Shown verbatim: the complete text as captured from the official PDF posted by the Oklahoma Legislature, fetched 2026-07-23. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
1 STATE OF OKLAHOMA
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2 1st Session of the 60th Legislature (2025)
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3 SENATE BILL 1067 By: Rosino
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6 AS INTRODUCED
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7 An Act relating to ambulances; amending Sections 2
7 and 3, Chapter 356, O.S.L. 2024 (36 O.S. Supp. 2024,
8 Sections 6050.2 and 6050.3), which relate to the Out-
8 of-Network Ambulance Service Provider Act; modifying
9 definitions; modifying reimbursement rates for
9 certain ambulance services; updating statutory
10 language; and providing an effective date.
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13 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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14 SECTION 1. AMENDATORY Section 2, Chapter 356, O.S.L.
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15 2024 (36 O.S. Supp. 2024, Section 6050.2), is amended to read as
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16 follows:
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17 Section 6050.2. As used in the Out-of-Network Ambulance Service
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18 Provider Act:
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19 1. "Ambulance service provider" means an ambulance service as
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20 defined by Section 1-2503 of Title 63 of the Oklahoma Statutes
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21 except that, for the purposes of this act, the term shall be limited
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22 to an ambulance service provider that provides ground transportation
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23 services;
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Req. No. 532 Page 1
1 2. "Covered ambulance services" means those unscheduled and
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2 emergency ground ambulance services which an enrollee is entitled to
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3 receive under the terms of a health care benefit plan;
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4 3. "Enrollee" means a person who is entitled to receive covered
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5 ambulance services under the terms of a health care benefit plan;
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6 4. "Health care benefit plan" means a plan, policy, contract,
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7 certificate, agreement, or other evidence of coverage for health
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8 care services offered, issued, renewed, or extended in this state by
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9 a health care insurer, or government-sponsored self-insured plans.
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10 Health care benefit plan does not include any health plan offered by
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11 a contracted entity as defined in Section 4002.2 of Title 56 of the
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12 Oklahoma Statutes that provides coverage to members of the state
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13 Medicaid program;
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14 5. "Health care insurer" means an entity that is subject to
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15 state insurance regulation and provides coverage for health benefits
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16 in this state and includes the following:
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17 a. an insurance company,
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18 b. a health maintenance organization,
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19 c. a hospital and medical service corporation,
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20 d. a risk-based provider organization, or
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21 e. a sponsor or self-funded plan.
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22 Health care insurer does not include a contracted entity as defined
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23 in Section 4002.2 of Title 56 of the Oklahoma Statutes that provides
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24 coverage to members of the state Medicaid program;
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Req. No. 532 Page 2
1 6. "Out-of-network" means a provider that does not contract
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2 with the health care insurer of the enrollee receiving the covered
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3 ambulance services; and
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4 7. "Clean claim" means a claim that has no defect of
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5 impropriety, including any lack of required substantiating
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6 documentation or particular circumstances requiring special
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7 treatment that prevents timely payment from being made on the claim.
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8 SECTION 2. AMENDATORY Section 3, Chapter 356, O.S.L.
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9 2024 (36 O.S. Supp. 2024, Section 6050.3), is amended to read as
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10 follows:
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11 Section 6050.3. A. The minimum allowable reimbursement rate
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12 under any health care benefit plan issued by a health care insurer
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13 to an out-of-network ambulance service provider for providing
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14 covered ambulance services shall be at the rates set or approved,
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15 whether in contract or ordinance, by a local governmental entity in
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16 the jurisdiction in which the covered ambulance services originate.
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17 B. In the absence of the rates as provided in subsection A of
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18 this section, the rate shall be the lesser of:
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19 1. Three hundred twenty-five percent (325%) of the current
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20 published rate for ambulance services as established by the Centers
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21 for Medicare and Medicaid Services under Title XVIII of the Social
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22 Security Act for the same services provided in the same geographic
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23 area; or
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24 2. The ambulance service provider's billed charges.
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1 C. B. Payment made in compliance with this section shall be
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2 considered payment in full for the covered ambulance services
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3 provided, except for any copayment, coinsurance, deductible, and
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4 other cost-sharing feature amounts required to be paid by the
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5 enrollee. An ambulance service provider is prohibited from billing
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6 the enrollee for any additional amounts for the paid covered
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7 ambulance services in excess of what the health care insurer pays.
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8 D. C. All copayments, coinsurance, deductible, and other cost-
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9 sharing feature amounts provided by applicable to amounts calculated
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10 in accordance with subsection A of this section shall not exceed the
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11 in-network copayment, coinsurance, deductible, and other cost-
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12 sharing features for the covered ambulance services received by the
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13 enrollee.
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14 E. D. In administering and paying claims, a health care insurer
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15 shall comply with Section 1219 of Title 36 of the Oklahoma Statutes.
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16 SECTION 3. This act shall become effective January 1, 2026.
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18 60-1-532 CAD 1/16/2025 3:02:45 PM
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Req. No. 532 Page 4Every fact on this page links to its source, starting with the official bill record.