Bill > SB1646

This bill requires health insurance plans in Oklahoma to cover medically necessary treatment for mental health and substance use disorders, defining "medically necessary treatment" as care that aligns with generally accepted standards, is clinically appropriate, and not solely for convenience or economic benefit. It prohibits health plans from limiting coverage for chronic or pervasive mental health and substance use disorders to short-term or acute treatment, and mandates that any utilization review, which is the process of a health plan approving, denying, or modifying requests for coverage, must adhere to these generally accepted standards, with denials and appeals reviewed by professionals of equal standing to the requesting provider. The bill also clarifies that health plans cannot retroactively change or deny payment for authorized treatments if the provider acted in good faith, must comply with out-of-network care requirements if in-network services aren't available, and must provide "meaningful benefits" for mental health and substance use disorders comparable to those for medical and surgical conditions across all benefit classifications. Furthermore, it prevents health plans from enforcing policies that undermine these requirements and empowers the Insurance Commissioner to create rules and assess penalties for violations, with the law taking effect on January 1, 2027.

Budget and Finance, Business and Industry

http://www.oklegislature.gov/BillInfo.aspx?Bill=sb1646&Session=2600