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ENGR. H. B. NO. 3647 Page 1
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ENGROSSED HOUSE
BILL NO. 3647 By: Stinson, Archer, and Newton
of the House
and
Rosino of the Senate
[ health information - Oklahoma Health Care
Transparency Initiative Act of 2026 - Office of the
State Coordinator for Health Information Exchange -
powers and duties of the Office - state-designated
entity for health information exchange –
requirement – exemptions - Oklahoma Health Care
Transparency Initiative - governance and oversight
– compliance - public health data - unique
identifier - confidentiality, privacy, and security
of data – penalties - remittance or mitigation of
penalties - Insurance Department - proceeds -
Oklahoma Health Care Authority - allowed uses of
funds - Health Care Cost Transparency Board -
Oklahoma Open Records Act – codification ]
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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 1-134.1 of Title 63, unless
there is created a duplication in numbering, reads as follows:
Sections 4 through 7 of this act shall be known and may be cited
as the "Oklahoma Health Care Transparency Initiative Act of 2026".
SECTION 2. AMENDATORY Section 1, Chapter 250, O.S.L.
2022 (63 O.S. Supp. 2025, Section 1-132.1), is amended to read as
follows:
Section 1-132.1. A. There is hereby created the Office of the
State Coordinator for Health Information Exchange within the
Oklahoma Health Care Authority.
B. The Office shall have the power and duty to oversee:
1. Oversee the designation of the state-designated entity for
health information exchange, as described under Section 1-133 of
Title 63 of the Oklahoma Statutes this title; and
2. Oversee the enforcement of the Oklahoma Health Care
Transparency Initiative.
C. The Office shall consist of the State Coordinator for Health
Information Exchange, who shall be appointed by and serve at the
pleasure of the Administrator of the Authority, and such other
employees of the Authority as the Administrator may assign to the
Office.
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SECTION 3. AMENDATORY 63 O.S. 2021, Section 1-133, as
last amended by Section 1, Chapter 243, O.S.L. 2024 (63 O.S. Supp.
2025, Section 1-133), is amended to read as follows:
Section 1-133. A. As used in this section:
1. "Health information exchange" means the electronic movement
of health-related information among organizations according to
nationally recognized standards for purposes including, but not
limited to, payment, treatment, and administration operations; and
2. "Health information exchange organization" means an entity
whose primary business activity is health information exchange and
which is governed by its stakeholders.
B. The State of Oklahoma:
1. Shall shall designate a health information exchange
organization as the state-designated entity for health information
exchange;
2. Shall establish a transition plan to ensure continued
operation of the health information exchange; and
3. May temporarily serve as the state-designated entity as part
of the transition plan described in paragraph 2 of this subsection.
C. Beginning July 1, 2023, all All health care providers as
defined by the rules promulgated by the Oklahoma Health Care
Authority Board and who are licensed by and located in this state
may report data to and utilize the state-designated entity. The
Office of the State Coordinator for Health Information Exchange may,
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as provided by rules promulgated by the Board, allow exemptions from
the requirement provided by this subsection on the basis of
financial hardship, size, or technological capability of a health
care provider or such other bases as may be provided by rules
promulgated by the Board. The Office of the State Coordinator for
Health Information Exchange shall begin implementation of this
program on or before July 1, 2027.
D. 1. A person who participates in the services or information
provided by the state-designated entity shall not be liable in any
action for damages or costs of any nature that result solely from
the person's use or failure to use information or data from the
state-designated entity that was entered or retrieved under relevant
state or federal privacy laws, rules, regulations, or policies
including, but not limited to, the Health Insurance Portability and
Accountability Act of 1996.
2. A person shall not be subject to antitrust or unfair
competition liability based on participation with the state-
designated entity as long as the participation provides an essential
governmental function for the public health and safety and enjoys
state action immunity.
E. A person who provides information and data to the state-
designated entity retains a property right in the information or
data, but grants to the other participants or subscribers a
nonexclusive license to retrieve and use that information or data
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under relevant state or federal privacy laws, rules, regulations, or
policies including, but not limited to, the Health Insurance
Portability and Accountability Act of 1996.
F. E. Patient-specific protected health information shall only
be disclosed in compliance with relevant state or federal privacy
laws, rules, regulations, or policies including, but not limited to,
the Health Insurance Portability and Accountability Act of 1996.
G. F. The Oklahoma Health Care Authority Board shall promulgate
rules to implement the provisions of this section.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.2 of Title 63, unless
there is created a duplication in numbering, reads as follows:
As used in the Oklahoma Health Care Transparency Initiative Act
of 2026:
1. "Board" means the Oklahoma Health Care Authority Board;
2. "Claims data" means information, including protected health
information, included in an institutional, professional, or pharmacy
claim or equivalent information transaction for a covered individual
including the amount paid to a provider of health care services plus
any amount owed by the covered individual;
3. "Covered individual" means a natural person who is a
resident of this state and is eligible to receive medical, dental,
or pharmaceutical benefits under any policy, contract, certificate,
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evidence of coverage, rider, binder, or endorsement that provides
for or describes coverage;
4. "Direct personal identifiers" means the identifiers of
covered individuals listed in 45 C.F.R., Section 164.514(b)(2) that
shall be removed in order for protected health information to be
considered de-identified under the Health Insurance Portability and
Accountability Act of 1996, such as the individual's name, street
address, email address, telephone number, or Social Security number.
