Req. No. 159 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 60th Legislature (2025) SENATE BILL 889 By: Murdock AS INTRODUCED An Act relating to hospitals; defining terms; requiring hospitals 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 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; authorizing certain compliance monitoring by the State Department of Health; authorizing certain actions for noncompliance; defining material violation; authorizing issuance of certain notice upon certain determination; specifying certain requirements for corrective action plans; prohibiting certain collection actions by noncompliant hospitals; aut horizing certain civil actions; imposing certain requirements on hospitals found noncompliant; providing certain construction ; 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: Req. No. 159 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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, read s as follows: As used in this act: 1. “Ancillary service” means a hospital item or service that a hospital customarily provides as part of a shoppable service; 2. “Chargemaster” means the list of all hospital items or services maintained by a hospital for which the hospital has established a charge; 3. “De-identified maximum negotiated charge ” means the highest charge that a hospital has negotiated with all third -party payors for a hospital item or service; 4. “De-identified minimum negotiated charge ” means the lowest charge that a hospital has negotiated with all third -party payors for a hospital item or service; 5. “Department” means the State Department of Health; 6. “Discounted cash price” means the charge that applies to an individual who pays cash, or a cash equivalent, for a hospital item or service; 7. “Gross charge” means the charge for a hospital item or service that is reflected on a hospital ’s chargemaster, absent any discounts; 8. “Hospital” means a hospital: Req. No. 159 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 a. licensed under Section 1 -702 of Title 63 of the Oklahoma Statutes, or b. owned or operated by a state agency; 9. “Hospital items or services ” means all items and services, including individual items and services and service packages, that may be provided by a hospital to a patient in connection with an inpatient admission or an outpatient department visit, as applicable, for which the hospital has established a standard charge, including: a. supplies and procedures, b. room and board, c. use of the facility and other areas, general ly referred to as facility fees, d. services of physicians and non -physician practitioners, generally referred to as professional charges, and e. any other item or service for wh ich a hospital has established a standard charge; 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 (.CS V) formats; Req. No. 159 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 11. “Payor-specific negotiated charge ” means the charge that a hospital has negotiated with a third -party payor for a hospital item or service; 12. “Service package” means an aggregation of individual hospital 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 e stablished by the hospital for a hospital item or service provided to a specif ic 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 negotiated 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 hospital item or service. SECTION 2. NEW LAW A new secti on 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 hospital shall make public: Req. No. 159 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. A digital file in a machine -readable format that contains a list of all standard charges for all hospital items or services as described by Section 3 of this act; and 2. A consumer-friendly list of standard charges 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 duplication in numbering, reads as follows: A. A hospital shall: 1. Maintain a list of all standard charges for all hospital items or services in accordance with this section; and 2. Ensure the list required under paragraph 1 of this subsection is available at all tim es to the public, including by posting the list electronically in the manner p rovided by this section. B. The standard charges contained in the list required to be maintained by a hospital under subsection A of this section shall reflect the standard char ges applicable to that location of the hospital, regardless of whether the hospital operates in more than one location or operates under the same license as another hospital. C. The list required under subsection A of this section shall include the following items, as applicable: 1. A description of each hospital item or service p rovided by the hospital; Req. No. 159 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. The following charges for each individual hospital item or service when provided in either an inpatient setting or an outpatient department setting, as applicable: a. the gross charge, b. the de-identified minimum negotiated 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 hospital for purposes of accounting or billing for the hospital item or service, including the Cu rrent 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. 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 hospital ’s publicly accessible Internet website. If the hospital operates multiple locations and maintains a single Internet website, the list required Req. No. 159 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 under subsection A of this section shall be posted for each location the hospital operates in a manner that clearly associates the list with the applicable location of the hospital. F. The list required under subsectio n A of this section shall: 1. Be available: a. free of charge, b. without having to establish a user account or password, and c. without having to submit personal identifying information; 2. Be digitally searchable; and 3. Use the Centers for Medicare and Medicaid Services naming convention specified under 45 C.F.R., Section 180.50 . G. The hospital shall update the list required under subsection A of this section at least once each year. The hospital shall clearly indicate the date on which the list wa s most recently updated, either on the list or in a manner that is clearly associated with the list. 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 hospital shall maintain and make publicly available a list of the standard charges described by Section 3 of this act for each of at Req. No. 159 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 least three hundred shoppable services provided by the hospital. The hospital 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 hospital does not provide all of the shoppable services described by paragraph 1 of this subsection, as many of those shoppable services the hospita l does provide. B. In selecting a shoppable service for purposes of inclusion in the list required under subsection A of this section, a hospital shall consider how frequently the hospital provides the service and the hospital’s billing rate for that serv ice. C. If a hospital does not provide three hundred shoppable services, the hospital shall maintain a list of the total number of shoppable services that the hospital provides in a manner that otherwise complies with the requirements of subsection A of t his 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 Req. No. 159 