1 STATE OF OKLAHOMA
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2 2nd Session of the 59th Legislature (2024)
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3 SENATE BILL 1703 By: Daniels
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6 AS INTRODUCED
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7 An Act relating to the state Medicaid program;
7 amending 63 O.S. 2021, Section 5051.2, which relates
8 to recovery of expenses; prohibiting certain insurers
8 from denying claims on specified grounds; requiring
9 insurer to accept certain authorization; requiring
9 insurer to respond to certain inquiry within
10 specified time frame; clarifying language; and
10 providing an effective date.
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13 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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14 SECTION 1. AMENDATORY 63 O.S. 2021, Section 5051.2, is
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15 amended to read as follows:
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16 Section 5051.2. A. Whenever the Oklahoma Health Care Authority
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17 pays for medical services or renders medical services, for or on
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18 behalf of a person who has been injured or suffered an illness or
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19 disease, the right of the provider of the services to reimbursement
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20 shall be automatically assigned to the Oklahoma Health Care
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21 Authority, upon notice to the insurer or other party obligated as a
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22 matter of law or agreement to reimburse the provider on behalf of
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23 the patient.
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 1 B. Upon the assignment, the Authority, for purposes of the
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2 claim for reimbursement, becomes a provider of medical services.
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3 C. The assignment of the right to reimbursement shall be
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4 applied and considered valid against any employer or insurer under
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5 the Administrative Workers’ Compensation Act in this state.
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6 D. Each insurer, upon receiving a claim from the Oklahoma
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7 Health Care Authority, shall accept the state’s right of recovery,
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8 to process and, if appropriate, pay the claim to the same extent
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9 that the plan would have been liable if it had been billed at the
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10 point of sale or by the original provider of services. Insurer The
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11 insurer shall not deny the Authority claims on the basis of the date
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12 of submission, the format of the claim, or for failure to present
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13 proper documentation of coverage at the point of sale.
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14 E. An insurer, except a Medicare Advantage plan, shall not deny
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15 the Authority claims solely on the basis that a claimed item or
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16 service did not receive prior authorization under the rules or
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17 coverage policies of the insurer. The insurer shall accept an
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18 authorization provided by the Authority for an item or service
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19 covered under the state Medicaid program or under a home- and
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20 community-based services waiver for such individual as if such
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21 authorization was made by the insurer for such item or service.
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22 F. If the Authority submits an inquiry regarding a claim to an
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23 insurer not later than three (3) years after the date of provision
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 1 of the claimed item or service, the insurer shall respond to the
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2 inquiry within sixty (60) days of receiving the inquiry.
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3 G. Insurer An insurer shall make appropriate payments to the
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4 Authority as long as the claim is submitted for consideration within
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5 three (3) years from the date the service was furnished. Any action
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6 by the Authority to enforce the payment of the claim shall be
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7 commenced within six (6) years of the submission of the claim by the
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8 Authority.
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9 SECTION 2. This act shall become effective November 1, 2024.
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11 59-2-2724 DC 1/16/2024 4:43:12 PM
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