In Oklahoma, the legislature has taken steps to curb health insurance overreach, but much more needs to be done.
The first of these bills, HB3190—the Ensuring Transparency in Prior Authorization Act—took effect on Jan. 1, 2025. Sponsored by Rep. Carl Newton and Sen. Jessica Garvin, the OSMA and Oklahoma Academy of Family Physicians (OAFP)-backed law was designed to give physicians and patients more control over prescribed patient care.
Key provisions of HB3190 include:
Prior authorization procedures must be published on websites accessible to patients and providers.
Patients with chronic conditions must be notified at least 60 days in advance of any changes to their care.
Appeals must be reviewed by providers with the same or similar specialties.
Health insurers must respond to urgent requests within 72 hours and to non-urgent requests within seven days.
Bills passed in the 2025 Legislative session further limit health insurers' prior authorization and clawback practices.
Decreases the window for health insurers to request a refund of payment from insured Oklahomans or health care providers under the Unfair Claims Settlement Practices Act.
Modifies various provisions related to health insurance, provides cost-sharing requirements, step-therapy protocols for prescribed drugs, requirements for processing claims and standards related to prior authorization.
While carryover legislation is currently pending in the Oklahoma House of Representatives and Senate that seeks to provide additional protections to Oklahoma’s patients.
Creates the Insurance Consumers Protection Act, which establishes specific legal rights of action for insured Oklahomans whose claims are refused in bad faith.
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