Bill > SB1953

This bill, known as the Employer Health Plan Transparency Act, aims to increase transparency and accountability in health insurance contracts for employers and their employees. It prohibits health plans from entering into contracts that restrict access to crucial claims and encounter data, which includes information about payments and medical records, for a period longer than fifteen days after a request. The act also prevents contracts from limiting the volume of data that can be audited or disclosed, including payment arrangements, fees, and information about overpayments, and it ensures that health plans can select their own auditors and conduct audits at least monthly. Furthermore, it forbids contracts from prohibiting or penalizing health plans for making de-identified or aggregate disclosures of information that comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a federal law that sets standards for protecting sensitive patient health information. Any contract violating these provisions will be considered void. The bill also mandates that health insurance issuers and providers must share information in a way that aligns with HIPAA's privacy and security rules, and regulated health plans receiving this information must also adhere to HIPAA privacy regulations. It requires claims to be submitted in standardized electronic formats, with unmodified copies of original files provided to health plans at no cost, and all non-claim costs must be itemized and accessible through various digital means. Health insurance issuers and providers must also submit an annual declaration to the Insurance Department confirming their compliance with the act, and the Insurance Commissioner is empowered to assess civil penalties, issue orders, and take action against licenses for violations, while also prohibiting retaliation against those who report violations.

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http://www.oklegislature.gov/BillInfo.aspx?Bill=sb1953&Session=2600