide a written notice to the facility that clearly
explains the manner in which the facility is not in compliance with
this act;
2. Request a corrective action plan from the facility if the
facility has materially violated a provision of this act, as
determined under Section 7 of this act; and
3. Impose an administrative penalty as determined in Section 8
of this act on the facility and publicize the penalty on the
Department’s Internet website if the facility fails to:
a. respond to the Department’s request to submit a
corrective action plan , or
b. comply with the requirements of a corrective action
plan submitted to the Department.
C. Beginning not later than ninety (90) days after the date of
the enactment of this act, the Department shall create and maintain
a publicly available list on i ts website of hospitals that have been
found to have violated the hospital price transparency rule, that
have been issued an administrative penalty or sent a warning notice,
a request for a corrective action plan, or any other written
communication from th e Department. Such penalties, notices, and
communications shall be subject to public disclosure under 5 U.S.C. ,
Section 552, notwithstanding any exemptions or exclusions to the
contrary, in full without redaction. Such list shall be updated at
least every thirty (30) days thereafter.
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D. Notwithstanding any provision of law to t he contrary, in
considering an application for renewal of a hospital ’s license or
certification, the Department shall consider whether the hospital is
or has been in compliance wit h hospital price transparency laws.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.17 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. A facility materially violates this act if the facility
fails to:
1. Comply with the requirements of Section 2 of this act; or
2. Publicize the facility ’s standard charges in the form and
manner required by Sections 3 and 4 of this act.
B. If the State Department of Health determines that a facility
has materially violated this act, the Department shall issue a
notice of material violation to the facility and request that the
facility submit a corrective action plan. The notice shall indicate
the form and manner in which the corrective action plan shall be
submitted to the Department, and clearly state the date by whic h the
facility shall submit the plan.
C. A facility that receives a notice under subsection B of this
section shall:
1. Submit a corrective actio n plan in the form and manner , and
by the specified date, prescribed by the notice of violation; and
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2. As soon as practicable after submission of a corrective
action plan to the Department, act to comply with the plan.
D. A corrective action plan submit ted to the Department shall:
1. Describe in detail the corrective action th e facility will
take to address any violation identified by the Department in the
notice provided under subsection B of this section ; and
2. Provide a date by which the facility w ill complete the
corrective action described by paragraph 1 of this subsection.
E. A corrective action plan is subject to review and approval
by the Department. After the Department reviews and approves a
facility’s corrective action plan, the Department shall monitor and
evaluate the facility ’s compliance with the plan.
F. A facility is considered to have fai led to respond to the
Department’s request to submit a corrective action plan if the
facility fails to submit a corrective action plan:
1. In the form and manner specified in the notice provided
under subsection B of this section ; or
2. By the date specified in the notice provided under
subsection B of this section .
G. A facility is considered to have failed to comply with a
corrective action plan if the facility fails to address a violation
within the specified period of time contained in the plan.
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SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.18 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. The State Department of Health shall impose an
administrative penalty on a facility in accordance with applicable
law and rules promulgated by the S tate Commissioner of Health if the
facility fails to:
1. Respond to the Department’s request to submit a corrective
action plan; or
2. Comply with the requirements of a corrective action plan
submitted to the Department.
B. The Department shall impose an administrative penalty on a
facility for a violation of each requirement of this act. The
Department shall set the penalty in an amount sufficient to ensure
compliance by facilities with the provisions of this act subject to
the limitations prescribed by subsection C of this section .
C. For a facility with one of the following total g ross
revenues as reported to the Centers for Medicare and Medicaid
Services or to another entity designated by the Commissioner through
rule in the year preceding the year in which a penalty is imposed,
the penalty imposed by the Department shall not be lower than:
1. In the case of thirty or fewer, Six Hundred Dollars
($600.00) for each day in which the hospital fails to comply with
such requirements;
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2. In the case of a hospital with a bed count that is greater
than thirty and equal to or fewer than five hundred fifty, Twenty
Dollars ($20.00) per bed for each day in which th e hospital fails to
comply with such requirements; or
3. In the case of a hospital with a bed count that is greater
than five hundred fifty, Eleven Thousand Dollars ( $11,000.00) for
each day in which the hospit al fails to comply with such
requirements.
D. Each day a violation continues is considered a separate
violation.
E. In determining the amount of the penalty, the Department
shall consider:
1. Previous violations by the facility ’s operator;
2. The seriousness of the v iolation;
3. The demonstrated good faith of the facility ’s operator; and
4. Any other matters as justice may require.
SECTION 9. REPEALER 63 O.S. 2021, Sections 1-725.1, 1-
725.2, 1-725.3, 1-725.4, and 1-725.5, are hereby repealed.
SECTION 10. This act shall become effective November 1, 2024.
59-2-3151 DC 1/17/2024 4:01:28 PM