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 2nd Session of the 60th Legislature (2026)
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3 SENATE BILL 1559 By: McIntosh
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6 AS INTRODUCED
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7 An Act relating to the state Medicaid program;
7 defining term; requiring the Oklahoma Health Care
8 Authority to conduct certain pilot program;
8 describing pilot program; stipulating certain
9 requirements related to contracts; requiring certain
9 competitive bidding process; providing certain
10 qualifications for direct primary care providers;
10 requiring certain annual reports; providing for
11 codification; and providing an effective date.
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14 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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15 SECTION 1. NEW LAW A new section of law to be codified
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16 in the Oklahoma Statutes as Section 1011.16 of Title 56, unless
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17 there is created a duplication in numbering, reads as follows:
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18 A. As used in this section, "direct primary care provider" has
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19 the same meaning as provided in Section 4605 of Title 36 of the
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20 Oklahoma Statutes.
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21 B. The Oklahoma Health Care Authority shall conduct a pilot
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22 program to test a direct primary care model for members of the state
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23 Medicaid program as provided in this section. The pilot program
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24 shall:
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Req. No. 2385 Page 1
1 1. Operate for a period of thirty-six (36) months, beginning no
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2 later than six (6) months following the effective date of this act;
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3 2. Serve a cohort of up to one thousand Medicaid beneficiaries;
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4 3. Include one or more direct primary care providers, selected
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5 based on criteria established by the Authority; and
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6 4. Utilize per-member-per-month payments to direct primary care
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7 providers and quality benchmarks compliant with federal regulations
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8 to promote value-based care.
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9 C. Contracts entered into for the pilot program established
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10 under this section shall:
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11 1. Be executed directly between the Oklahoma Health Care
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12 Authority and one or more direct primary care providers, independent
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13 of capitated contracts entered into by the Authority and contracted
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14 entities under the Ensuring Access to Medicaid Act;
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15 2. Specify:
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16 a. the primary care services to be provided,
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17 b. the target populations to be served,
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18 c. the terms of per-member-per-month payments for direct
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19 primary care providers, and
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20 d. quality benchmarks to ensure accountability and
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21 performance; and
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22 3. Be compliant with federal regulations including 42 C.F.R.,
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23 Part 438.
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Req. No. 2385 Page 2
1 D. 1. The Authority shall establish a competitive bidding
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2 process to select direct primary care providers for the pilot
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3 program. The selection process shall account for the distinct
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4 operational model of direct primary care, facilitating effective
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5 integration of direct primary care into the Medicaid framework.
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6 2. To qualify for the pilot program, a direct primary care
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7 provider shall meet federal enrollment and quality standards as
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8 provided in 42 C.F.R., Section 455.410 and 42 C.F.R., Part 438, with
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9 credentialing processes tailored to accommodate the noninsurance
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10 framework of direct primary care.
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11 E. During the operation of and at the conclusion of the pilot
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12 program, the Authority shall electronically submit annual reports to
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13 the President Pro Tempore of the Senate, the Speaker of the House of
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14 Representatives, and the Governor detailing:
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15 1. Access to primary care services;
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16 2. Patient satisfaction;
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17 3. Clinical outcomes;
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18 4. Cost outcomes; and
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19 5. Recommendations for policy changes, particularly regarding
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20 the integration of direct primary care models into the state
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21 Medicaid program.
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22 SECTION 2. This act shall become effective November 1, 2026.
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24 60-2-2385 DC 1/12/2026 6:45:16 PM
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Req. No. 2385 Page 3Every fact on this page links to its source, starting with the official bill record.