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Oklahoma Legislature· SB 889Approved by Governor 05/23/2025

An act relating to hospitals, the official text

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1                  STATE OF OKLAHOMA

1

2                 1st Session of the 60th Legislature (2025)

2

3 SENATE BILL 889  By: Murdock
3

4

4

5

5

6                  AS INTRODUCED

6

7   An Act relating to hospitals; defining terms;

7   requiring hospitals to make public certain file and

8   list; stating requirements for list of standard

8   charges; requiring certain digital publication of

9   specified information; requiring certain online

9   display of list; stipulating requirements related to

10  accessibility and formatting of list; requiring

10  annual update of list; stating requirements for list

11  of standard charges and selection of shoppable

11  services; requiring list to include certain

12  information; directing certain display and

12  availability of list; authorizing certain compliance

13  monitoring by the State Department of Health;

13  authorizing certain actions for noncompliance;

14  defining material violation; authorizing issuance of

14  certain notice upon certain determination; specifying

15  certain requirements for corrective action plans;

15  prohibiting certain collection actions by

16  noncompliant hospitals; authorizing certain civil

16  actions; imposing certain requirements on hospitals

17  found noncompliant; providing certain construction;

17  repealing 63 O.S. 2021, Sections 1-725.1, 1-725.2, 1-

18  725.3, 1-725.4, and 1-725.5, which relate to the

18  Transparency in Health Care Prices Act; providing for

19  codification; and providing an effective date.

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20

20

21

21

22 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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23

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    Req. No. 159                                              Page 1
1   SECTION 1.    NEW LAW  A new section of law to be codified

1

2 in the Oklahoma Statutes as Section 1-725.11 of Title 63, unless
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3 there is created a duplication in numbering, reads as follows:
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4   As used in this act:

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5   1. "Ancillary service" means a hospital item or service that a

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6 hospital customarily provides as part of a shoppable service;
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7   2. "Chargemaster" means the list of all hospital items or

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8 services maintained by a hospital for which the hospital has
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9 established a charge;
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10  3. "De-identified maximum negotiated charge" means the highest

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11 charge that a hospital has negotiated with all third-party payors
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12 for a hospital item or service;
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13  4. "De-identified minimum negotiated charge" means the lowest

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14 charge that a hospital has negotiated with all third-party payors
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15 for a hospital item or service;
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16  5. "Department" means the State Department of Health;

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17  6. "Discounted cash price" means the charge that applies to an

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18 individual who pays cash, or a cash equivalent, for a hospital item
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19 or service;
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20  7. "Gross charge" means the charge for a hospital item or

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21 service that is reflected on a hospital's chargemaster, absent any
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22 discounts;
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23  8. "Hospital" means a hospital:

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24

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    Req. No. 159                                           Page 2
1   a. licensed under Section 1-702 of Title 63 of the

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2                 Oklahoma Statutes, or

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3   b. owned or operated by a state agency;

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4   9. "Hospital items or services" means all items and services,

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5 including individual items and services and service packages, that
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6 may be provided by a hospital to a patient in connection with an
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7 inpatient admission or an outpatient department visit, as
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8 applicable, for which the hospital has established a standard
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9 charge, including:
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10  a. supplies and procedures,

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11  b. room and board,

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12  c. use of the facility and other areas, generally

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13                referred to as facility fees,

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14  d. services of physicians and non-physician

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15                practitioners, generally referred to as professional

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16                charges, and

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17  e. any other item or service for which a hospital has

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18                established a standard charge;

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19  10. "Machine-readable format" means a digital representation of

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20 information in a file that can be imported or read into a computer
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21 system for further processing. The term includes Extensible Markup
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22 Language (.XML), JavaScript Object Notation (.JSON), and Comma-
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23 Separated Values (.CSV) formats;
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24

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    Req. No. 159                                             Page 3
1   11. "Payor-specific negotiated charge" means the charge that a

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2 hospital has negotiated with a third-party payor for a hospital item
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3 or service;
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4   12. "Service package" means an aggregation of individual

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5 hospital items or services into a single service with a single
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6 charge;
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7   13. "Shoppable service" means a service that may be scheduled

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8 by a health care consumer in advance;
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9   14. "Standard charge" means the regular rate established by the

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10 hospital for a hospital item or service provided to a specific group
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11 of paying patients. The term includes all of the following, as
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12 defined under this section:
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13         a. the gross charge,

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14         b. the payor-specific negotiated charge,

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15         c. the de-identified minimum negotiated charge,

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16         d. the de-identified maximum negotiated charge, and

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17         e. the discounted cash price; and

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18  15. "Third-party payor" means an entity that is, by statute,

