Bill > SB1047

This bill, known as the Oklahoma Surprise Medical Billing Act, aims to protect patients from unexpected high medical bills in certain situations. The legislation defines a "surprise bill" as a charge from an out-of-network healthcare provider or facility that exceeds a patient's normal cost-sharing obligations, specifically for emergency care or non-emergency services provided at an in-network facility. Under the bill, out-of-network providers are prohibited from surprise billing patients for emergency care or services at in-network facilities. Health insurance carriers must directly reimburse out-of-network providers at the "minimum benefit standard" (defined as the 80th percentile of allowed amounts for similar services) and ensure that patients pay no more than they would for in-network services. If an out-of-network provider bills a patient more than allowed, they must refund the excess amount within 30 days. The bill also establishes a verification process through the Insurance Commissioner to confirm reimbursement amounts, with potential penalties for carriers that underpay. If a carrier fails to reimburse at the minimum benefit standard, they may be subject to a penalty split between the healthcare provider and the Oklahoma Health Insurance High Risk Pool. The act is set to become effective on November 1, 2025, providing a comprehensive framework to protect patients from unexpected medical billing practices.

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http://www.oklegislature.gov/BillInfo.aspx?Bill=sb1047&Session=2600