Oklahoma has enacted a new law to protect patients from surprise ambulance bills, reports
News 9. The law, effective November 1, 2024, aims to shield patients from unexpected charges
during emergency ambulance rides. It also provides financial support for rural EMS services,
helping them acquire equipment and offer competitive wages. This legislation is expected to
improve the financial stability of EMS providers and ensure better patient protection without
increasing insurance premiums.

Oklahoma passed legislation addressing price transparency in an effort to limit medical debt,
reports KSWO. The new law aims to alleviate the burden of medical debt for Oklahomans by
establishing more transparent billing practices and limiting predatory debt collection tactics.

Oklahoma passed legislation simplifying the prior authorization process, reports KFOR. This
legislation requires prior authorization procedures to be published on websites available to
patients and providers, those with chronic conditions must be notified no less than 60 days prior
to changes that will affect them, appeals must be reviewed by providers of the same or similar
specialties, and insurers must respond to urgent requests within 72 hours and nonurgent
requests within seven days. Moreover, the new law requires hospitals prove compliance with
federal price transparency regulations before pursuing collections. The new law aims to improve
health care efficiency and reduce administrative burdens on health care providers, ultimately
benefiting patient care and accessibility.

A legislative report released by the Oklahoma Department of Human Services highlights health
care affordability challenges affecting the state's aging population, reports The Journal Record.
The report explains that seniors throughout the state are concerned about the cost of health
care and the lack of affordable transportation to services. Similarly, when asked about
recommendations to address other concerns, interview participants responded that the state
needs to examine opportunities address the deficit in affordable prescription drugs and medical
equipment.

Oklahoma has approved and is in the process of implementing a 25 percent rate increase for providers who work with individuals with intellectual and developmental disabilities, reports The Oklahoman. Policymakers claim that the impetus for the increase is the 13-year wait list for intellectual and developmental disability services in the state, which lead to poor health outcomes and an increased reliance on private and unpaid caregiving across Oklahoma–which can be expensive and time consuming for families. DHS bumped its provider reimbursement rates to increase pay for a variety of medical professionals, including nurses, speech therapists, group home employees and direct care staffers who help developmentally disabled Oklahomans and those who help low-income seniors.

A caregiver from Del City lost both her employment and medical coverage after a major stroke left her unable to work, leaving her completely without coverage when she later suffered a second stroke, according to the Oklahoma Policy Institute. Despite qualifying for a hospital program that provides medical assistance to uninsured individuals, the woman was unable to afford her medications. Her son, who suffers from diabetes, scaled back on his own medications to pay for his mothers’ and has suffered health consequences as a result. A patchwork of community-based programs has helped, but the services are time-limited and provide only a temporary solution. More permanent supports are needed to help Oklahoma residents afford needed care.

While some Oklahoma hospitals have suspended or pulled back on filing lawsuits against their former patients in light of COVID-19, others are continuing with business as usual, according to Oklahoma Watch. At least 1,178 lawsuits were filed since the governor declared a statewide health emergency on April 2. In the bulk of those cases, hospitals have sought to collect anywhere from a few hundred dollars to more than $10,000. Although the vast majority of bills stem from hospital visits that occurred during or before 2019, patient advocates point out that the lawsuits are ill-timed as many families are struggling financially during the pandemic.

Amid a spike in coronavirus cases across Oklahoma, COVID-19 data from Tulsa County suggests that people of color, particularly Asian and Latinx people, are being disproportionately harmed by the virus, according to The Black Wall Street Times. Despite national data indicating that non-Hispanic Black and Indigenous Americans are 5 times more likely to be hospitalized due to COVID-19 than non-Hispanic White Americans, local data shows that Black and Indigenous people in Tulsa County have disproportionately low rates of COVID-19 infection. A potential explanation for the discrepancy could be increased access to testing and treatment for COVID-19 for some racial and ethnic groups over others. 

Health insurance companies in Oklahoma will be required to cover mental health and substance use disorders the same way they cover physical ailments under a new state law, reports The Oklahoman. Despite federal requirements passed in 2008, many states still struggle to provide equal coverage for mental health and substance use treatment. This inequality can come in the form of fewer in-network physicians or unequal reimbursement rates for behavioral health compared to physical health. 

As coronavirus spreads into rural Oklahoma, hospitals serving those communities face difficulties that go beyond those of their metropolitan counterparts, reports The Oklahoman. Rural hospitals less likely to receive shipments of personal protective equipment (PPE) -- a concern not only for staff safety but potentially leading to debilitating workforce shortages if providers fall ill. Moreover, the COVID-19 outbreak comes at a time when rural hospitals are struggling financially due to declining rural populations and rising costs, among other factors.

