1 STATE OF OKLAHOMA
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2 1st Session of the 59th Legislature (2023)
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3 SENATE BILL 17 By: Garvin
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6 AS INTRODUCED
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7 An Act relating to health insurance; defining terms;
7 prohibiting insurers from refusing coverage to an
8 insured under certain circumstances; providing for an
8 insured to seek care from an out-of-network provider
9 under certain circumstances; requiring out-of-network
9 providers to be reimbursed for covered services at
10 the same rate as in-network providers; providing for
10 codification; and declaring an emergency.
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13 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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14 SECTION 1. NEW LAW A new section of law to be codified
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15 in the Oklahoma Statutes as Section 6971 of Title 36, unless there
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16 is created a duplication in numbering, reads as follows:
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17 A. As used in this section:
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18 1. “Durable medical equipment” means equipment as defined
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19 pursuant to paragraph 2 of Section 375.2 of Title 59 of the Oklahoma
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20 Statutes;
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21 2. “Health benefit plan” means a health benefit plan as defined
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22 pursuant to subsection C of Section 6060.4 of Title 36 of the
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23 Oklahoma Statutes;
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 1 3. “Health care provider” means a provider as defined pursuant
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2 to Section 6571 of Title 36 of the Oklahoma Statutes;
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3 4. “Health maintenance organization” or “HMO” means a health
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4 maintenance organization as defined pursuant to paragraph 12 of
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5 Section 6902 of Title 36 of the Oklahoma Statutes; and
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6 5. “Preferred provider organization” or “PPO” means a preferred
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7 provider organization as defined pursuant to paragraph 8 of Section
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8 6054 of Title 36 of the Oklahoma Statutes.
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9 B. No health benefit plan, HMO, PPO, or other provider network
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10 authorized to administer health care coverage in this state shall
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11 refuse coverage to an insured for durable medical equipment and
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12 supplies as prescribed by a health care provider, regardless of
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13 whether they are in-network or out-of-network, unless there is an
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14 in-network provider within a thirty-mile radius of the patient’s 5-
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15 digit zip code that can provide in-person evaluation for medical
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16 equipment, supplies, and related services.
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17 C. If a health care provider deems it necessary that an insured
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18 receive covered medical equipment or supplies within twenty-four
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19 (24) hours, the insured shall not be subject to drop-shipped orders
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20 and may seek such equipment and supplies from any health care
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21 provider who can provide the necessary services and supplies within
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22 the requested timeframe.
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23 D. When a covered person is required to utilize an out-of-
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24 network health care provider, the out-of-network provider shall be
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 1 reimbursed at the same rate and benefit level for the provided
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2 services as an in-network provider for the health benefit plan, HMO,
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3 PPO, or other provider network authorized to administer health care
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4 coverage in this state.
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5 SECTION 2. 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 59-1-591 RD 12/8/2022 2:28:01 PM
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