Bill > SB787

This bill establishes the Oklahoma Health Care Cost Containment and Affordability Act, which introduces significant regulations for healthcare pricing and insurance in Oklahoma. The legislation limits total payments to healthcare providers for hospital services to either 200% of Medicare/Medicaid rates or the median amount paid by health benefit plans, whichever is less. Healthcare providers are prohibited from charging patients more than authorized cost-sharing amounts, and the total payment cannot exceed the specified limits. The bill requires healthcare providers and insurance carriers to provide detailed information to state departments for transparency and monitoring purposes, with strict confidentiality protections. The Insurance Department and State Department of Health are granted authority to audit healthcare providers and insurers, impose penalties for non-compliance (including refunds and financial penalties up to $1,000), and promulgate regulations to implement the act. Additionally, the bill mandates that insurance rate filings be reviewed with considerations such as affordability, medical trends, inflation indices, and the ability of lower-income individuals to pay for health insurance. The act is set to become effective on November 1, 2025, and aims to make healthcare more affordable and accessible for Oklahoma residents by introducing stringent cost containment measures.

Health and Social Services

http://www.oklegislature.gov/BillInfo.aspx?Bill=sb787&Session=2600