Bill
Bill > SB1264
OK SB1264
OK SB1264Health insurance; requiring coverage of certain genetic testing and cancer imaging. Effective date.
summary
Introduced
02/05/2024
02/05/2024
In Committee
04/11/2024
04/11/2024
Crossed Over
03/18/2024
03/18/2024
Passed
Dead
05/31/2024
05/31/2024
Introduced Session
2024 Regular Session
Bill Summary
health insurance - coverage - exclusions - codification - effective date ] AUTHOR: Add the following House Coauthors: Provenzano, Munson, Townley, Baker, and West (Tammy) AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill and insert: "[ health insurance - genetic testing - cancer imaging - coverage - exclusions - codification - 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 duplication 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 multi-gene testing for an inherited mutation associated with an increased risk of cancer; 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 coverage 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 medical 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 level 2a or higher, b. Centers for Medicare and Medicaid Services national 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 provides clinical utility and when ordered or recommended by a health care provider in accordance with the most recent version of the NCCN clinical practice recommendations that are level 2a or higher, or in accordance with other nationally recognized clinical practice guidelines. C. Coverage under this section shall not be subject 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 result in health savings account ineligibility under Section 223 of the federal Internal Revenue Code, as amended, the provisions of this section shall only apply to health savings accounts with qualified high deductible health plans with respect to the deductible 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 federal Internal Revenue Code, as amended, regardless of whether the minimum deductible has been satisfied. SECTION 2. This act shall become effective November 1, 2024." Passed the House of Representatives the 17th day of April, 2024. Presiding Officer of the House of Representatives Passed the Senate the ____ day of __________, 2024. Presiding Officer of the Senate ENGROSSED SENATE BILL NO. 1264 By: Stanley of the Senate and Miller of the House [ health insurance - coverage - exclusions - codification - effective date
AI Summary
This bill requires health benefit plans in Oklahoma, including the Oklahoma Employees Insurance Plan, to provide coverage for certain genetic testing and cancer imaging services. Specifically, it mandates coverage for clinical genetic testing for inherited gene mutations associated with increased cancer risk, as well as evidence-based cancer imaging for individuals at increased cancer risk, when ordered or recommended by a healthcare provider in accordance with recognized medical guidelines. The bill also prohibits the application of annual deductibles, copayments, or coinsurance limits for these covered services. The provisions of the bill are set to take effect on November 1, 2024.
Committee Categories
Budget and Finance, Health and Social Services, Labor and Employment
Sponsors (12)
Nicole Miller (R)*,
Brenda Stanley (R)*,
Rhonda Baker (R),
Jon Echols (R),
Andy Fugate (D),
Cyndi Munson (D),
Melissa Provenzano (D),
Trish Ranson (D),
Marilyn Stark (R),
Amanda Swope (D),
Tammy Townley (R),
Tammy West (R),
Last Action
Enacting clause restored (on 05/28/2024)
Bill Topics
Health
- ‐ Disease Prevention
- ‐ Health Insurance Reform
- ‐ Treatment of Specific Diseases
Official Document
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