1| STATE OF OKLAHOMA |
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2| 2nd Session of the 60th Legislature (2026) |
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3|HOUSE BILL 3647 By: Stinson |
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4| |
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5| |
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6| AS INTRODUCED |
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7| An Act relating to health information; creating the |
| Oklahoma Health Care Transparency Initiative Act of |
8| 2026; amending Section 1, Chapter 250, O.S.L. 2022 |
| (63 O.S. Supp. 2025, Section 1-132.1), which relates |
9| to the Office of the State Coordinator for Health |
| Information Exchange; modifying powers and duties of |
10| the Office; amending 63 O.S. 2021, Section 1-133, as |
| last amended by Section 1, Chapter 243, O.S.L. 2024 |
11| (63 O.S. Supp. 2025, Section 1-133), which relates to |
| state-designated entity for health information |
12| exchange; modifying time period of certain |
| requirement; modifying and adding certain exemptions; |
13| defining terms; creating the Oklahoma Health Care |
| Transparency Initiative; providing for governance and |
14| oversight of the initiative; requiring submitting |
| entity to submit certain information to |
15| state-designated entity; allowing voluntary |
| submission of certain information by certain health |
16| benefit plan, person, or entity; mandating compliance |
| with certain requirements; requiring submission of |
17| public health data for integration into the |
| initiative; requiring assignment of unique |
18| identifier; providing for confidentiality, privacy, |
| and security of certain data; listing circumstances |
19| under which certain data may be made available; |
| prohibiting certain use or disclosure of data; |
20| providing certain construction; authorizing certain |
| penalties; limiting amount of penalties; providing |
21| for certain remittance or mitigation of penalties; |
| requiring the Insurance Department to remit certain |
22| proceeds to the Oklahoma Health Care Authority; |
| specifying allowed uses of certain funds; amending 51 |
23| O.S. 2021, Section 24A.3, as last amended by Section |
| 1, Chapter 404, O.S.L. 2025 (51 O.S. Supp. 2025, |
24| Section 24A.3), which relates to the Oklahoma Open |
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1| Records Act; modifying certain definition; providing |
| for codification; and declaring an emergency. |
2| |
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3| |
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4| |
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5|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: |
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6| SECTION 1. NEW LAW A new section of law to be codified |
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7|in the Oklahoma Statutes as Section 1-134.1 of Title 63, unless |
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8|there is created a duplication in numbering, reads as follows: |
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9| Sections 4 through 7 of this act shall be known and may be cited |
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10|as the "Oklahoma Health Care Transparency Initiative Act of 2026". |
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11| SECTION 2. AMENDATORY Section 1, Chapter 250, O.S.L. |
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12|2022 (63 O.S. Supp. 2025, Section 1-132.1), is amended to read as |
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13|follows: |
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14| Section 1-132.1. A. There is hereby created the Office of the |
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15|State Coordinator for Health Information Exchange within the |
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16|Oklahoma Health Care Authority. |
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17| B. The Office shall have the power and duty to oversee: |
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18| 1. Oversee the state-designated entity for health information |
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19|exchange, as described under Section 1-133 of Title 63 of the |
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20|Oklahoma Statutes this title; and |
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21| 2. Oversee the Oklahoma Health Care Transparency Initiative. |
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22| C. The Office shall consist of the State Coordinator for Health |
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23|Information Exchange, who shall be appointed by and serve at the |
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24|pleasure of the Administrator of the Authority, and such other |
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1|employees of the Authority as the Administrator may assign to the |
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2|Office. |
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3| SECTION 3. AMENDATORY 63 O.S. 2021, Section 1-133, as |
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4|last amended by Section 1, Chapter 243, O.S.L. 2024 (63 O.S. Supp. |
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5|2025, Section 1-133), is amended to read as follows: |
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6| Section 1-133. A. As used in this section: |
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7| 1. "Health information exchange" means the electronic movement |
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8|of health-related information among organizations according to |
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9|nationally recognized standards for purposes including, but not |
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10|limited to, payment, treatment, and administration; and |
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11| 2. "Health information exchange organization" means an entity |
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12|whose primary business activity is health information exchange and |
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13|which is governed by its stakeholders. |
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14| B. The State of Oklahoma: |
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15| 1. Shall designate a health information exchange organization |
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16|as the state-designated entity for health information exchange; |
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17| 2. Shall establish a transition plan to ensure continued |
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18|operation of the health information exchange; and |
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19| 3. May temporarily serve as the state-designated entity as part |
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20|of the transition plan described in paragraph 2 of this subsection. |
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21| C. Beginning July 1, 2023, all 1. All health care providers as |
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22|defined by the rules promulgated by the Oklahoma Health Care |
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23|Authority Board and who are licensed by and located in this state |
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24|may report data to and utilize the state-designated entity. The |
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1|Office of the State Coordinator for Health Information Exchange |
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2|shall begin implementation of this requirement on or before July 1, |
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3|2026. |
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4| 2. The Office of the State Coordinator for Health Information |
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5|Exchange may, as provided by rules promulgated by the Board, allow |
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6|exemptions from the requirement provided by paragraph 1 of this |
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7|subsection on the basis of: |
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8| a. financial hardship, |
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9| b. size of the practice, or |
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10| c. technological capability of a, |
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11| d. type of health care provider, or |
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12| e. such other bases basis as may be provided by rules |