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 a ny ancillary service or, if the hospital 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, e. the de-identified maximum negotiated charge that applies to each shop pable service included on the list and any ancillary service, and f. any code used by the hospital for purposes of accounting or billing for each shoppable service included on the list and any ancillary service, including the Current Procedural Terminology (CPT) code, the Healthcare Common Procedure Coding System (HCPCS) code, the Diagnosis Related Group (DRG) code, Req. No. 159 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 the National Drug Code (NDC), or other common identifier; and 2. If applicable: a. state each location at which the hospital provides the shoppable service and whether the standard charges included in the list apply at t hat 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 hospital. E. The list required under subsection A or C of this section, as applicable, shall be: 1. Displayed in the manner prescrib ed by subsection E of Section 3 of this act for the list required under that s ection; 2. Available: a. free of charge, b. without having to register or establish a user account or password, and c. without having to submit personal identifying information; 3. Searchable by service description, billing code, and payor; and Req. No. 159 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 4. Updated in the manner prescribed by subsection G of Section 3 of this act for the list required under that section. F. Notwithstanding any other provision of this section, a hospital is considered to meet the requirements of this section if the hospital maintains, as determined by the State Department of Health, an Internet-based price estimator tool that: 1. Provides a cost estimate for each shoppable service and any ancillary service included on the list maintained by the hospital under subsection A of this section; 2. Allows a person to obtain an estimate of the amount the person will be obligated to pay the hospital if the person elects to use the hospital to provide the service; and 3. Is: a. prominently displayed on the hospital ’s publicly accessible Internet website, and b. accessible to the public: (1) without charge, and (2) without having to register or establish a user account or password. 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: Req. No. 159 Page 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 A. The State Department of Health may monitor each hospital ’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; and 3. Auditing the Internet websites of hospitals for compliance with this act. B. If the Department determines that a hospital is not in compliance with a provision of this act, the Department may take any of the following actions: 1. Provide a written notice to the hosp ital that clearly explains the manner in which the hospital is not in complian ce with this act; 2. Request a corrective action plan from the hospital if the hospital has materially violated a provision of this act, as determined under Section 6 of this act; and 3. Impose an administrative penalty on the hospital and publicize the penalty on the Department ’s Internet website if the hospital fails to: a. respond to the Department ’s request to submit a corrective action plan, or Req. No. 159 Page 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. comply with the requiremen ts of a corrective action plan 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 a s follows: A. A hospital materially violates this act if the hospital fails to publicize: 1. Pricing information as required by Section 2 of this act; or 2. The hospital’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 hospital has materially violated this act, the Department may issue a notice of material violation to the hospital and request that the hospital submit a corrective action plan. The notice shall ind icate the form and manner in which the corrective action plan shall be submitted to the Department, and clearly state the date by which the hospital shall submit the plan. C. A hospital that receives a notice under subsection B of this section shall: 1. Submit a corrective action plan in the form and manner, and by the specified date, prescribed by the notice of violation; and 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 submitted to the Department shall: Req. No. 159 Page 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1. Describe in detail the corrective action the hospital 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 hospital will complete the corrective action described by parag raph 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 hospital’s corrective action plan, the Department shall monitor and evaluate the hospital ’s compliance with the plan. F. A hospital is considered to have failed to respond to the Department’s request to submit a corrective action plan if the hospital 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 hospital is considered to have failed to comply with a corrective action plan if the hospital fails to address a violation within the specified period of time contained in the plan. 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 follow s: A. A hospital that is not in material compliance with this act on the date that items or services are purchased from or provided to Req. No. 159 Page 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 a patient by the hospital shall not initia te or pursue collection action against the patient or patient guarantor for a debt owed for the items or services. B. If a patient believes that a hospital was not in material compliance with this act on a date on or after the effective date of this act that items or services were purchased by or provided to the patient, and the hospital takes a collection action against the patient or patient guarantor, the patient or patient guarantor may file suit to determine if the hospital was materially out of compliance with this act on the date of service and if the noncompliance is related to the items or services. The hospital shall not take a collection action against the patient or patient guarantor while the lawsuit is pending. C. A hospital that has been fo und by a judge or jury to be materially out of compliance with this act: 1. Shall refund the payor any amount of the debt the pay or has paid and shall pay a penalty to the patient or patient guarantor in an amount equal to the total amount of the debt; 2. Shall dismiss or cause to be dismissed any court action with prejudice and pay any reasonable attorney fees and costs incurred by the patient or patient guarantor relating to the action; and 3. Shall remove or cause to be removed from the patient ’s or patient guarantor’s credit report any report made to a consumer reporting agency relating to the debt. Req. No. 159 Page 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 D. Nothing in this act: 1. Prohibits a hospital from billing a patient, patient guarantor, or third-party payor, including a health insurer, for items or services provided to the patient; or 2. Requires a hospital to refund any payment made to the hospital for items or services provided to the patient, as long as no collection action is taken in violation of this act. SECTION 8. 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 9. This act shall become effective November 1, 2025. 60-1-159 DC 1/16/2025 10:38:08 AM