1 STATE OF OKLAHOMA
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2 1st Session of the 60th Legislature (2025)
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3 SENATE BILL 109 By: Stanley
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6 AS INTRODUCED
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7 An Act relating to health insurance; defining terms;
7 requiring coverage of certain genetic testing and
8 cancer imaging; specifying terms of coverage;
8 providing certain exclusions; providing for
9 codification; and providing an effective date.
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12 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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13 SECTION 1. NEW LAW A new section of law to be codified
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14 in the Oklahoma Statutes as Section 6060.5b of Title 36, unless
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15 there is created a duplication in numbering, reads as follows:
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16 A. For the purposes of this section:
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17 1. “Clinical utility” means clinical utility as defined
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18 pursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes;
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19 2. “Evidence-based cancer imaging” means appropriate
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20 preventative screening and imaging supported by evidence;
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21 3. “Genetic testing for an inherited mutation” means multi-gene
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22 testing for an inherited mutation associated with an increased risk
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23 of cancer;
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 1 4. “Health benefit plan” means a health benefit plan as defined
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2 pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; and
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3 5. “Health care provider” means any physician, hospital, or
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4 other entity or person that is licensed or otherwise authorized in
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5 this state to furnish health care services.
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6 B. Any health benefit plan including the Oklahoma Employees
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7 Insurance Plan that is offered, issued, or renewed in this state on
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8 or after the effective date of this act shall provide coverage for:
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9 1. Clinical genetic testing for an inherited gene mutation for
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10 individuals with a personal or family history of cancer when such
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11 test provides clinical utility and when ordered or recommended by a
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12 health care provider in accordance with medical and scientific
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13 evidence including, but not limited to:
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14 a. the most recent version of the National Comprehensive
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15 Cancer Network (NCCN) clinical practice
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16 recommendations that are Category 2A or higher,
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17 b. Centers for Medicare and Medicaid Services national
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18 coverage determinations or Medicare administrative
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19 contractor local coverage determinations, or
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20 c. nationally recognized clinical practice guidelines;
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21 and
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22 2. Evidence-based cancer imaging for individuals with an
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23 increased risk of cancer when such test provides clinical utility
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24 and when ordered or recommended by a health care provider in
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 1 accordance with the most recent version of the NCCN clinical
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2 practice recommendations that are Category 2A or higher, or in
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3 accordance with other nationally recognized clinical practice
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4 guidelines.
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5 C. Coverage under this section shall not be subject to any
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6 annual deductibles, copayments, or coinsurance limits as established
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7 for all covered benefits under the health benefit plan.
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8 D. If application of this section would result in health
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9 savings account ineligibility under Section 223 of the Internal
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10 Revenue Code of 1986, as amended, the provisions of this section
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11 shall only apply to health savings accounts with qualified high
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12 deductible health plans with respect to the deductible of such a
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13 plan after the enrollee has satisfied the minimum deductible.
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14 Provided, however, the provisions of this section shall apply to
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15 items or services that are preventive care pursuant to Section
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16 223(c)(2)(C) of the Internal Revenue Code of 1986, as amended,
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17 regardless of whether the minimum deductible has been satisfied.
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18 SECTION 2. This act shall become effective November 1, 2025.
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20 60-1-52 CAD 12/23/2024 1:12:51 PM
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