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19 contract, or agreement, legally responsible for payment of a claim
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20 for a hospital item or service.
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21  SECTION 2.    NEW LAW        A new section of law to be codified

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22 in the Oklahoma Statutes as Section 1-725.12 of Title 63, unless
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23 there is created a duplication in numbering, reads as follows:
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24  Notwithstanding any other law, a hospital shall make public:

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    Req. No. 159                                            Page 4
1   1. A digital file in a machine-readable format that contains a

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2 list of all standard charges for all hospital items or services as
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3 described by Section 3 of this act; and
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4   2. A consumer-friendly list of standard charges for a limited

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5 set of shoppable services as provided in Section 4 of this act.
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6   SECTION 3.    NEW LAW  A new section of law to be codified

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7 in the Oklahoma Statutes as Section 1-725.13 of Title 63, unless
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8 there is created a duplication in numbering, reads as follows:
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9   A. A hospital shall:

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10  1. Maintain a list of all standard charges for all hospital

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11 items or services in accordance with this section; and
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12  2. Ensure the list required under paragraph 1 of this

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13 subsection is available at all times to the public, including by
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14 posting the list electronically in the manner provided by this
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15 section.
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16  B. The standard charges contained in the list required to be

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17 maintained by a hospital under subsection A of this section shall
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18 reflect the standard charges applicable to that location of the
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19 hospital, regardless of whether the hospital operates in more than
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20 one location or operates under the same license as another hospital.
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21  C. The list required under subsection A of this section shall

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22 include the following items, as applicable:
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23  1. A description of each hospital item or service provided by

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24 the hospital;
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    Req. No. 159                                           Page 5
1   2. The following charges for each individual hospital item or

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2 service when provided in either an inpatient setting or an
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3 outpatient department setting, as applicable:
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4   a. the gross charge,

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5   b. the de-identified minimum negotiated charge,

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6   c. the de-identified maximum negotiated charge,

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7   d. the discounted cash price, and

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8   e. the payor-specific negotiated charge, listed by the

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9                 name of the third-party payor and plan associated with

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10                the charge and displayed in a manner that clearly

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11                associates the charge with each third-party payor and

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12                plan; and

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13  3. Any code used by the hospital for purposes of accounting or

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14 billing for the hospital item or service, including the Current
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15 Procedural Terminology (CPT) code, the Healthcare Common Procedure
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16 Coding System (HCPCS) code, the Diagnosis Related Group (DRG) code,
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17 the National Drug Code (NDC), or other common identifier.
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18  D. The information contained in the list required under

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19 subsection A of this section shall be published in a single digital
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20 file that is in a machine-readable format.
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21  E. The list required under subsection A of this section shall

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22 be displayed in a prominent location on the hospital's publicly
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23 accessible Internet website. If the hospital operates multiple
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24 locations and maintains a single Internet website, the list required
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    Req. No. 159                                              Page 6
1 under subsection A of this section shall be posted for each location
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2 the hospital operates in a manner that clearly associates the list
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3 with the applicable location of the hospital.
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4   F. The list required under subsection A of this section shall:

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5   1. Be available:

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6   a. free of charge,

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7   b. without having to establish a user account or

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8                 password, and

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9   c. without having to submit personal identifying

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10                information;

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11  2. Be digitally searchable; and

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12  3. Use the Centers for Medicare and Medicaid Services naming

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13 convention specified under 45 C.F.R., Section 180.50.
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14  G. The hospital shall update the list required under subsection

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15 A of this section at least once each year. The hospital shall
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16 clearly indicate the date on which the list was most recently
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17 updated, either on the list or in a manner that is clearly
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18 associated with the list.
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19  SECTION 4.    NEW LAW        A new section of law to be codified

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20 in the Oklahoma Statutes as Section 1-725.14 of Title 63, unless
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21 there is created a duplication in numbering, reads as follows:
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22  A. Except as provided by subsection C of this section, a

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23 hospital shall maintain and make publicly available a list of the
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24 standard charges described by Section 3 of this act for each of at
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    Req. No. 159                                               Page 7
1 least three hundred shoppable services provided by the hospital.
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2 The hospital may select the shoppable services to be included in the
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3 list, except that the list shall include:
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4   1. The seventy services specified as shoppable services by the

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5 Centers for Medicare and Medicaid Services; or
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6   2. If the hospital does not provide all of the shoppable

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7 services described by paragraph 1 of this subsection, as many of
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8 those shoppable services the hospital does provide.
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9   B. In selecting a shoppable service for purposes of inclusion

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10 in the list required under subsection A of this section, a hospital
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11 shall consider how frequently the hospital provides the service and
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12 the hospital's billing rate for that service.
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13  C. If a hospital does not provide three hundred shoppable

