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 438 By: Coleman
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6 AS INTRODUCED
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7 An Act relating to health insurance; amending 36 O.S.
7 2021, Section 1219.6, which relates to methods of
8 payments to providers; requiring notice of certain
8 fee; requiring certain instructions; requiring
9 submission of certain annual report; updating
9 statutory language; and providing an effective date.
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1 2 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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13 SECTION 1. AMENDATORY 36 O.S. 2021, Section 1219.6, is
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1 4 amended to read as follows:
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15 Section 1219.6. A. As used in this section:
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16 1. "Health maintenance organization" means an entity that is
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1 7 organized for the purpose of providing or arranging health care,
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1 8 which has been granted a certificate of authority by the Insurance
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1 9 Commissioner as a health maintenance organization pursuant to the
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2 0 Health Maintenance Organization Act of 2003;
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21 2. "Credit card payment" means a type of electronic funds
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2 2 transfer in which a health insurance plan or health insurer or its
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2 3 contracted vendor issues a single-use series of numbers associated
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2 4 with the payment of health care services performed by a health care
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1 provider and chargeable to a predetermined dollar amount, whereby
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2 the health care provider is responsible for processing the payment
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3 by a credit card terminal or Internet portal. Such term shall
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4 include virtual or online credit card payments, whereby no physical
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5 credit card is presented to the health care provider and the single-
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6 use credit card expires upon payment processing;
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7 3. "Electronic funds transfer payment" means a payment by any
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8 method of electronic funds transfer other than through the Automated
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9 Clearing House Network (ACH), as codified in 45 CFR C.F.R., Sections
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1 0 162.1601 and 162.1602;
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11 4. "Health care provider" means any physician, dentist,
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1 2 pharmacist, optometrist, psychologist, registered optician, licensed
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1 3 professional counselor, physical therapist, chiropractor, hospital
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1 4 or other entity or person that is licensed or otherwise authorized
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1 5 in this state to furnish health care services;
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16 5. "Health care provider agent" means a person or entity that
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1 7 contracts with a health care provider establishing an agency
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1 8 relationship to process bills for services provided by the health
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1 9 care provider under the terms and conditions of a contract between
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2 0 the agent and health care provider. Such contracts may permit the
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2 1 agent to submit bills, request reconsideration and receive
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2 2 reimbursement;
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23 6. "Health care services" means the examination or treatment of
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2 4 persons for the prevention of illness or the correction or treatment
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1 of any physical or mental condition resulting from illness, injury
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2 or other human physical problem and includes, but is not limited to:
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3 a. hospital services which include the general and usual
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4 services and care, supplies and equipment furnished by
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5 hospitals,
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6 b. medical services which include the general and usual
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7 services and care rendered and administered by doctors
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8 of medicine, doctors of dental surgery and doctors of
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9 podiatry, and
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10 c. other health care services which include appliances
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11 and supplies; nursing care by a registered nurse or a
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12 licensed practical nurse; care furnished by such other
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13 licensed practitioners; institutional services
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14 including the general and usual care, services,
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15 supplies and equipment furnished by health care
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16 institutions and agencies or entities other than
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17 hospitals; physiotherapy; ambulance services; drugs
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18 and medications; therapeutic services and equipment
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19 including oxygen and the rental of oxygen equipment;
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20 hospital beds; iron lungs; orthopedic services and
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21 appliances including wheelchairs, trusses, braces,
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22 crutches and prosthetic devices including artificial
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23 limbs and eyes; and any other appliance, supply or
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24 service related to health care;
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1 7. "Health insurance plan" means any hospital or medical
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2 insurance policy or certificate; qualified higher deductible health
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3 plan; health maintenance organization subscriber contract; contract
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4 providing benefits for dental care whether such contract is pursuant
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5 to a medical insurance policy or certificate; stand-alone dental
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6 plan, health maintenance provider contract or managed health care
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7 plan; and
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8 8. "Health insurer" means any entity or person that issues
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9 health insurance plans, as defined in this section.
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10 B. Any health insurance plan issued, amended or renewed on or
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1 1 after January 1, 2020, between a health insurer or its contracted
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1 2 vendor or a health maintenance organization and a health care
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1 3 provider for the provision of health care services to a plan
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1 4 enrollee shall not contain restrictions on methods of payment from
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1 5 the health insurer or its vendor or the health maintenance
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1 6 organization to the health care provider in which the only
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1 7 acceptable payment method is a credit card payment.
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18 C. If initiating or changing payments to a health care provider
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1 9 using a credit card, a health insurance plan, health insurer or its
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2 0 contracted vendor, or health maintenance organization shall:
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21 1. Notify the health care provider of any fees associated with
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2 2 a particular payment method; and
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1 2. Advise the health care provider of the available methods of
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2 payment and provide clear instructions on how to select a preferred
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3 method of payment.
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4 D. If initiating or changing payments to a health care provider
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5 using electronic funds transfer payments, including virtual credit
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6 card payments, a health insurance plan, health insurer or its
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7 contracted vendor, or health maintenance organization shall:
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8 1. Notify the health care provider if of any fees that are
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9 associated with a particular payment method; and
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10 2. Advise the provider of the available methods of payment and
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1 1 provide clear instructions to the health care provider as to how to
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1 2 select an alternative payment method.
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13 D. E. A health insurance plan, health insurer or its contracted
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1 4 vendor, or health maintenance organization that initiates or changes
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1 5 payments to a health care provider through the Automated Clearing
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1 6 House Network, as codified in 45 CFR C.F.R., Sections 162.1601 and
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1 7 162.1602, shall not charge a fee solely to transmit the payment to a
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1 8 health care provider unless the health care provider has consented
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1 9 to the fee. A health care provider agent may charge reasonable fees
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2 0 when transmitting an Automated Clearing House Network payment
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2 1 related to transaction management, data management, portal services
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2 2 and other value-added services in addition to the bank transmittal.
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1 E. F. Beginning January 1, 2026, health insurers shall submit
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2 an annual report to the Insurance Department no later than January
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3 31 that includes:
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4 1. The percentage of payments provided by credit card and
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5 electronic funds transfer; and
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6 2. The total amount of payments that were reduced to cover fees
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7 for payment by credit card or electronic funds transfer.
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8 G. The provisions of this section shall not be waived by
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9 contract, and any contractual clause in conflict with the provisions
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1 0 of this section or that purport to waive any requirements of this
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1 1 section are void.
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12 F. H. Violations of this section shall be subject to
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1 3 enforcement by the Insurance Commissioner.
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14 SECTION 2. This act shall become effective November 1, 2025.
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16 60-1-657 CAD 1/14/2025 3:51:26 PM
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Req. No. 657 Page 6Every fact on this page links to its source, starting with the official bill record.