The Prosthetic Access and Accountability Act of 2026 aims to enhance access to prosthetic care and ensure accountability from health benefit plans in Oklahoma. The bill establishes a clear goal of treatment focused on restoring physical function for individuals requiring prosthetic benefits, prohibiting discrimination based on disability. It defines key terms related to prosthetic care and outlines that medical necessity should be determined by the treating provider, not limited by factors such as diagnosis or age. Additionally, the bill mandates that health benefit plans ensure access to necessary clinical care and prosthetic services, and it establishes a rebuttable presumption of negligence for plans that deny or unreasonably delay coverage for physician-prescribed devices.

The legislation also imposes liability on health benefit plans for personal injury or financial loss resulting from such denials or delays, allowing affected enrollees to seek compensatory and punitive damages. The Insurance Commissioner is tasked with enforcing the provisions of the act, investigating complaints, and maintaining annual reports on denials and adverse outcomes. Health benefit plans that violate the act may face fines, daily penalties for unreasonable delays, or revocation of their authority. Coverage requests for prostheses and orthoses must be reviewed within specified time frames, with automatic approval for failures to respond, and enrollees harmed by violations are granted the right to pursue civil action. The act is set to take effect on January 1, 2027.