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13| promulgated by the Board. |
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14| D. 1. A person who participates in the services or information |
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15|provided by the state-designated entity shall not be liable in any |
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16|action for damages or costs of any nature that result solely from |
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17|the person's use or failure to use information or data from the |
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18|state-designated entity that was entered or retrieved under relevant |
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19|state or federal privacy laws, rules, regulations, or policies |
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20|including, but not limited to, the Health Insurance Portability and |
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21|Accountability Act of 1996. |
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22| 2. A person shall not be subject to antitrust or unfair |
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23|competition liability based on participation with the |
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24|state-designated entity as long as the participation provides an |
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1|essential governmental function for the public health and safety and |
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2|enjoys state action immunity. |
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3| E. A person who provides information and data to the |
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4|state-designated entity retains a property right in the information |
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5|or data, but grants to the other participants or subscribers a |
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6|nonexclusive license to retrieve and use that information or data |
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7|under relevant state or federal privacy laws, rules, regulations, or |
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8|policies including, but not limited to, the Health Insurance |
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9|Portability and Accountability Act of 1996. |
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10| F. Patient-specific protected health information shall only be |
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11|disclosed in compliance with relevant state or federal privacy laws, |
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12|rules, regulations, or policies including, but not limited to, the |
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13|Health Insurance Portability and Accountability Act of 1996. |
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14| G. The Oklahoma Health Care Authority Board shall promulgate |
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15|rules to implement the provisions of this section. |
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16| SECTION 4. NEW LAW A new section of law to be codified |
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17|in the Oklahoma Statutes as Section 1-134.2 of Title 63, unless |
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18|there is created a duplication in numbering, reads as follows: |
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19| As used in the Oklahoma Health Care Transparency Initiative Act |
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20|of 2026: |
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21| 1. "Board" means the Oklahoma Health Care Authority Board; |
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22| 2. "Claims data" means information included in an |
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23|institutional, professional, or pharmacy claim or equivalent |
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24|information transaction for a covered individual including the |
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1|amount paid to a provider of health care services plus any amount |
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2|owed by the covered individual; |
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3| 3. "Covered individual" means a natural person who is a |
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4|resident of this state and is eligible to receive medical, dental, |
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5|or pharmaceutical benefits under any policy, contract, certificate, |
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6|evidence of coverage, rider, binder, or endorsement that provides |
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7|for or describes coverage; |
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8| 4. "Direct personal identifiers" means information relating to |
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9|a covered individual that contains primary or obvious identifiers, |
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10|such as the individual's name, street address, email address, |
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11|telephone number, or Social Security number. Direct personal |
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12|identifiers shall not include geographic or demographic information |
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13|that would allow the identification of a covered individual; |
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14| 5. "Enrollment data" means demographic information and other |
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15|identifying information related to covered individuals, including |
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16|direct personal identifiers; |
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17| 6. "Office" means the Office of the State Coordinator for |
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18|Health Information Exchange created under Section 1-132.1 of Title |
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19|63 of the Oklahoma Statutes; |
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20| 7. "Oklahoma Health Care Transparency Initiative" means an |
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21|initiative to create a database, including ongoing all-payer claims |
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22|database projects that receive and store data from a submitting |
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23|entity relating to medical, dental, pharmaceutical, and other |
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24|insurance claims information, unique identifiers, and geographic and |
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1|demographic information for covered individuals as permitted in the |
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2|Oklahoma Health Care Transparency Initiative Act of 2026, and |
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3|provider files, for the purpose of implementing the Oklahoma Health |
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4|Care Transparency Initiative Act of 2026; |
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5| 8. "Protected health information" means health information as |
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6|protected by the Health Insurance Portability and Accountability Act |
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7|of 1996, Pub. L. No. 104-191; |
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8| 9. "Provider" means an individual or entity licensed by the |
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9|state to provide health care services; |
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10| 10. "State-designated entity for health information exchange" |
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11|or "state-designated entity" means the health information exchange |
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12|organization designated by the State of Oklahoma as the |
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13|state-designated entity for health information exchange under |
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14|Section 1-133 of Title 63 of the Oklahoma Statutes; |
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15| 11. a. "Submitting entity" means: |
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16| (1) an entity that provides health or dental |
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17| insurance or a health or dental benefit plan in |
