Bill Text For HB3259 - Introduced

 1|                          STATE OF OKLAHOMA                            |
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 2|             2nd Session of the 60th Legislature (2026)                |
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 3|HOUSE BILL 3259                      By: Lepak                         |
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 6|                            AS INTRODUCED                              |
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 7|       An Act relating to health insurance; providing                  |
  |       definitions; prohibiting all-or-nothing,                        |
 8|       anti-steering, gag, or most favored nation clauses in           |
  |       contracts between providers and general contracting             |
 9|       entities; prohibiting provider network contracts that           |
  |       include all-or-nothing, gag, or most favored nation             |
10|       clauses; prohibiting providers from amending or                 |
  |       renewing contracts with all-or-nothing,                         |
11|       anti-steering, gag, or most favored nation clauses;             |
  |       clarifying that all provider network contract                   |
12|       all-or-nothing, anti-steering, gag, or most favored             |
  |       nation clauses are void and unenforceable; directing            |
13|       that general contracting entities should only                   |
  |       encourage obtaining care services from particular               |
14|       providers if the enrollee is the primary beneficiary;           |
  |       providing for codification; and providing an                    |
15|       effective date.                                                 |
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19|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:                  |
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20|    SECTION 1.     NEW LAW     A new section of law to be codified     |
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21|in the Oklahoma Statutes as Section 6070 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.  As used in this act:                                           |
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   Req. No. 14014                                                  Page 1
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 1|    1.  "All-or-nothing clause" means a provision in a provider        |
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 2|network contract that requires a general contracting entity to:        |
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 3|         a.    include all members of a provider in a network plan,    |
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 4|              or                                                       |
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 5|         b.    enter into or maintain an additional contract with an   |
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 6|              affiliate of a provider as a condition of entering       |
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 7|              into a contract.                                         |
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 8|    2.  "Anti-steering clause" means a provision in a provider         |
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 9|network contract that restricts the ability of a general contracting   |
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10|entity to encourage an enrollee to obtain a health care service from   |
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11|a competitor of the provider, including offering incentives to         |
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12|encourage enrollees to use specific providers;                         |
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13|    3.  "Gag clause" means a provision in a provider network           |
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14|contract that restricts the ability of a general contracting entity    |
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15|or provider to disclose:                                               |
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16|         a.    price or quality information, including the allowed     |
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17|              amount, negotiated rates or discounts, fees for          |
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18|              services, or other claim-related financial obligations   |
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19|              included in the contract, to a governmental entity as    |
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20|              authorized by law or its contractors or agents, an       |
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21|              enrollee, a treating provider of an enrollee, a plan     |
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22|              sponsor, or potential eligible enrollees and plan        |
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23|              sponsors, or                                             |
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24|         b.    out-of-pocket costs to an enrollee;                     |
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   Req. No. 14014                                                  Page 2
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 1|    4.  "General contracting entity" means a person who enters into    |
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 2|a direct contract with a provider for the delivery of health care      |
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 3|services to covered individuals regardless of whether the person, in   |
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 4|the ordinary course of business, establishes a provider network for    |
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 5|access by another party; and                                           |
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 6|    5.  "Most favored nation clause" means a provision in a provider   |
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 7|network contract that:                                                 |
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 8|         a.    prohibits or grants an option to prohibit:              |
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 9|              (1)   a provider from contracting with another general   |
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10|                   contracting entity to provide health care           |
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11|                   services at a lower rate, or                        |
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12|              (2)   a general contracting entity from contracting      |
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13|                   with another provider to provide health care        |
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14|                   services at a higher rate,                          |
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15|         b.    requires or grants an option to require:                |
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16|              (1)   a provider to accept a lower rate for health       |
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17|                   care services if the provider agrees with another   |
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18|                   general contracting entity to accept a lower rate   |
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19|                   for the services, or                                |
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20|              (2)   a general contracting entity to pay a higher       |
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21|                   rate for health care services if the entity         |
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22|                   agrees with another provider to pay a higher rate   |
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23|                   for the services,                                   |
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   Req. No. 14014                                                  Page 3
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 1|         c.    requires or grants an option to require termination     |
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 2|              or renegotiation of an existing provider network         |
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 3|              contract if:                                             |
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 4|              (1)   a provider agrees with another general             |
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 5|                   contracting entity to accept a lower rate for       |
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 6|                   providing health care services, or                  |
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 7|              (2)   a general contracting entity agrees with a         |
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 8|                   provider to pay a higher rate for health care       |
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 9|                   services, or                                        |
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10|         d.    requires:                                               |
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11|              (1)   a provider to disclose the provider's              |
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12|                   contractual reimbursement rates with other          |
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13|                   general contracting entities, or                    |
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14|              (2)   a general contracting entity to disclose the       |
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15|                   general contracting entity's contractual            |
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16|                   reimbursement rates with other providers.           |
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17|    B.  A provider may not:                                            |
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18|    1.  Offer to a general contracting entity a provider network       |
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19|contract that includes an all-or-nothing, anti-steering, gag, or       |
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20|most favored nation clause;                                            |
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21|    2.  Enter into a provider network contract that includes an        |
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22|all-or-nothing, gag, or most favored nation clause; or                 |
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23|    3.  Amend or renew an existing provider network contract           |
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24|previously entered into with a general contracting entity so that      |
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   Req. No. 14014                                                  Page 4
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 1|the contract as amended or renewed adds or retains an                  |
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 2|all-or-nothing, anti-steering, gag, or most favored nation clause.     |
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 3|    C.  Any provision in a provider network contract that is an        |
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 4|all-or-nothing, anti-steering, gag, or most favored nation clause is   |
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 5|void and unenforceable.  The remaining provisions in the provider      |
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 6|network contract remain in effect and are enforceable.                 |
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 7|    D.  A general contracting entity that encourages an enrollee to    |
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 8|obtain a health care service from a particular provider, including     |
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 9|offering incentives to encourage enrollees to use specific             |
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10|providers, has a fiduciary duty to the enrollee to engage in that      |
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11|conduct only for the primary benefit of the enrollee.                  |
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12|    SECTION 2.  This act shall become effective November 1, 2026.      |
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14|    60-2-14014     MJ     11/19/25                                     |
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   Req. No. 14014                                                  Page 5
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