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14 services, the hospital shall maintain a list of the total number of
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15 shoppable services that the hospital provides in a manner that
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16 otherwise complies with the requirements of subsection A of this
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17 section.
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18  D. The list required under subsection A or C of this section,

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19 as applicable, shall:
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20  1. Include:

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21           a. a plain-language description of each shoppable service

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22                included on the list,

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23           b. the payor-specific negotiated charge that applies to

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24                each shoppable service included on the list and any

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    Req. No. 159                                       Page 8
1                 ancillary service, listed by the name of the third-

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2                 party payor and plan associated with the charge and

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3                 displayed in a manner that clearly associates the

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4                 charge with the third-party payor and plan,

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5   c. the discounted cash price that applies to each

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6                 shoppable service included on the list and any

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7                 ancillary service or, if the hospital does not offer a

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8                 discounted cash price for one or more of the shoppable

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9                 or ancillary services on the list, the gross charge

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10                for the shoppable service or ancillary service, as

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11                applicable,

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12  d. the de-identified minimum negotiated charge that

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13                applies to each shoppable service included on the list

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14                and any ancillary service,

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15  e. the de-identified maximum negotiated charge that

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16                applies to each shoppable service included on the list

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17                and any ancillary service, and

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18  f. any code used by the hospital for purposes of

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19                accounting or billing for each shoppable service

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20                included on the list and any ancillary service,

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21                including the Current Procedural Terminology (CPT)

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22                code, the Healthcare Common Procedure Coding System

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23                (HCPCS) code, the Diagnosis Related Group (DRG) code,

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    Req. No. 159                                               Page 9
1                 the National Drug Code (NDC), or other common

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2                 identifier; and

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3       2. If applicable:

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4       a. state each location at which the hospital provides the

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5                 shoppable service and whether the standard charges

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6                 included in the list apply at that location to the

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7                 provision of that shoppable service in an inpatient

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8                 setting, an outpatient department setting, or in both

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9                 of those settings, as applicable, and

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10      b. indicate if one or more of the shoppable services

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11                specified by the Centers for Medicare and Medicaid

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12                Services is not provided by the hospital.

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13      E. The list required under subsection A or C of this section,

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14 as applicable, shall be:
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15      1. Displayed in the manner prescribed by subsection E of

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16 Section 3 of this act for the list required under that section;
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17      2. Available:

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18      a. free of charge,

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19      b. without having to register or establish a user account

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20                or password, and

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21      c. without having to submit personal identifying

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22                information;

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23      3. Searchable by service description, billing code, and payor;

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24 and
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    Req. No. 159                                             Page 10
1   4. Updated in the manner prescribed by subsection G of Section

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2 3 of this act for the list required under that section.
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3   F. Notwithstanding any other provision of this section, a

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4 hospital is considered to meet the requirements of this section if
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5 the hospital maintains, as determined by the State Department of
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6 Health, an Internet-based price estimator tool that:
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7   1. Provides a cost estimate for each shoppable service and any

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8 ancillary service included on the list maintained by the hospital
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9 under subsection A of this section;
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10  2. Allows a person to obtain an estimate of the amount the

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11 person will be obligated to pay the hospital if the person elects to
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12 use the hospital to provide the service; and
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13  3. Is:

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14  a. prominently displayed on the hospital's publicly

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15                accessible Internet website, and

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16  b. accessible to the public:

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17                (1) without charge, and

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18                (2) without having to register or establish a user

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19                account or password.

19

20  SECTION 5.    NEW LAW  A new section of law to be codified

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21 in the Oklahoma Statutes as Section 1-725.15 of Title 63, unless
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22 there is created a duplication in numbering, reads as follows:
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    Req. No. 159                                           Page 11
1   A. The State Department of Health may monitor each hospital's

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2 compliance with the requirements of this act using any of the
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3 following methods:
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4   1. Evaluating complaints made by persons to the Department

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5 regarding noncompliance with this act;
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6   2. Reviewing any analysis prepared regarding noncompliance with

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7 this act; and
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8   3. Auditing the Internet websites of hospitals for compliance

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9 with this act.
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10  B. If the Department determines that a hospital is not in

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11 compliance with a provision of this act, the Department may take any
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12 of the following actions:
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13  1. Provide a written notice to the hospital that clearly

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14 explains the manner in which the hospital is not in compliance with
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15 this act;
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16  2. Request a corrective action plan from the hospital if the

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17 hospital has materially violated a provision of this act, as
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18 determined under Section 6 of this act; and
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19  3. Impose an administrative penalty on the hospital and

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20 publicize the penalty on the Department's Internet website if the
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21 hospital fails to:
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22  a. respond to the Department's request to submit a

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23                corrective action plan, or

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    Req. No. 159                                Page 12
1   b. comply with the requirements of a corrective action

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2                 plan submitted to the Department.