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18| this state, including, but not limited to, an |
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19| insurance company, medical services plan, managed |
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20| care organization, hospital plan, hospital |
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21| medical service corporation, health maintenance |
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22| organization, or fraternal benefit society, |
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23| provided that the entity has covered individuals |
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24| |
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1| and the entity had at least two thousand (2,000) |
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2| covered individuals in the previous calendar |
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3| year, |
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4| (2) a health benefit plan offered or administered by |
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5| or on behalf of the state or an agency or |
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6| instrumentality of the state, including, but not |
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7| limited to, benefits administered by a managed |
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8| care organization, notwithstanding the number of |
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9| covered individuals in the previous year, |
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10| (3) a health benefit plan offered or administered by |
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11| or on behalf of the federal government with the |
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12| agreement of the federal government, |
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13| (4) the Workers' Compensation Commission, |
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14| (5) any other entity providing a plan of health |
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15| insurance or health benefits subject to state |
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16| insurance regulation, or a third-party |
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17| administrator; provided, that the entity has |
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18| covered individuals and the entity had at least |
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19| two thousand (2,000) covered individuals in the |
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20| previous calendar year, |
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21| (6) a health benefit plan subject to the Employee |
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22| Retirement Income Security Act of 1974, Pub. L. |
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23| No. 93-406, and that is fully insured, |
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24| |
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1| (7) a risk-based provider organization licensed by |
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2| the Insurance Department, and |
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3| (8) any entity that contracts with the Department of |
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4| Corrections to provide medical, dental, or |
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5| pharmaceutical care to inmates. |
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6| b. A submitting entity shall not include: |
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7| (1) an entity that provides health insurance or a |
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8| health benefit plan that is accident-only, |
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9| specified disease, hospital indemnity, long-term |
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10| care, disability income, or other supplemental |
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11| benefit coverage, |
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12| (2) an employee of a welfare benefit plan as defined |
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13| by federal law that is also a trust established |
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14| pursuant to collective bargaining subject to the |
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15| Labor Management Relations Act of 1947, Pub. L. |
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16| No. 80-101, |
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17| (3) a health benefit plan subject to the Employee |
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18| Retirement Income Security Act of 1974, Pub. L. |
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19| No. 93-406, that is self-funded, |
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20| (4) a Medicare supplemental policy as defined by 42 |
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21| C.F.R., Section 403.205, or |
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22| (5) a pharmacy benefits manager; and |
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23| |
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24| |
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1| 12. "Unique identifier" means any identifier that is guaranteed |
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2|to be unique among all identifiers for covered individuals but does |
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3|not include direct personal identifiers. |
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4| SECTION 5. NEW LAW A new section of law to be codified |
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5|in the Oklahoma Statutes as Section 1-134.3 of Title 63, unless |
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6|there is created a duplication in numbering, reads as follows: |
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7| A. Beginning July 1, 2027, there is hereby created the Oklahoma |
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8|Health Care Transparency Initiative. The initiative shall be |
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9|governed by the state-designated entity for health information |
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10|exchange and overseen by the Office of the State Coordinator for |
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11|Health Information Exchange. |
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12| B. Beginning on a date determined by the Oklahoma Health Care |
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13|Authority Board, and thereafter in a frequency specified in rules |
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14|promulgated by the Board, a submitting entity shall submit claims |
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15|data, unique identifiers, and geographic and demographic information |
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16|for covered individuals as permitted in the Oklahoma Health Care |
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17|Transparency Initiative Act of 2026, and provider files to the |
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18|state-designated entity for health information exchange in |
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19|accordance with standards and procedures promulgated by the Board. |
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20|The Office shall begin implementation of the requirements of this |
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21|subsection on or before July 1, 2026. |
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22| C. 1. A health benefit plan, person, or entity excluded from |
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23|the definition of submitting entity as provided by Section 4 of this |
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24|act shall not be subject to the requirements of subsection B of this |
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1|section, but may voluntarily submit claims data, unique identifiers, |
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2|and geographic and demographic information for covered individuals |
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3|as permitted in the Oklahoma Health Care Transparency Initiative Act |
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4|of 2026, and provider files to the state-designated entity in |
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5|accordance with standards and procedures promulgated by the Board. |
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6| 2. To the extent the excluded health benefit plan, person, or |