Oklahoma’s Attorney General has joined a bipartisan coalition of 46 attorneys general from across the country filing an amicus brief in the U.S. Supreme Court that supports the authority of the states to address the rising cost of prescription drugs, reports FOX25. The brief supports a law proposed by the state of Arkansas in 2015 that sought to require pharmacy benefit managers (PBMs) to raise their reimbursement rate for a drug if the rate were to fall below the pharmacy's wholesale cost.

The Federal Communications Commission authorized more than $6.7 million in funding over 10 years to expand broadband access in rural Oklahoma, reports Tulsa World. The investment will reduce barriers to healthcare by supporting telehealth, as well as increase educational and economic opportunities, for over 2,400 unserved homes and businesses within the state. 

Oklahoma ranks in the top ten for states with the highest rates of surprise medical bills, reports Oklahoma Watch. A study by the Peterson Center on Healthcare and the Kaiser Family Foundation found that one in five emergency room visits in Oklahoma resulted in at least one out-of-network charge for patients with employer-sponsored health plans in 2017. Despite several legislative attempts, Oklahoma remains one of 25 states without laws protecting patients against out-of-network surprise bills as of 2019.  

Oklahoma ranks in the top ten for states with the highest rates of surprise medical bills, reports Oklahoma Watch. A study by the Peterson Center on Healthcare and the Kaiser Family Foundation found that one in five emergency room visits in Oklahoma resulted in at least one out-of-network charge for patients with employer-sponsored health plans in 2017. Despite several legislative attempts, Oklahoma remains one of 25 states without laws protecting patients against out-of-network surprise bills as of 2019.

The Oklahoma Health Care Authority announced the statewide expansion of a pilot program to improve the health of Medicaid members with chronic conditions by optimizing their medication. A secure data platform analyzes social, medical and behavioral data to identify health needs, barriers to care and dangerous gaps in care. The platform then uses artificial intelligence to generate personalized treatment plans according to clinical best practices, which it sends to patients’ providers. Plan implementation is monitored to ensure that patients remain on track.

Despite efforts to increase the number of doctors in rural areas, many Oklahoma counties still lack the physicians needed to provide sufficient care for residents, reports The Oklahoman. Seventy-two of the state's 77 counties are designated as primary health-professional shortage areas by the federal government and 30 of them have 10 or fewer doctors of any type. Oklahoma has been creating incentives for doctors to practice in rural areas since the 1970s, but big-city amenities and educational and professional resources draw many physicians to other areas. Additionally, new physicians are increasingly choosing specialty practice so they can earn more and pay off sizable debt from medical school more quickly. This exacerbates the rural-urban divide because most specialty practices are located in urban areas. As a result, the state is funding a $5 million, five-year program to help pay off doctors' student debts if they agree to practice in a rural area.

Dozens of Oklahoma hospitals have filed more than 22,000 lawsuits against their former patients over unpaid medical bills since 2016, according to Oklahoma Watch. These billing practices highlight a heated debate in the medical community across the country. Consumer advocates argue that hospitals, especially those that are nonprofits, sue too often and should prioritize their moral obligation to their patients. Hospital officials say they already offer millions of dollars in charity care for those who meet certain income standards and that they only take legal action when necessary.  Patients sued are at a disadvantage in court, because few people in these situations can afford a lawyer or know what steps to take.

Oklahoma’s legislature enacted HB 2351, entering the state into the Interstate Medical Licensure Compact (IMLC), effective November 1, 2019, reports The Oklahoman. The IMLC is an agreement among more than 25 states that allows qualified physicians to obtain expedited medical licenses in any compact-member state, reducing barriers to the provision of telemedicine services across state lines. This flexibility expands access to specialists for patients living in rural, frontier and other underserved areas.  

Proposed legislation in Oklahoma would establish a pilot program to attract physicians to rural parts of the state, according to The Journal Record. If signed into law, the bill would provide an income tax credit of up to $25,000 annually for up to five years for doctors who set up practices in communities of less than 25,000 people. To qualify for the income tax credit, doctors would have to have completed their medical training or medical residency in Oklahoma and would have to live in the same rural counties where they practice.

The Oklahoma State Department of Health was awarded a five-year grant from the U.S. Health Resources and Services Administration totaling more than $890,000 to improve access to healthcare services for people who are uninsured, isolated or medically vulnerable, reports The Oklahoman. The health department will work with the federal agency to produce a statewide primary care needs assessment, identify unmet healthcare needs and barriers to care (like workforce shortages) and advance strategies which improve access to comprehensive primary healthcare services in Oklahoma.

