1| STATE OF OKLAHOMA | | | 2| 2nd Session of the 60th Legislature (2026) | | | 3|HOUSE BILL 4460 By: Newton | | | 4| | | | 5| | | | 6| AS INTRODUCED | | | 7| An Act relating to health insurance; defining terms; | | providing patient protection; establishing health | 8| plan responsibilities; providing requirements for | | payment for clinicians and hospitals; providing for | 9| enforcement; providing for codification; and | | providing an effective date. | 10| | | | 11| | | | 12| | | | 13|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 14| SECTION 1. NEW LAW A new section of law to be codified | | | 15|in the Oklahoma Statutes as Section 6587 of Title 36, unless there | | | 16|is created a duplication in numbering, reads as follows: | | | 17| As used in this act: | | | 18| 1. "Allowed amount" means the maximum payment the health plan | | | 19|shall pay for a covered health care service, inclusive of a | | | 20|patient's responsibility; | | | 21| 2. "Clinician" means a health care professional qualified in | | | 22|the clinical practice of medicine; | | | 23| 3. "Cost share" means any copayments, coinsurance, deductibles, | | | 24|and any other out-of-pocket expenses required by a patient's | | | Req. No. 14074 Page 1 ___________________________________________________________________________
1|commercial health plan, as defined in state and federal law and | | | 2|regulations where applicable and inclusive of all cost-sharing | | | 3|obligations under the enrollee's commercial health plan; | | | 4| 4. "Health plan" means an insurance policy or contract, medical | | | 5|or hospital service agreement, membership or subscription contract, | | | 6|or other arrangement under which health services for commercially | | | 7|insured individuals are provided or the expenses of such services | | | 8|are reimbursed and paid; and | | | 9| 5. "Provider" means any licensed health care professional or | | | 10|facility providing medical services to patients. | | | 11| SECTION 2. NEW LAW A new section of law to be codified | | | 12|in the Oklahoma Statutes as Section 6588 of Title 36, unless there | | | 13|is created a duplication in numbering, reads as follows: | | | 14| A. Health plans issuing commercially insured products and | | | 15|benefits shall be solely responsible for collecting the patient | | | 16|cost-sharing amounts directly from enrollees. | | | 17| B. Health plans shall not cancel or terminate coverage or | | | 18|impose penalties due to an enrollee's nonpayment of cost-sharing | | | 19|obligations. | | | 20| C. Health plans shall, at minimum, meet all state timely | | | 21|payment requirements for payment to the provider. | | | 22| D. Health plans shall provide enrollees with affordable payment | | | 23|plans for cost-sharing amounts owed and due under the terms of the | | | 24|enrollees' commercially insured benefits. | | | Req. No. 14074 Page 2 ___________________________________________________________________________
1| SECTION 3. NEW LAW A new section of law to be codified | | | 2|in the Oklahoma Statutes as Section 6589 of Title 36, unless there | | | 3|is created a duplication in numbering, reads as follows: | | | 4| A. Health plans shall pay full in-network or out-of-network | | | 5|allowable amounts, inclusive of both payer and patient share, for | | | 6|services rendered directly by clinicians or hospitals in a timely | | | 7|manner, regardless of when or whether the patient has paid their | | | 8|cost share. | | | 9| B. Health plans shall not contractually require clinicians to | | | 10|collect patient cost-sharing amounts. | | | 11| SECTION 4. NEW LAW A new section of law to be codified | | | 12|in the Oklahoma Statutes as Section 6590 of Title 63, unless there | | | 13|is created a duplication in numbering, reads as follows: | | | 14| Health plans found in violation of this act shall be subject to | | | 15|penalties, including but not limited to, fines and sanctions as | | | 16|determined by the Attorney General. | | | 17| SECTION 5. This act shall become effective November 1, 2026. | | | 18| | | | 19| 60-2-14074 TJ 12/04/25 | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | Req. No. 14074 Page 3