Various bills impacting health care providers, facilities and patients made it through the Legislature this session. Topics addressed include prescriptive authority, insurance coverage and hospital pricing.
Governor vetoes, lawmakers override
A bill with overwhelming bipartisan support expanding insurance coverage for breast cancer imaging and advanced diagnostic tests passed despite a veto from the governor. House Bill 1389 was authored by Sen. Brenda Stanley (R-Midwest City) and Rep. Melissa Provenzano (D-Tulsa), who currently has breast cancer. The goal was to promote early detection, resulting in less expensive and more effective treatments.
In his veto message, Gov. Kevin Stitt argued it would create new costs when mammograms are already covered, and providers could order more tests if needed. Lawmakers overrode the veto, and 28 female lawmakers signed a letter to Stitt expressing “profound disappointment” in his decision.
A highly debated policy addressing the prescriptive authority of qualified advanced practice registered nurses also passed.
House Bill 2298 is by House Speaker Kyle Hilbert (R-Bristow) and Senate Pro Tem. Lonnie Paxton (R-Tuttle). It allows certified nurse practitioners, clinical nurse specialists or certified nurse midwives to prescribe independently of a physician. They must complete a minimum of 6,240 supervised clinical practice hours and apply to the Oklahoma Board of Nursing for this authority.
It allows these professionals to administer Schedule III, IV and V controlled dangerous substances, which includes things like anabolic steroids, Ambien and Xanax. Supporters have argued it will expand health care access – especially in rural communities.
A similar policy made it to the governor’s desk last session but was vetoed. Stitt vetoed the measure again this session, saying he supported the policy if it was limited to primary care but not when it expands to “the specialties they say they’re trained for.” But the Legislature overrode his veto.
The “Oklahoma Community Health Worker Act,” or SB 424, directs the Oklahoma State Department of Health to establish a voluntary certificate for community health workers, who help link people to health care and social services. It was authored by Sen. Christi Gillespie (R-Broken Arrow) and Rep. Ellyn Hefner (D-Oklahoma City).
Stitt vetoed the measure, saying that although these workers offer important services, this would create “another license and more government intervention.” But lawmakers overrode his veto.
The Legislature overrode a veto on SB 804 by Sen. Adam Pugh (R-Edmond) and Rep. Preston Stinson (R-Edmond). The policy directs the State Commissioner of Health to promulgate rules governing minimum standards for resident care, including standards on medical care and administration of medications.
It would also require assisted living centers to establish and maintain an internal quality assurance committee that meets quarterly to monitor things like trends and incidents and recommend internal policies for resident care.
Stitt said in his veto message that this bill would require assisted living centers to “ jump through more regulatory hoops” and is “another example of regulatory overreach that adds red tape without actually making anything better.”
Finally, the Legislature overrode Stitt’s veto on HB 2778 by Rep. Trey Caldwell (R-Faxon) and Sen. Chuck Hall (R-Perry), which expands access to Oklahoma’s child care subsidy program for employees of child care facilities. The incentive was originally written by Rep. Suzanne Schreiber (D-Tulsa) in HB 1849.
It will create the Teacher Recruitment and Retention Program with a sunset of Nov. 1, 2028. The program will be administered by the Oklahoma Partnership for School Readiness – which serves as the state’s Early Childhood Advisory Council – under the direction of Oklahoma Human Services (DHS).
Eligibility would extend to child care employees at licensed facilities with a total annual gross household income not exceeding $120,000 for a two-parent household or $60,000 for a single-parent household. Children would be required to attend a program participating in the DHS child care subsidy program.
Employees who meet the household income limits would have their income exempt from consideration for calculating cost-sharing or co-payment responsibilities. And, if an employee qualifies under usual subsidy program requirements, they would have their co-payment waived.
Stitt said in his veto message that although child care workers play a vital role, creating an “unfunded $11 million subsidy for recruitment efforts is not a fiscally responsible solution.”
The Oklahoma Partnership for School Readiness said in a Facebook post the program is aimed at supporting recruitment and retention in the child care workforce.
