1 STATE OF OKLAHOMA
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2 2nd Session of the 59th Legislature (2024)
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3 SENATE BILL 1752 By: Garvin
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6 AS INTRODUCED
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7 An Act relating to the state Medicaid program;
7 amending Section 1, Chapter 309, O.S.L. 2022 (36 O.S.
8 Supp. 2023, Section 6012), which relates to health
8 care plan recognition; modifying certain authority of
9 the Insurance Department; requiring the Department to
9 recognize certain health care plans for specified
10 purpose; modifying conditions for recognition;
10 amending 56 O.S. 2021, Section 1010.1, as amended by
11 Section 2, Chapter 309, O.S.L. 2022 (56 O.S. Supp.
11 2023, Section 1010.1), which relates to premium
12 assistance program; modifying certain deadline and
12 requirements for participation by certain health care
13 plans; updating statutory reference; providing an
13 effective date; and declaring an emergency.
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16 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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17 SECTION 1. AMENDATORY Section 1, Chapter 309, O.S.L.
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18 2022 (36 O.S. Supp. 2023, Section 6012), is amended to read as
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19 follows:
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20 Section 6012. A health care plan recognized by the The
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21 Insurance Department that participates shall recognize self-funded
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22 or self-insured health care plans for the exclusive purpose of
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23 participation in the premium assistance program created under
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24 Section 1010.1 of Title 56 of the Oklahoma Statutes as of the
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 1 effective date of this act that at a later date becomes a self-
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2 funded or self-insured health care plan may continue to be
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3 recognized by the Insurance Department as a health care plan if such
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4 plan meets if such plans meet the requirements under subsection J of
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5 Section 1010.1 of Title 56 of the Oklahoma Statutes. The A self-
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6 funded or self-insured health care plan recognized by the Department
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7 under this section shall only be considered a health care plan for
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8 the exclusive purposes of the premium assistance program created
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9 under Section 1010.1 of Title 56 of the Oklahoma Statutes.
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10 SECTION 2. AMENDATORY 56 O.S. 2021, Section 1010.1, as
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11 amended by Section 2, Chapter 309, O.S.L. 2022 (56 O.S. Supp. 2023,
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12 Section 1010.1), is amended to read as follows:
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13 Section 1010.1. A. Section 1010.1 et seq. of this title shall
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14 be known and may be cited as the “Oklahoma Medicaid Program Reform
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15 Act of 2003”.
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16 B. Recognizing that many Oklahomans do not have health care
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17 benefits or health care coverage, that many small businesses cannot
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18 afford to provide health care benefits to their employees, and that,
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19 under federal law, barriers exist to providing Medicaid benefits to
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20 the uninsured, the Legislature hereby establishes provisions to
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21 lower the number of uninsured, assist businesses in their ability to
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22 afford health care benefits and coverage for their employees, and
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23 eliminate barriers to providing health coverage to eligible
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24 enrollees under federal law.
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 1 C. Unless otherwise provided by law, the Oklahoma Health Care
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2 Authority shall provide coverage under the state Medicaid program to
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3 children under the age of eighteen (18) years whose family incomes
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4 do not exceed one hundred eighty-five percent (185%) of the federal
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5 poverty level.
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6 D. 1. The Authority is directed to apply for a waiver or
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7 waivers to the Centers for Medicare and Medicaid Services (CMS) that
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8 will accomplish the purposes outlined in subsection B of this
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9 section. The Authority is further directed to negotiate with CMS to
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10 include in the waiver authority provisions to:
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11 a. increase access to health care for Oklahomans,
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12 b. reform the Oklahoma Medicaid Program to promote
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13 personal responsibility for health care services and
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14 appropriate utilization of health care benefits
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15 through the use of public-private cost sharing,
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16 c. enable small employers, and/or employed, uninsured
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17 adults with or without children to purchase employer-
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18 sponsored, state-approved private, or state-sponsored
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19 health care coverage through a state premium
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20 assistance payment plan. If by January 1, 2012, the
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21 Employer/Employee Partnership for Insurance Coverage
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22 Premium Assistance Program is not consuming more than
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23 seventy-five percent (75%) of its dedicated source of
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 1 funding, then the program will be expanded to include
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2 parents of children eligible for Medicaid, and
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3 d. develop flexible health care benefit packages based
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4 upon patient need and cost.
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5 2. The Authority may phase in any waiver or waivers it receives
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6 based upon available funding.
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7 3. The Authority is authorized to develop and implement a
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8 premium assistance plan to assist small businesses and/or their
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9 eligible employees to purchase employer-sponsored insurance or “buy-
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10 in” to a state-sponsored benefit plan.
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11 4. a. The Authority is authorized to seek from the Centers
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12 for Medicare and Medicaid Services any waivers or
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13 amendments to existing waivers necessary to accomplish
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14 an expansion of the premium assistance program to:
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15 (1) include for-profit employers with two hundred
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16 fifty employees or less up to any level supported
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17 by existing funding resources, and
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18 (2) include not-for-profit employers with five
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19 hundred employees or less up to any level
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20 supported by existing funding resources.
