1| STATE OF OKLAHOMA | | | 2| 1st Session of the 60th Legislature (2025) | | | 3|SENATE BILL 1005 By: Stewart | | | 4| | | | 5| | | | 6| AS INTRODUCED | | | 7| An Act relating to hospitals; requiring hospitals to | | implement certain policy; requiring hospitals to | 8| provide certain itemized statement on request; | | listing required information for itemized statement; | 9| stipulating requirements and procedures for providing | | statement to third-party payor; authorizing certain | 10| fee; authorizing certain enforcement; defining term; | | creating exception; providing for codification; and | 11| providing an effective date. | | | 12| | | | 13| | | | 14|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 15| SECTION 1. NEW LAW A new section of law to be codified | | | 16|in the Oklahoma Statutes as Section 1-724.1 of Title 63, unless | | | 17|there is created a duplication in numbering, reads as follows: | | | 18| A. Each hospital licensed by the State Department of Health | | | 19|shall develop, implement, and enforce a written policy for the | | | 20|billing of hospital services and supplies. The policy shall | | | 21|include: | | | 22| 1. A periodic review of the itemized statements required by | | | 23|subsection B of this section; and | | | 24| | | | Req. No. 177 Page 1 ___________________________________________________________________________
1| 2. A procedure for handling complaints relating to billed | | | 2|services. | | | 3| B. Not later than thirty (30) business days after the date of | | | 4|the hospital discharge of a person who received hospital services, | | | 5|the hospital shall automatically provide an itemized statement of | | | 6|the billed services provided to the person. The itemized statement | | | 7|shall be printed in a conspicuous manner and shall list the | | | 8|following information: | | | 9| 1. Provider's name and National Provider Identifier (NPI) | | | 10|number; | | | 11| 2. Date or dates of service; | | | 12| 3. Admission date; | | | 13| 4. Discharge date; | | | 14| 5. Revenue codes corresponding to each service rendered; | | | 15| 6. Current Procedural Terminology (CPT) or Healthcare Common | | | 16|Procedure Coding System (HCPCS) codes corresponding to each service | | | 17|rendered; | | | 18| 7. Description of each service; | | | 19| 8. Amount charged by the provider for each service; | | | 20| 9. Units and quantities of each service provided, specifically | | | 21|procedures, tests, or medications that may be measured in units; | | | 22| 10. Subtotal of each service; | | | 23| 11. Insurance payments; | | | 24| 12. Patient payments; | | | Req. No. 177 Page 2 ___________________________________________________________________________
1| 13. Payment due date; | | | 2| 14. Provider's contact information; and | | | 3| 15. A section on hospital payments and adjustments, which shall | | | 4|include: | | | 5| a. date or dates of service, | | | 6| b. description of hospital payment and adjustment, | | | 7| c. any discounts and credits, | | | 8| d. total hospital payment and adjustments, and | | | 9| e. final hospital payment after adjustments. | | | 10| C. A hospital shall provide an itemized statement of billed | | | 11|services to a third-party payor who is actually or potentially | | | 12|responsible for paying all or part of the billed services provided | | | 13|to a patient and who has received a claim for payment of those | | | 14|services. To be entitled to receive a statement, the third-party | | | 15|payor must request the statement from the hospital and must have | | | 16|received a claim for payment. The request must be made not later | | | 17|than one year after the date on which the payor received the claim | | | 18|for payment. The hospital shall provide the statement to the payor | | | 19|not later than thirty (30) business days after the date on which the | | | 20|payor requests the statement. If a third-party payor receives a | | | 21|claim for payment of part but not all of the billed services, the | | | 22|third-party payor may request an itemized statement of only the | | | 23|billed services for which payment is claimed or to which any | | | 24|deduction or copayment applies. If a third-party payor requests | | | Req. No. 177 Page 3 ___________________________________________________________________________
1|more than two copies of the statement, the hospital may charge a | | | 2|reasonable fee for the third and subsequent copies provided to that | | | 3|person. The fee shall not exceed the hospital's cost to copy, | | | 4|process, and deliver the copy to the person. | | | 5| D. The State Department of Health may enforce this section by | | | 6|assessing an administrative penalty, obtaining an injunction, or | | | 7|providing any other appropriate remedy, including suspending, | | | 8|revoking, or refusing to renew a hospital's license. | | | 9| E. As used in this section, "hospital" has the same meaning as | | | 10|provided by Section 1-701 of Title 63 of the Oklahoma Statutes. | | | 11| F. This section shall not apply to a hospital maintained or | | | 12|operated by the federal government. | | | 13| SECTION 2. This act shall become effective November 1, 2025. | | | 14| | | | 15| 60-1-177 DC 1/16/2025 3:39:01 PM | | | 16| | | | 17| | | | 18| | | | 19| | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | Req. No. 177 Page 4