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3   SECTION 6.     NEW LAW  A new section of law to be codified

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4 in the Oklahoma Statutes as Section 1-725.16 of Title 63, unless
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5 there is created a duplication in numbering, reads as follows:
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6   A. A hospital materially violates this act if the hospital

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7 fails to publicize:
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8   1. Pricing information as required by Section 2 of this act; or

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9   2. The hospital's standard charges in the form and manner

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10 required by Sections 3 and 4 of this act.
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11  B. If the State Department of Health determines that a hospital

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12 has materially violated this act, the Department may issue a notice
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13 of material violation to the hospital and request that the hospital
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14 submit a corrective action plan. The notice shall indicate the form
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15 and manner in which the corrective action plan shall be submitted to
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16 the Department, and clearly state the date by which the hospital
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17 shall submit the plan.
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18  C. A hospital that receives a notice under subsection B of this

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19 section shall:
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20  1. Submit a corrective action plan in the form and manner, and

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21 by the specified date, prescribed by the notice of violation; and
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22  2. As soon as practicable after submission of a corrective

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23 action plan to the Department, act to comply with the plan.
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24  D. A corrective action plan submitted to the Department shall:

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    Req. No. 159                                     Page 13
1   1. Describe in detail the corrective action the hospital will

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2 take to address any violation identified by the Department in the
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3 notice provided under subsection B of this section; and
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4   2. Provide a date by which the hospital will complete the

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5 corrective action described by paragraph 1 of this subsection.
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6   E. A corrective action plan is subject to review and approval

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7 by the Department. After the Department reviews and approves a
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8 hospital's corrective action plan, the Department shall monitor and
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9 evaluate the hospital's compliance with the plan.
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10  F. A hospital is considered to have failed to respond to the

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11 Department's request to submit a corrective action plan if the
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12 hospital fails to submit a corrective action plan:
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13  1. In the form and manner specified in the notice provided

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14 under subsection B of this section; or
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15  2. By the date specified in the notice provided under

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16 subsection B of this section.
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17  G. A hospital is considered to have failed to comply with a

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18 corrective action plan if the hospital fails to address a violation
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19 within the specified period of time contained in the plan.
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20  SECTION 7.    NEW LAW         A new section of law to be codified

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21 in the Oklahoma Statutes as Section 1-725.17 of Title 63, unless
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22 there is created a duplication in numbering, reads as follows:
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23  A. A hospital that is not in material compliance with this act

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24 on the date that items or services are purchased from or provided to
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    Req. No. 159                                               Page 14
1 a patient by the hospital shall not initiate or pursue collection
1

2 action against the patient or patient guarantor for a debt owed for
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3 the items or services.
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4   B. If a patient believes that a hospital was not in material

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5 compliance with this act on a date on or after the effective date of
5

6 this act that items or services were purchased by or provided to the
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7 patient, and the hospital takes a collection action against the
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8 patient or patient guarantor, the patient or patient guarantor may
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9 file suit to determine if the hospital was materially out of
9

10 compliance with this act on the date of service and if the
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11 noncompliance is related to the items or services. The hospital
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12 shall not take a collection action against the patient or patient
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13 guarantor while the lawsuit is pending.
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14  C. A hospital that has been found by a judge or jury to be

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15 materially out of compliance with this act:
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16  1. Shall refund the payor any amount of the debt the payor has

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17 paid and shall pay a penalty to the patient or patient guarantor in
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18 an amount equal to the total amount of the debt;
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19  2. Shall dismiss or cause to be dismissed any court action with

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20 prejudice and pay any reasonable attorney fees and costs incurred by
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21 the patient or patient guarantor relating to the action; and
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22  3. Shall remove or cause to be removed from the patient's or

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23 patient guarantor's credit report any report made to a consumer
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24 reporting agency relating to the debt.
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    Req. No. 159                                     Page 15
1   D. Nothing in this act:

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2   1. Prohibits a hospital from billing a patient, patient

2

3 guarantor, or third-party payor, including a health insurer, for
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4 items or services provided to the patient; or
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5   2. Requires a hospital to refund any payment made to the

5

6 hospital for items or services provided to the patient, as long as
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7 no collection action is taken in violation of this act.
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8   SECTION 8.    REPEALER   63 O.S. 2021, Sections 1-725.1, 1-

8

9 725.2, 1-725.3, 1-725.4, and 1-725.5, are hereby repealed.
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10  SECTION 9. This act shall become effective November 1, 2025.

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11

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12  60-1-159      DC         1/19/2025 5:45:19 AM

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    Req. No. 159                                              Page 16
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