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7|entity voluntarily submits data described in this subsection to the |
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8|state-designated entity, the health benefit plan, person, or entity |
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9|shall comply with all requirements of the Oklahoma Health Care |
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10|Transparency Initiative Act of 2026, other than subsection B of this |
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11|section, including, but not limited to, compliance with applicable |
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12|state and federal data privacy and security laws. |
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13| D. 1. The State Department of Health shall submit all public |
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14|health data and vital statistics data collected by the Department |
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15|under Title 63 of the Oklahoma Statutes to the state-designated |
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16|entity for integration into the Oklahoma Health Care Transparency |
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17|Initiative database created under this section including, but not |
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18|limited to, data collected regarding hospital discharge and |
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19|emergency department records for the uninsured, birth and death |
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20|records, and disease registry data. |
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21| 2. The data submitted under paragraph 1 of this subsection |
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22|shall be assigned a unique identifier and may be used in accordance |
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23|with the Oklahoma Health Care Transparency Initiative Act of 2026 |
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24| |
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1|and the rules promulgated under the Oklahoma Health Care |
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2|Transparency Initiative Act of 2026. |
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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 1-134.4 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. Data and other information submitted under Section 5 of this |
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7|act shall be treated as confidential and shall be exempt from |
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8|disclosure as a record under the Oklahoma Open Records Act as |
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9|defined in Section 24A.3 of Title 51 of the Oklahoma Statutes and |
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10|are not subject to subpoena except to the extent provided in the |
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11|Oklahoma Insurance Code. |
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12| B. Data and other information submitted under Section 5 of this |
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13|act may only be collected, stored, used, disclosed, or released in |
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14|compliance with applicable state and federal data privacy and |
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15|security law, rules promulgated by the Oklahoma Health Care |
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16|Authority Board, and data governance policies established by the |
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17|state-designated entity for health information exchange. |
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18| C. Data and other information in the Oklahoma Health Care |
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19|Transparency Initiative shall, to the extent authorized by rules |
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20|promulgated by the Board, be available: |
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21| 1. When disclosed in a form and manner that ensures the privacy |
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22|and security of protected health information as required by state |
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23|and federal laws, as a resource to insurers, employers, purchasers |
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24|of health care, researchers, state agencies, and health care |
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1|providers to allow for assessment of health care utilization, |
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2|expenditures, and performance in this state, including, but not |
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3|limited to, as a resource for hospital community health needs |
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4|assessments; and |
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5| 2. To state programs regarding health care quality and costs |
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6|for use in improving health care in the state, subject to rules |
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7|prescribed by the Board conforming to state and federal privacy laws |
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8|or limiting access to limited-use data sets. |
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9| D. Data and other information in the Oklahoma Health Care |
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10|Transparency Initiative shall not be used to disclose trade secrets |
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11|of submitting entities. |
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12| E. Notwithstanding any other section of law, the Oklahoma |
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13|Health Care Transparency Initiative shall not publicly disclose any |
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14|data or other information that contains direct personal identifiers. |
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15| F. The Oklahoma Health Care Transparency Initiative Act of 2026 |
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16|shall not be construed to supersede, limit, amend, or abrogate any |
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17|data privacy or security law, rule, or policy. |
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18| SECTION 7. NEW LAW A new section of law to be codified |
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19|in the Oklahoma Statutes as Section 1-134.5 of Title 63, unless |
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20|there is created a duplication in numbering, reads as follows: |
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21| A. Except for state or federal agencies that are submitting |
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22|entities, a submitting entity that fails to submit data as required |
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23|by the Oklahoma Health Care Transparency Initiative Act of 2026 or |
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24| |
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1|the rules promulgated by the Oklahoma Health Care Authority Board |
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2|may be subject to a fine assessed by the Insurance Department. |
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3| B. The Insurance Commissioner shall adopt a schedule of fines |
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4|not to exceed One Thousand Dollars ($1,000.00) per day for each day |
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5|the violation occurs, to be determined by the severity of the |
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6|violation. |
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7| C. A fine assessed under this section may be remitted or |
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8|mitigated upon such terms and conditions as the Insurance |
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9|Commissioner considers proper and consistent with public health and |
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10|safety. |
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11| D. Of the proceeds from fines remitted under this section, the |
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12|Insurance Department shall retain a portion of such proceeds |
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13|necessary to cover the cost to the Department of administering the |