Other health policies of note
Two bills – HB 2784 and HB 2793 – by Caldwell and Hall formally establish a public-private partnership mechanism to develop a Level I trauma center that serves eastern Oklahoma. That partnership is between the Saint Francis Health System and Oklahoma State University Medical Authority, according to a press release.
A Level I trauma center offers 24/7 access to trauma surgeons, anesthesiologists and specialists, like neurosurgeons and orthopedists. It also acts as a teaching facility for trauma care.
“Saint Francis seeks to operate a Level I Trauma Center in Tulsa that will enhance life-saving care for adult and pediatric trauma patients and, through a continued partnership with Oklahoma State University, provide training for our state’s next generation of doctors,” said Dr. Cliff Robertson, the president and CEO of Saint Francis Health System, in the release.
Senate Bill 889 by Sen. Casey Murdock (R-Felt) and Rep. Mark Lepak (R-Claremore) requires hospitals to publish a list of prices for 300 common services in an easy-to-understand manner. That includes things like a simple description of the service, its billing code, discounted cash price and negotiated insurance rates. The State Department of Health may monitor hospital compliance.
Murdock said in a press release this will codify health care price transparency regulations put in place during President Donald Trump’s first term. According to a hospital price transparency report from the nonprofit PatientRightsAdvocate.org, only 12% of hospitals reviewed in Oklahoma are fully complying with the federal rule.
“Requiring providers to publish clear and accurate pricing for common procedures gives patients the power to shop around for the best care at the best price,” Murdock said in the release. “By putting this federal policy into state law, we’re ensuring that hospital price transparency is here to stay, no matter what happens in Washington.”
SB 176 by Sen. Jo Anna Dossett (D-Tulsa) and Rep. Cynthia Roe (R-Lindsay) requires health benefit plans offering coverage for contraceptive drugs to provide coverage for a three-month supply the first time an enrollee obtains it and a six-month supply each subsequent time.
SB 672 by Sen. Julie McIntosh (R-Porter) and Rep. Kevin West (R-Moore) states that during a pandemic under a declared state of emergency, the governor shall not close or force the closing of any business “without documented scientific evidence that the nature of a particular business actually contributes to the direct spreading of disease relating to the pandemic.”
"This bill is not about actions taken in the past, but about how we're going to move forward as a state to protect the free enterprise of our business owners in the same way we allow the public the freedom to choose how best to protect themselves," West said in a press release.
Finally, HB 1601 by Rep. Emily Gise (R-Oklahoma City) and Sen. Mark Mann (D-Oklahoma City) allows teachers to use up to six weeks of accrued sick leave to extend their six-week paid maternity leave. They can’t exceed 12 weeks unless additional time is recommended by a licensed medical professional.
“Some school districts were uncertain if they could do this, so HB 1601 clarifies that teachers can use up to six weeks of accrued sick leave in addition to their state leave,” Mann said in a press release. “This is better for mothers and babies, it helps retain great educators, and it also helps us compete with private sector companies that already provide 12 weeks of maternity leave.”
What remains on the governor’s desk?
A few health bills are sitting on Stitt’s desk as of Monday. He has until June 14 to take action on them, or they will be considered “pocket vetos.” Those include:
- SB 207: Establishes the Oklahoma Rare Disease Advisory Council in the State Department of Health. It would provide guidance and recommendations to educate the public, Legislature and other agencies on the needs of individuals with rare diseases. The measure was authored by Sen. Tom Woods (R-Westville) and Rep. Josh West (R-Grove).
- HB 2645: Beginning in the 2026 tax year, doctors who practice medicine in a rural area can get an up to $20,000 income tax credit. A qualifying doctor can claim the credit for up to four taxable years. A rural area is considered a city or town with a population of less than 25,000 that is at least 25 miles from the nearest city or town with a population greater than 25,000. The bill was authored by Hilbert and Paxton.
- HB 2262: Requires a facility advertising memory care to disclose the type of care they provide. The policy was authored by Rep. Nicole Miller (R-Edmond) and Stanley.
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