Cherokee tribal land in Oklahoma will soon be home to the largest Native American health facility in the U.S, according to FOX 25 News. The facility will include the country’s first tribally affiliated medical school with the goal of training more future doctors in Oklahoma and getting them to stay. Cherokee officials hope the medical school will help bridge the gap when it comes to doctor shortages, which are a serious issue in rural communities.

Forty-one of Oklahoma's 77 counties are designated “maternity deserts,” meaning they lack a hospital performing deliveries or an obstetrics provider, reports NewsOK. Most of the counties are rural, and women who live there are more likely to live in poverty than the statewide average. The decline in hospitals performing deliveries is partially due to the economics of running a maternity unit – for example, they must be staffed around the clock, which isn't feasible in areas that don't have a large enough population. Ideas to expand maternity care in rural areas include: offering incentives for doctors to work in rural areas; training doctors who grew up in rural areas and are more likely to return to practice; and expanding Medicaid to increase the number of women receiving coverage for prenatal care.

Oklahoma's Medicaid program is implementing a first-in-the-nation drug pricing policy where the state only compensates drug companies the full price for their medications if they work as advertised, according to Business Insider. While the program is designed to hold pharmaceutical companies accountable for the efficacy and safety of their drugs, participation is voluntary—potentially mitigating the desired effect. But drug companies that do sign up will have their effective products included in a “preferred drug list,” which could result in a greater long-term profits.

Oklahoma formally withdrew its request for a 1332 waiver to begin a reinsurance program through the Affordable Care Act after federal officials failed to approve it on time, reports Oklahoma Watch. The reinsurance program would have created a pool of money to reimburse insurers for high costs on the exchange, which has seen average monthly premiums rise from $277 in 2015 to $571 this year. Several states have applied for similar waivers; the federal government has approved requests in Alaska and Minnesota.

Oklahoma is seeking to improve healthcare quality and access in the state while reducing costs by developing a system that provides more affordable healthcare options. The state is exploring a Section 1332 Waiver, which allows states to obtain flexibility within selected requirements of the Affordable Care Act (ACA). This Oklahoma State Dept. of Health report incorporates a revised concept paper, as well as recommendations and findings from the multi-stakeholder task force. 

A bill that allows insurance to be sold across state lines was signed into law, according to NewsOK. The law allows the Oklahoma Insurance Commissioner to enter into agreements with other states that allow cross-border insurance sales. Backers of the bill promoted it as a way to make less expensive health insurance available to Oklahoma residents.

As of June 1, Medicaid provider payments will be cut by 25 percent. Providers warn that this cut will sharply curtail their ability to deliver care, with rural and elderly Oklahomans hit hardest, according to Modern Healthcare. The Oklahoma Association of Health Care Providers estimated the cuts would leave more than 90 percent of the state’s nursing homes operating at a loss and in danger of closing, and four out of five hospitals would be forced to stop delivering babies. In addition, the Oklahoma Health Department will close five to seven community health departments. 

Maternal deaths are on the rise in the United States and the increase of chronic conditions - especially hypertension, diabetes, and obesity - may explain why, reports Health Affairs Blog. For the past two years, Oklahoma was one of twelve states selected to participate in the Every Mother Initiative to strengthen states’ efforts to address a leading cause of maternal death among their populations. The Oklahoma Maternal Mortality Review Committee identified pregnancy-induced hypertension and hemorrhage as major contributors to maternal mortality in the state. To address this problem, Oklahoma designed and launched hospital-based maternal safety quality improvement initiatives to identify, treat, and respond to complications related to these contributors during pregnancy. 

Oklahoma has the worst access to healthcare of all U.S. states under the Physician Access Index scoring system, reports Modern Healthcare. The system measures more than 30 benchmarks and ranks the states based on patient access to a variety of healthcare providers – including physicians, nurse practitioners and physician assistants. The data reveals that poverty can be a key barrier to access, and states can improve access by increasing residency funding, implementing telehealth programs, permitting nurse practitioners to expand their practice abilities and widening Medicaid eligibility requirements. 

The Oklahoma State Department of Health’s plan includes the intent to promote value-based health models across systems that will accelerate health improvement and yield a return on investment. To that end, the Department engaged Milliman, Inc. to analyze the implementation and uptake of care delivery models adopted in other states, and to identify potential factors affecting successful implementation of healthcare payment reform. Milliman’s report recommends that Oklahoma should consider developing Medicaid ACOs, getting critical access hospitals and small rural hospitals to participate with the National Rural ACO, increasing state efforts to integrate behavioral and physical health, streamlining quality and efficiency metrics and removing barriers to adoption of enabling technologies such as telehealth.

Founded with the goal of price transparency, the Surgery Center of Oklahoma is committed to charging fair prices, reports Think Progress. The center has been posting all of its prices online for the past several years and reportedly charges significantly less than other hospitals in the area.