Oklahoma SB 804: Medical procedure pricing; creating Oklahoma Health Care Cost Reduction and Transparency Act of 2017. Effective date.

Bill Text

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STATE OF OKLAHOMA

1st Session of the 56th Legislature (2017)

SENATE BILL 804 By: Brecheen

AS INTRODUCED

An Act relating to medical procedure pricing;
creating the Oklahoma Health Care Cost Reduction and
Transparency Act of 2017; defining certain terms;
requiring State Department of Health to make certain
information available on its website; providing that
certain data be considered property of state;
requiring certain hospitals to provide certain
information to the Department; requiring State Board
of Health to promulgate certain rules; stating
subjects to be addressed in rules; requiring
hospitals and ambulatory surgical facilities to
provide certain information to the Department;
requiring Board to promulgate certain rules; stating
subjects to be addressed in rules; requiring certain
hospital or ambulatory surgical facility to provide
certain information to patient within certain time
period after request; requiring Department to provide
certain hyperlinks on its website; providing for
inapplicability of certain act; permitting State
Commissioner of Health to suspend or revoke certain
license if certain act is violated; providing for
codification; and providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725 of Title 63, unless there
is created a duplication in numbering, reads as follows:

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This act shall be known and may be cited as the "Oklahoma Health
Care Cost Reduction and Transparency Act of 2017".
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.1 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. As defined in this act:
1. "Ambulatory surgical center" means a healthcare facility as
defined in Section 2657 of Title 63 of the Oklahoma Statutes;
2. "Board" means the State Board of Health;
3. "Department" means the State Department of Health;
4. "Health insurer" means an entity as defined in paragraph 7
of Section 4522 of Title 36 of the Oklahoma Statutes; and
5. "Hospital" means a healthcare facility as defined in Section
1-701 of Title 63 of the Oklahoma Statutes.
B. The Department shall make available to the public on its
website the most current price information it receives from
hospitals and ambulatory surgical facilities pursuant to subsections
A and C of Section 3 of this act.
C. Any data disclosed to the Department by a hospital or
ambulatory surgical facility pursuant to the provisions of this act
shall be and will remain the sole property of the facility that
submitted the data. Any data or product derived from the data
disclosed pursuant to this act, including a consolidation or
analysis of the data, shall be and will remain the sole property of

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the state. The Department shall not allow proprietary information
it receives pursuant to the provisions of this act to be used by any
person or entity for commercial purposes.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-725.2 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Beginning with the quarter ending June 30, 2018, and at
least annually thereafter, each hospital that bills Medicaid shall
provide to the Department, utilizing electronic health records
software, the following information about the one hundred most
frequently reported admissions by diagnostic-related groups for
inpatients, as established by the Board on an annual basis, along
with the related Current Procedural Terminology (CPT) and Healthcare
Common Procedure Coding System (HCPCS) codes:
1. The amount that shall be charged to a patient for each
diagnostic-related group if all charges are paid in full without a
public or private third party paying for any portion of the charges;
2. The amount of Medicaid reimbursement for each diagnostic-
related group, including claims and pro rata supplemental payments;
and
3. The amount of Medicare reimbursement for each diagnostic-
related group.

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Prior to providing this information to the Department, each
hospital shall redact the names of the insured and any other
information that would otherwise identify such individuals.
A hospital shall not be required to report the information
required by this subsection for any of the one hundred most
frequently reported admissions where the reporting of that
information reasonably could lead to the identification of the
person or persons admitted to the hospital in violation of the
federal Health Insurance Portability and Accountability Act of 1996
or other federal law.
B. The Board sh