The bill amends the Oklahoma Right to Shop Act by updating definitions and clarifying the shared savings incentive program. It introduces the term "Average allowed amount," which refers to the mean of all allowed amounts paid for a comparable health care service. Additionally, it modifies the definition of "Shared savings incentive" to require insurance carriers to provide financial incentives to enrollees for choosing certain health care services. The bill also specifies that insurance carriers must offer a shared savings incentive program, ensuring that enrollees' financial liabilities do not exceed in-network costs when they opt for services from non-network providers who agree to lower amounts.
Furthermore, the bill mandates that insurance carriers establish the shared savings incentive program as part of their insurance policies, notify enrollees about the program, and publish a list of comparable health care services and applicable incentives on their websites. It requires carriers to provide enrollees with the average allowed amount for covered services upon request and to credit enrollees with shared savings incentives at least quarterly. The act is set to take effect on November 1, 2025.