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14|assessment and collection of such fines, and the Department shall |
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15|remit the remainder of the proceeds to the Oklahoma Health Care |
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16|Authority. The Authority may only use proceeds from fines assessed |
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17|under this section to fund operations of the Oklahoma Health Care |
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18|Transparency Initiative. |
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19| SECTION 8. AMENDATORY 51 O.S. 2021, Section 24A.3, as |
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20|last amended by Section 1, Chapter 404, O.S.L. 2025 (51 O.S. Supp. |
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21|2025, Section 24A.3), is amended to read as follows: |
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22| Section 24A.3. As used in the Oklahoma Open Records Act: |
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23| 1. "Record" means all documents including, but not limited to, |
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24|any book, paper, photograph, microfilm, data files created by or |
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1|used with computer software, computer tape, disk, record, sound |
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2|recording, film recording, video record or other material regardless |
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3|of physical form or characteristic, created by, received by, under |
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4|the authority of, or coming into the custody, control or possession |
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5|of public officials, public bodies or their representatives in |
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6|connection with the transaction of public business, the expenditure |
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7|of public funds or the administering of public property. Record |
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8|shall also mean applications and other documents related to |
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9|licensure matters that are filed of record in a district court, |
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10|including, but not limited to, marriage licenses, process server |
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11|licenses, closing out sale licenses, transient merchant licenses, |
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12|pool hall licenses, and bail bondsmen registration. Record does not |
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13|mean: |
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14| a. computer software, or |
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15| b. nongovernment personal effects, or |
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16| c. data or other information submitted to the |
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17| state-designated entity for information exchange under |
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18| Section 1-133 of Title 63 of the Oklahoma Statutes or |
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19| under the Oklahoma Health Care Transparency Initiative |
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20| Act of 2026; |
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21| 2. "Public body" shall include, but not be limited to, any |
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22|office, department, board, bureau, commission, agency, trusteeship, |
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23|authority, council, committee, trust or any entity created by a |
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24|trust, county, city, village, town, township, district, school |
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1|district, fair board, court, executive office, advisory group, task |
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2|force, study group or any subdivision thereof, supported in whole or |
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3|in part by public funds or entrusted with the expenditure of public |
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4|funds or administering or operating public property, and all |
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5|committees, or subcommittees thereof. Except for the records |
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6|required by Section 24A.4 of this title, public body does not mean |
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7|judges, justices, the Council on Judicial Complaints, the |
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8|Legislature or legislators. Public body shall not include an |
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9|organization that is exempt from federal income tax under Section |
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10|501(c)(3) of the Internal Revenue Code of 1986, as amended, and |
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11|whose sole beneficiary is a college or university, or an affiliated |
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12|entity of the college or university, that is a member of The |
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13|Oklahoma State System of Higher Education. Such organization shall |
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14|not receive direct appropriations from the Legislature. The |
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15|following persons shall not be eligible to serve as a voting member |
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16|of the governing board of the organization: |
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17| a. a member, officer, or employee of the Oklahoma State |
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18| Regents for Higher Education, |
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19| b. a member of the board of regents or other governing |
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20| board of the college or university that is the sole |
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21| beneficiary of the organization, or |
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22| c. an officer or employee of the college or university |
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23| that is the sole beneficiary of the organization; |
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24| |
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1| 3. "Public office" means the physical location where public |
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2|bodies conduct business or keep records; |
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3| 4. "Public official" means any official or employee of any |
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4|public body as defined herein; and |
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5| 5. "Law enforcement agency" means any public body charged with |
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6|enforcing state or local criminal laws and initiating criminal |
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7|prosecutions including, but not limited to: police departments; |
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8|state and local fire marshals when investigating potential |
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9|violations of federal, state, or local criminal laws or when acting |
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10|on behalf of a law enforcement agency; county sheriffs; the |
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11|Department of Public Safety; the Oklahoma State Bureau of Narcotics |
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12|and Dangerous Drugs Control; the Alcoholic Beverage Laws Enforcement |
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13|Commission; and the Oklahoma State Bureau of Investigation. |
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14| SECTION 9. It being immediately necessary for the preservation |
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15|of the public peace, health or safety, an emergency is hereby |
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16|declared to exist, by reason whereof this act shall take effect and |
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17|be in full force from and after its passage and approval. |
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19| 60-2-14605 TJ 12/10/25 |
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Req. No. 14605 Page 17