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STATE OF OKLAHOMA
1st Session of the 60th Legislature (2025)
HOUSE BILL 2270 By: Miller
AS INTRODUCED
An Act relating to health insurance; defining terms;
requiring coverage of certain genetic testing and
cancer imaging; specifying terms o f coverage;
providing exclusions; providing for codification; and
providing an effective 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 as Section 6060.5b of Title 36, unless
there is created a dupl ication in numbering, reads as follows:
A. For the purposes of this section:
1. "Clinical utility" means clinical utility as defined
pursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes;
2. "Evidence-based cancer imaging " means appropriate
preventative screening and imaging supported by evidence;
3. "Genetic testing for an inherited mutation " means multigene
testing for an inherited mutation associated with an incr eased risk
of cancer;
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4. "Health benefit plan" means a health benefit plan as defined
pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; and
5. "Health care provider " means any physician, hospital, or
other entity or person that is licensed or otherwise authorized in
this state to furnish health care services.
B. Any health benefit plan including the Oklahoma Employees
Insurance Plan that is offered, issued, or renewed in this state on
or after the effective date of this act shall provide c overage for:
1. Clinical genetic testing for an inherited gene mutation for
individuals with a personal or family history of cancer when such
test provides clinical utility and when ordered or recommended by a
health care provider in accordance with medic al and scientific
evidence including, but not limited to:
a. the most recent version of the National Comprehensive
Cancer Network (NCCN) clinical practice
recommendations that are Category 2A or higher,
b. Centers for Medicare and Medicaid Services nationa l
coverage determinations or Medicare administrative
contractor local coverage determinations, or
c. nationally recognized clinical practice guidelines;
and
2. Evidence-based cancer imaging for individuals with an
increased risk of cancer when such test p rovides clinical utility
and when ordered or recommended by a health care provider in
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accordance with the most recent version of the NCCN clinical
practice recommendations that are Category 2A or higher, or in
accordance with other nationally recognized cl inical practice
guidelines.
C. Coverage under this section shall not be subje ct to any
annual deductibles, copayments, or coinsurance limits as established
for all covered benefits under the health benefit plan.
D. If application of this section would re sult in health
savings account ineligibility under Section 223 of the Internal
Revenue Code of 1986, as amended, the provisions of this section
shall only apply to health savings accounts with qualified high
deductible health plans with respect to the dedu ctible of such a
plan after the enrollee has satisfied the minimum deductible.
Provided, however, the provisions of this section shall apply to
items or services that are preventive care pursuant to Section
223(c)(2)(C) of the Internal Revenue Code of 198 6, as amended,
regardless of whether the minimum deductible has been satisfied.
SECTION 2. This act shall become effective November 1, 2025.
60-1-10929 TJ 12/28/24