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Oklahoma Legislature· SB 2038Second Reading referred to Business and Insurance

An act relating to health insurance, the official text

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 2038           By: Goodwin
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6                            AS INTRODUCED

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7           An Act relating to health insurance; defining terms;

7           prohibiting issue of certain outcomes by artificial

8           intelligence; prohibiting certain health insurance

8           issuer from issuing certain outcome from the use of

9           certain AI system; requiring certain decisions to be

9           reviewed by certain licensed health care provider;

10          requiring certain health insurance issuer to provide

10          certain disclosure to certain claimant; allowing

11          certain promulgation of rules by Insurance

11          Commissioner; allowing Commissioner to investigate

12          and review use of AI by certain issuer; providing for

12          codification; and declaring an emergency.

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15 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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16  SECTION 1.      NEW LAW  A new section of law to be codified

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17 in the Oklahoma Statutes as Section 6568 of Title 36, unless there
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18 is created a duplication in numbering, reads as follows:
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19  As used in this act:

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20  1. "Adverse consumer outcome" means a decision by a health

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21 insurance issuer that is subject to insurance regulatory standards
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22 enforced by the Insurance Department that adversely impacts the
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23 consumer in a manner that violates those standards or any claim
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24 denial;
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    Req. No. 3029                                                Page 1
1   2. "AI system" means a machine-based system that can, with

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2 varying levels of autonomy, for a given set of objectives, generate
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3 outputs such as productions, recommendations, content such as text,
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4 images, videos, or sounds, or other outputs influencing decisions
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5 made in real or virtual environments. AI system includes the term
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6 artificial intelligence;
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7   3. "Artificial intelligence" means a computer system, program,

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8 or set of algorithms capable of performing tasks on producing
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9 outposts that imitate intelligent human behaviors;
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10  4. "Health insurance coverage" means benefits consisting of

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11 medical care and items and services paid for as medical care,
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12 provided directly, through insurance or through reimbursement, under
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13 any hospital or medical service policy or certificate, hospital or
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14 medical service plan contract, or health maintenance organization
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15 contract offered by a health insurance issuer;
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16  5. "Health insurance issuer" means the same as described in

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17 Section 103 of Title 36 of the Oklahoma Statutes; and
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18  6. "Medical necessity" means the same as defined in Section

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19 7310 of Title 63 of the Oklahoma Statutes.
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20  SECTION 2.     NEW LAW  A new section of law to be codified

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21 in the Oklahoma Statutes as Section 6569 of Title 36, unless there
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22 is created a duplication in numbering, reads as follows:
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23  A. A licensed professional shall issue any final adverse

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24 consumer outcome issued by a health insurance issuer. A health
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    Req. No. 3029                                            Page 2
1 insurance issuer authorized to do business in this state shall not
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2 issue an adverse consumer outcome with regard to denial, reduction,
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3 or termination of health insurance coverage or benefits that results
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4 from the use or application of any AI system. Any review process
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5 concerning denial, reduction, or termination of insurance plans or
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6 benefits that results from the use of AI systems shall be reviewed
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7 by a licensed professional and all such final decisions shall be
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8 issued by a licensed professional. A health insurance issuer shall
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9 provide a disclosure notice to the claimant that such final decision
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10 was issued by a professional, not an AI system.
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11  B. No insurer shall issue a final adverse consumer outcome on a

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12 claim without consulting with the claimant's provider on medical
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13 necessity. All final decisions on medical necessity shall be made
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14 by a licensed health care provider, not an insurer. Such provider
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15 shall have the opportunity to review all non-privileged information
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16 relating to such claim.
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17  C. The Commissioner may investigate and review the development,

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18 investigation, and use of AI systems necessary to ensure compliance
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19 with this act.
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20  D. Any insurer who violates any provisions of this act may be

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21 subject to a fine not more than Ten Thousand Dollars ($10,000.00)
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22 per violation.
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23  E. The Commissioner may promulgate rules necessary to enforce

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24 the provisions of this act.
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    Req. No. 3029                                   Page 3
1   SECTION 3. It being immediately necessary for the preservation

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2 of the public peace, health or safety, an emergency is hereby
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3 declared to exist, by reason whereof this resolution shall take
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4 effect and be in full force from and after its passage and approval.
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6   60-2-3029      CAD  1/15/2026 10:57:30 AM

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    Req. No. 3029                              Page 4
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