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SENATE FLOOR VERSION
March 6, 2025
AS AMENDED
SENATE BILL NO. 1096 By: Frix and Coleman of the
Senate
and
Tedford of the House
An Act relating to health benefit plan legislation;
defining terms; requiring assignment of certain
legislation to certain committees; requiring analysis
of certain legislation by the Insurance Department
following certain majority vote; prohibiting
advancement of certain legislation; directing
furnishing of report; specifying report contents;
allowing Department to co ntract with certain third
parties for report production; providing for
exceptions to act; limiting amount of reports to be
conducted; requiring transmission and publication of
report; 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 601 3 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. For the purposes of this act:
1. “Bureau” means the Legislative Service Bureau;
2. “Department” means the Insurance Department;
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3. “Health benefit plan” means a health benefit plan as defined
pursuant to Section 6060.4 of Title 36 of the Okla homa Statutes;
4. “Legislative actuary” means the person who, or firm or
entity that, enters into a contract with the Legislative Service
Bureau pursuant to Section 452.15 of Title 74 of the Oklahoma
Statutes to provide the actuarial services and other duties provide d
for in this act; and
5. “Mandate” means any bill or joint resolution introduced or
amended by a member or a committee of the Legislature that:
a. provides, offers, or expands coverage for specific
health care services or providers, treatment s, medical
supplies, or populations, or
b. implements operational or administrative processes
such as prior authorization, reporting requirements,
or claims procedures related to providing, offering,
or expanding coverage as set forth in subparagraph a
of this paragraph.
B. When a bill providing for a mandate impacting any health
benefit plan in this state is introduced, it shall be assigned to
the respective Senate or House of Representatives standing committee
or subcommittee that is primarily responsibl e for the consideration
of insurance legislation.
C. If a majority of the committee votes in favor of an impact
analysis of the bill, an analysis shall be required as provided in
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this act. If a majority of the total membership of such committee
is opposed to the bil l or should such bill not receive a hearing in
such committee, no impact analysis shall be necessary.
D. Except as otherwise provided by subsections B and D of
Section 2 of this act, no bill providing for a mandate impacting any
health benefit plan in this state may be reported out of the
committee to which it is assigned or may be considered or adopted by
the House of Representatives or the Senate unless an impact analysis
of the bill is requested in accordance with Section 2 of this act.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 601 4 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. When a committee of the Legislature votes to submit a bill
providing for a mandate impacting any health benefit plan in this
state for an impact analysis as provided for in Section 1 of this
act, the Legislative Service Bureau shall submit the bill to the
Insurance Department for the purposes of conducting an impact
analysis.
B. 1. When conducting such impact analysis, the Department
shall analyze the proposed mandate and prepare a written report to
be returned to the Legislative Service Bureau within sixty (60) days
from referral.
2. Such report shall inc lude, but not be limited to:
a. social impact, including:
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(1) the extent to which the mandate addresses a
significant public health issue,
(2) the number of individuals and demographics
affected by the proposed mandate, and
(3) any anticipated impact on access to heal th care
services,
b. medical efficacy, including:
(1) a review of peer-reviewed studies, clinical
guidelines, and other scientific evidence
evaluating the effectiveness of the treatment or
service, and
(2) input from medical experts and profess ional
organizations as appropriate , and
c. financial impact, including:
(1) the estimated effect on insurance premiums for
consumers and employers,
(2) the potential cost implications for insurers,
health care providers, and state -funded programs
that provide payment for covered services, and
(3) any anticipated impact on the stability of the
state’s insurance market.
3. The Department may contract with a third -party vendor who
specializes in actuarial services, insurance mandate reviews, or
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other services as deemed necessary by the Department to implement
the provisions of this act.
4. The Department may seek the input and expertise of any
agency of this state to evaluate the potential impact to state -
funded programs that provide payment for covered services.
C. Any amendment, conference committee report, or other
legislative proposal to a bill providing for a mandate impacting
health benefit plans in this state, which has not been submitted by
the Bureau for analysis following a majority vote of the comm ittee
to which the bill is assigned, may, following written request of the
chair of the committee to which the bill is assigned or the Majority
Floor Leader of the respective chamber of the Legislature, be
submitted by the Bureau to the Department for review.
D. The Bureau shall not submit more than five (5) referrals for
analysis to the Department per fiscal year. Any additional referral
for analysis must be approved by the Department in writing at the
discretion of the Insurance Commissioner before subm ission by the
Bureau.
E. Upon return of the analysis by the Department, the Bureau
shall provide a copy by electronic means to the author of the
legislative measure, and to the chair of the legislative
committee(s) to which the measure is assigned. The applicable
legislative staff shall make such report available on the
legislative website.
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SECTION 3. This act shall become effective November 1, 2025.
COMMITTEE REPORT BY: COMMITTEE ON BUSINESS AND INSURANCE
March 6, 2025 - DO PASS AS AMENDED