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1 STATE OF OKLAHOMA
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2 2nd Session of the 60th Legislature (2026)
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3 SENATE BILL 1626 By: Frix
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5 AS INTRODUCED
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6 An Act relating to health insurance; defining terms;
6 prohibiting certain contracts that include certain
7 provisions; establishing violations that constitute
7 an unfair or deceptive act; allowing for certain
8 party to submit certain waiver to the Insurance
8 Commissioner; creating certain waiver; requiring
9 Commissioner to approve or deny certain waiver within
9 certain time period; establishing certain
10 requirements to approve certain waiver; establishing
10 certain contracts as null and void; allowing the
11 Attorney General to subpoena certain records;
11 allowing the Attorney General to institute certain
12 proceedings; subjecting certain records and papers to
12 inspection by the Commissioner; allowing Commissioner
13 to require certain health insurance carrier to
13 produce certain list; allowing Commissioner to impose
14 certain administrative penalty; allowing Commissioner
14 to deny sale of certain health insurance plan;
15 allowing Commissioner to refer certain contract to
15 the Attorney General; prohibiting certain changes to
16 privacy protections and standards; prohibiting
16 certain limitation of network; authorizing
17 Commissioner to promulgate rules and regulations;
17 providing for codification; and providing an
18 effective date.
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21 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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22 SECTION 1. NEW LAW A new section of law to be codified
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23 in the Oklahoma Statutes as Section 366 of Title 36, unless there is
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24 created a duplication in numbering, reads as follows:
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Req. No. 2456 Page 1
1 A. As used in this section:
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2 1. "All-or-nothing clause" means a provision of a health care
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3 contract that requires the health insurance carrier or health plan
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4 administrator to include all members of a health care provider in a
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5 network plan or requires the health insurance carrier or health plan
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6 administrator to enter into any additional contract with an
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7 affiliate of the health care provider as a condition of entering
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8 into a contract with such health care provider;
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9 2. "Anti-steering clause" means a provision of a health care
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10 contract that restricts the ability of the health insurance carrier
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11 or health plan administrator to encourage an enrollee to obtain a
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12 health care service from a competitor of the hospital or health
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13 system, or the ability to offer incentives to encourage enrollees to
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14 utilize specific health care providers;
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15 3. "Anti-tiering clause" means a provision in a health care
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16 contract that restricts the ability of the health insurance carrier
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17 or health plan administrator to introduce or modify a tiered network
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18 plan or assign health care providers into tiers or requires the
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19 health insurance carrier or health plan administrator to place all
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20 members of a health care provider in the same tier of a tiered
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21 network;
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22 4. "Enrollee" means an individual who is entitled to receive
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23 health care services under the terms of a health benefit plan;
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1 5. "Gag clause" means a provision of a health care contract
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2 that restricts the ability of either the health insurance carrier,
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3 health plan administrator, or provider to disclose:
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4 a. any price or quality information, including the
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5 allowed amount, negotiated rates or discounts, any
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6 fees for services, or any other claim-related
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7 financial obligations included in the provider
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8 contract, to a governmental entity as authorized by
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9 law or its contractors or agents, any enrollee,
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10 treating provider, plan sponsor, or potential eligible
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11 enrollee and plan sponsor, or
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12 b. out-of-pocket costs to an enrollee;
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13 6. "Health benefit plan" means the same as defined in Section
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14 6060.4 of Title 36 of the Oklahoma Statutes;
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15 7. "Health care contract" means a contract, agreement, or
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16 understanding, entered into, amended, restated, or renewed either
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17 orally or in writing between a health care provider and a health
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18 insurance carrier, health plan administrator, plan sponsor, or its
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19 contractors or agents for the delivery of health care services to an
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20 enrollee of a health benefit plan;
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21 8. "Health care provider" means an entity, corporation,
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22 organization, parent corporation, member, affiliate, subsidiary, or
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23 entity under common ownership, whether for-profit or nonprofit, that
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24 is or whose members are licensed or otherwise authorized by this
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1 state to furnish, bill, or receive payment for health care service
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2 delivery in the normal course of business, and includes health
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3 systems, hospitals, hospital-based facilities, freestanding
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4 emergency facilities, imaging centers, large physician groups with
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5 eight or more physicians, physician staffing organizations, and
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6 urgent care clinics;
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7 9. "Health insurance carrier" means the same as defined in
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8 Section 6592 of Title 36 of the Oklahoma Statutes;
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9 10. "Health plan administrator" means a third-party
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10 administrator who acts on behalf of a plan sponsor to administer a
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11 health benefit plan;
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12 11. "Most-favored-nations clause" means a provision of a health
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13 care contract that:
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14 a. prohibits or grants a health insurance carrier or
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15 health plan administrator an option to prohibit a
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16 participating health care provider from contracting
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17 with another contracting entity to provide health care
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18 services at the same or a lower price than the payment
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19 specified in the health care contract,
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20 b. requires or grants a health insurance carrier or
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21 health plan administrator an option to require a
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22 participating health care provider to accept a lower
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23 payment in the event the participating health care
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1 provider agrees to provide health care services to
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2 another contracting entity at a lower price,
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3 c. requires or grants a health insurance carrier or
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4 health plan administrator an option to require
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5 termination or renegotiation of an existing health
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6 care contract if a participating health care provider
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7 agrees to provide health care services to another
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8 contracting entity at the same or a lower price, or
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9 d. restricts other health insurance carriers or health
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10 plan administrators not party to the contract from
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11 paying the same or lower rates for items or services
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12 than the contracting health insurance carrier or
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13 health plan administrator pays for such items or
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14 services;
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15 12. "Network plan" means a health benefit plan that either
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16 requires enrollees to use, or creates incentives for enrollees to
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17 use, certain health care providers managed, owned, affiliated, under
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18 contract with, or employed by a health insurance carrier, a health
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19 plan administrator, or plan sponsor. Network plans include health
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20 maintenance organization (HMO) plans, preferred provider
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21 organization (PPO) plans, and exclusive provider organization (EPO)
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22 plans; and
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23 13. "Tiered network plan" means a health benefit plan that
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24 sorts health care providers into specific groups to which different
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1 provider reimbursement, enrollee cost sharing, or provider access
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2 requirements are applied for the same services.
