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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
SENATE BILL 1918 By: Bullard
AS INTRODUCED
An Act relating to health insurance claims; defining
terms; prohibiting health benefit plans from
disallowing direct payment for covered services;
requiring certain discounted prices to be deemed full
payment; providing direct payment be applied to
deductible and out-of-pocket expense subject to
certain procedures; d irecting publication of certain
procedures on certain website; prohibiting certain
contract terms; providing for codification; and
providing an effecti ve date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes a s Section 6060.50 of Title 36, unless
there is created a duplication in numbering, reads as follows:
A. As used in this section:
1. “Health benefit plan” means a health benefit plan as defined
pursuant to Section 6060.4 of Title 36 of the Oklahoma Statut es; and
2. “Health care provider ” means any physician, dentist,
pharmacist, optometrist, psychologist, registered optician, licensed
professional counselor, physical therapist, chiropractor, hospital ,
or other entity or person that is licensed or otherwis e authorized
in this state to furnish health care services .
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B. 1. No health benefit plan may prohibit a health care
provider from accepting directly from an enrollee f ull payment for a
health care service in lieu of submitting a claim to the enrollee ’s
health benefit plan.
2. For purposes of this subsection, the discounted cash price
for services rendered from a health care provider is considered full
payment.
C. Payment for a health care service made pursuant to
subsection B of this section shall be applied toward the enrollee ’s
deductible and annual maximum out -of-pocket expense if the service
is a medically necessary covered serv ice under the health plan.
D. 1. A health benefit plan that is offered, i ssued, or
renewed in this state shall e stablish a procedure for enrollees to
claim credit for any direct payment made for a cove red health care
service under this section and identify any necessary documentation
to be submitted with a claim for credi t.
2. Information about the procedur e and necessary documentation
described in paragraph 1 of this su bsection shall be readily
available to the enrollee on the health benefit plan ’s website.
E. No requirement of this section may be waived, v oided, or
nullified by contract.
SECTION 2. This act shall become effective November 1, 2024.
59-2-2372 RD 1/18/2024 11:25:18 AM