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21 b. Foster parents employed by employers with greater than
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22 two hundred fifty employees shall be exempt from the
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23 qualifying employer requirement provided for in this
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24 paragraph and shall be eligible to qualify for the
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 1 premium assistance program provided for in this
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2 section if supported by existing funding.
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3 E. For purposes of this paragraph, “for-profit employer” shall
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4 mean an entity which is not exempt from taxation pursuant to the
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5 provisions of Section 501(c)(3) of the Internal Revenue Code and
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6 “not-for-profit employer” shall mean an entity which is exempt from
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7 taxation pursuant to the provisions of Section 501(c)(3) of the
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8 Internal Revenue Code.
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9 F. The Authority is authorized to seek from the Centers for
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10 Medicare and Medicaid Services any waivers or amendments to existing
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11 waivers necessary to accomplish an extension of the premium
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12 assistance program to include qualified employees whose family
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13 income does not exceed two hundred fifty percent (250%) of the
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14 federal poverty level, subject to the limit of federal financial
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15 participation.
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16 G. The Authority is authorized to create as part of the premium
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17 assistance program an option to purchase a high-deductible health
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18 insurance plan that is compatible with a health savings account.
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19 H. 1. There is hereby created in the State Treasury a
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20 revolving fund to be designated the “Health Employee and Economy
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21 Improvement Act (HEEIA) Revolving Fund”.
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22 2. The fund shall be a continuing fund, not subject to fiscal
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23 year limitations, and shall consist of:
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 1 a. all monies received by the Authority pursuant to this
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2 section and otherwise specified or authorized by law,
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3 b. monies received by the Authority due to federal
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4 financial participation pursuant to Title XIX of the
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5 Social Security Act, and
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6 c. interest attributable to investment of money in the
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7 fund.
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8 3. All monies accruing to the credit of the fund are hereby
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9 appropriated and shall be budgeted and expended by the Authority to
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10 implement a premium assistance plan and to fund the state share for
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11 the Oklahoma Medicaid program on or after July 1, 2020, unless
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12 otherwise provided by law.
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13 I. 1. The Authority shall establish a procedure for verifying
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14 an applicant’s individual income by utilizing available Oklahoma Tax
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15 Commission records, new hire report data collected by the Oklahoma
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16 Employment Security Commission, and child support payment data
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17 collected by the Department of Human Services in accordance with
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18 federal and state law.
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19 2. The Oklahoma Tax Commission, Oklahoma Employment Security
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20 Commission, and Department of Human Services shall cooperate in
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21 accordance with federal and state law with the Authority to
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22 establish procedures for the secure electronic transmission of an
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23 applicant’s individual income data to the Authority.
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 1 3. The Department of Public Safety shall cooperate in
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2 accordance with federal and state law with the Authority to
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3 establish procedures for the secure electronic transmission of an
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4 applicant’s individual identification data to the Authority.
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5 J. A health care plan An employer participating in the premium
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6 assistance program created under this section as of the effective
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7 date of this act that at a later date becomes November 1, 2024, may
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8 utilize a self-funded or self-insured health care plan may continue
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9 to participate in the premium assistance program as a participating
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10 health care plan if:
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11 1. The health care plan has continuously participated in the
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12 premium assistance program without interruption up to the date it
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13 becomes a self-funded or self-insured health care plan;
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14 2. The self-funded or self-insured health care plan continues
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15 to be recognized as a health care plan is recognized by the
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16 Insurance Department under Section 1 of this act Section 6012 of
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17 Title 36 of the Oklahoma Statutes;
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18 3. 2. The self-funded or self-insured health care plan
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19 continues to cover covers all essential health benefits as required
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20 by the Centers for Medicare and Medicaid Services Authority and all
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21 other health benefits required under applicable federal laws;
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22 3. The self-funded or self-insured health care plan otherwise
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23 complies with all applicable federal laws including but not limited
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24 to the Employee Retirement Income Security Act of 1974 (ERISA); and
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 1 4. The Authority receives the necessary federal approval for
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2 self-funded or self-insured health care plans to participate in the
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3 premium assistance program.
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4 SECTION 3. This act shall become effective July 1, 2024.
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5 SECTION 4. It being immediately necessary for the preservation
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6 of the public peace, health or safety, an emergency is hereby
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7 declared to exist, by reason whereof this act shall take effect and
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8 be in full force from and after its passage and approval.
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10 59-2-2774 DC 1/17/2024 10:49:15 AM
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Statutes affected:
Introduced: 56-1010.1
Committee Substitute: 56-1010.1
Floor (House): 56-1010.1
Floor (Senate): 56-1010.1
Engrossed: 56-1010.1
Enrolled (final version): 56-1010.1