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3 B. Except as provided in this subsection, no health insurance
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4 carrier, health care provider, health plan administrator, or any
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5 agent or other entity that contracts on behalf of a health insurance
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6 carrier, a health care provider, or a health plan administrator
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7 shall offer, solicit, request, amend, renew, or enter into a health
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8 care contract that would include any of the following provisions:
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9 1. An all-or-nothing clause;
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10 2. An anti-steering clause;
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11 3. An anti-tiering clause;
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12 4. A gag clause;
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13 5. A most-favored-nations clause; or
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14 6. Any other clause that results or intends to result in
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15 anticompetitive effects as specified through regulation by the
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16 Insurance Commissioner.
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17 C. Except as provided in subsection D of this section, a
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18 violation of this section constitutes an unfair or deceptive act
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19 under Section 1204 of Title 36 of the Oklahoma Statutes and shall be
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20 subject to enforcement by the Attorney General.
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21 D. 1. A party to a health care contract that contains a
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22 provision specified in subsection B of this section may submit the
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23 health care contract to the Commissioner for a waiver. The health
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24 care contract shall be accompanied by:
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1 a. the name and business address of each party to the
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2 health care contract,
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3 b. any identification of each location at which any party
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4 to the agreement or policy provides health care
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5 services, and
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6 c. any information required to demonstrate that the
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7 proposed agreement or policy results in an improvement
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8 in the welfare of consumers in this state that could
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9 not have been accomplished through alternative means
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10 that are less restrictive.
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11 2. The Commissioner shall approve or deny any waiver
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12 application in writing within sixty (60) days. The Commissioner may
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13 approve a waiver to allow a contract to include a provision pursuant
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14 to subsection B of this section if the Commissioner determines that:
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15 a. the agreement or policy results in an improvement in
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16 the welfare of consumers in this state such that the
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17 competitive benefit of including the provision
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18 outweighs the harm to competition,
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19 b. such improvement in the welfare could not have been
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20 accomplished through alternative means that are less
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21 restrictive, and
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22 c. the agreement or policy shall not otherwise constitute
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23 a contract, combination, or conspiracy in restraint of
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24 trade.
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1 3. Except for contracts granted a waiver under this subsection,
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2 any provision of a health care contract described in subsection B of
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3 this section shall be unenforceable.
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4 E. The Attorney General may subpoena any records necessary to
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5 enforce any provisions of this section or to investigate suspected
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6 violations of any provisions of this section. The Attorney General
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7 may institute proceedings on behalf of this state or as parens
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8 patriae of the persons residing in this state for injunctive relief
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9 to prevent and restrain a violation of any provision of this
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10 section, civil penalties for violations of the provisions of
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11 subsection D of this section, criminal penalties for violations of
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12 the provisions of subsection D of this section, and other equitable
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13 relief for violations of the provisions of this section including,
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14 without limitation, disgorgement or restitution.
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15 F. 1. All records and papers of health insurance carriers
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16 pertaining to health benefit plans or negotiations between the
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17 health insurance carrier and any health care provider shall be
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18 subject to inspection by the Commissioner or by any agent he or she
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19 may designate for that purpose. The Commissioner may require any
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20 health insurance carrier to produce a list of all health care
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21 contracts, transactions, or pricing agreements entered into within
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22 the preceding twelve (12) months.
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23 2. Except for contracts granted a waiver under subsection D of
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24 this section, the Commissioner may impose an administrative penalty
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1 of up to Five Thousand Dollars ($5,000.00) upon a health insurance
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2 carrier per day for each day that a contract that has been deemed
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3 unenforceable pursuant to subsection D of this section is in effect.
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4 3. The Commissioner may deny the sale of any health insurance
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5 plan where the contract between the health insurance carrier and any
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6 health care provider is in violation of subsection D of this
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7 section.
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8 4. The Commissioner may refer any health care contract subject
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9 to this section to the Attorney General to review for compliance
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10 with this section. The referral of any health care contract by the
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11 Commissioner to the Attorney General shall not constitute a
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12 violation any confidentiality agreement between the health insurance
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13 carrier and the Commissioner that may exist under Title 36 of the
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14 Oklahoma Statutes. The authority of the Attorney General to
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15 prosecute violations of antitrust or consumer protection
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16 requirements shall not be altered by this section.
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17 G. Any party that suffers a loss as a result of the violation
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18 of this section shall be entitled to initiate an action and seek all
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19 remedies, damages, costs, and fees.
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20 H. Nothing in this section shall be construed to limit network
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21 design, cost, or quality initiatives by a group health plan, health
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22 insurance carrier, or administrators working on behalf of a plan
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23 sponsor, including accountable care organizations, exclusive
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24 provider organizations, networks that tier providers by cost or
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1 quality or steer enrollees to centers of excellence, or other pay-
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2 for-performance programs.
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3 I. The Commissioner may promulgate rules and regulations
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4 necessary for the provisions of this section.
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5 SECTION 2. This act shall become effective November 1, 2026.
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7 60-2-2456 CAD 1/13/2026 4:38:24 PM
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Req. No. 2456 Page 10Every fact on this page links to its source, starting with the official bill record.