Direct personal identifiers include geographic or demographic
information that would allow the identification of a covered
individual;
5. "Enrollment data" means demographic information and other
identifying information related to covered individuals, including
direct personal identifiers and protected health information;
6. "Health plan" has the same meaning as defined in Section
6060.4 of Title 36 of the Oklahoma Statutes;
7. "HIPAA" means the Health Insurance Portability and
Accountability Act of 1996, Pub. L. No. 104-191, and its
implementing regulations set forth in 45 C.F.R., Parts 160, 162, and
164;
8. "Limited data set" means the definition set forth in 45
C.F.R., Section 164.514(e)(2);
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9. "Office" means the Office of the State Coordinator for
Health Information Exchange created under Section 1-132.1 of Title
63 of the Oklahoma Statutes;
10. "Oklahoma Health Care Transparency Initiative" means an
initiative to create a database, including ongoing all-payer claims
database projects that receive and store data from a submitting
entity relating to medical, dental, pharmaceutical, and other
insurance claims information, unique identifiers, and geographic and
demographic information for covered individuals as permitted in the
Oklahoma Health Care Transparency Initiative Act of 2026, and
provider files, for the purpose of implementing the Oklahoma Health
Care Transparency Initiative Act of 2026;
11. "Protected health information" means the same as defined by
the Health Insurance Portability and Accountability Act of 1996,
Pub. L. No. 104-191, including 45 C.F.R., Section 160.103;
12. "Provider" means "health care provider" as defined by
HIPAA, including 45 C.F.R., Section 160.103, licensed by the state
to provide health care services;
13. "State-designated entity for health information exchange"
or "state-designated entity" means the health information exchange
organization designated by the State of Oklahoma as the state-
designated entity for health information exchange under Section 1-
133 of Title 63 of the Oklahoma Statutes;
14. a. "Submitting entity" means:
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(1) an entity that provides health or dental
insurance or a health or dental benefit plan in
this state, including, but not limited to, an
insurance company, medical services plan, managed
care organization, hospital plan, hospital
medical service corporation, health maintenance
organization, fraternal benefit society, or other
health plan, provided that the entity has covered
individuals and the entity had at least two
thousand covered individuals in the previous
calendar year,
(2) a health benefit plan offered or administered by
or on behalf of the state or an agency or
instrumentality of the state, including, but not
limited to, benefits administered by a managed
care organization, notwithstanding the number of
covered individuals in the previous year,
(3) a health benefit plan offered or administered by
or on behalf of the federal government with the
agreement of the federal government,
(4) any other entity providing a plan of health
insurance or health benefits subject to state
insurance regulation, or a third-party
administrator; provided, that the entity has
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covered individuals and the entity had at least
two thousand covered individuals in the previous
calendar year,
(5) a health benefit plan subject to the Employee
Retirement Income Security Act of 1974, Pub. L.
No. 93-406, and that is fully insured,
(6) a risk-based provider organization licensed by
the Insurance Department,
(7) any entity that contracts with the Department of
Corrections to provide medical, dental, or
pharmaceutical care to inmates, and
(8) a pharmacy benefits manager, and
b. A submitting entity shall not include:
(1) an entity that provides health insurance or a
health benefit plan that is accident-only,
specified disease, hospital indemnity, long-term
care, disability income, or other supplemental
benefit coverage,
(2) an employee of a welfare benefit plan as defined
by federal law that is also a trust established
pursuant to collective bargaining subject to the
Labor Management Relations Act of 1947, Pub. L.
No. 80-101, or
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(3) a Medicare supplemental policy as defined by 42
C.F.R., Section 403.205; and
15. "Unique identifier" means any identifier that is guaranteed
to be unique among all identifiers for covered individuals but does
not include direct personal identifiers and meets the requirements
of 45 C.F.R., Section 164.514(c).
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.3 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Beginning July 1, 2027, there is hereby created the Oklahoma
Health Care Transparency Initiative. The initiative shall be
governed by the state-designated entity for health information
exchange and enforced by the Office of the State Coordinator for
Health Information Exchange.
B. Beginning on a date determined by the Oklahoma Health Care
Authority Board, and thereafter in a frequency specified in rules
promulgated by the Board, a submitting entity shall submit claims
data, unique identifiers, and geographic and demographic information
for covered individuals as permitted in the Oklahoma Health Care
Transparency Initiative Act of 2026, and provider files to the
state-designated entity for health information exchange in
accordance with standards and procedures promulgated by the Board
and in accordance with the data governance policies established by
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the state-designated entity. The Office shall begin implementation
of the requirements of this subsection on or before July 1, 2027.
C. 1. A health benefit plan, person, or entity excluded from
the definition of submitting entity as provided by Section 4 of this
act shall not be subject to the requirements of subsection B of this
section, but may voluntarily submit claims data, unique identifiers,
and geographic and demographic information for covered individuals
as permitted in the Oklahoma Health Care Transparency Initiative Act
of 2026, and provider files to the state-designated entity in
accordance with standards and procedures promulgated by the Board.
2. To the extent the excluded health benefit plan, person, or
entity voluntarily submits data described in this subsection to the
state-designated entity, the health benefit plan, person, or entity
shall comply with all requirements of the Oklahoma Health Care
Transparency Initiative Act of 2026, other than subsection B of this
section, including, but not limited to, compliance with applicable
state and federal data privacy and security laws.
D. 1. The State Department of Health shall submit all public
health data and vital statistics data collected by the Department
under Title 63 of the Oklahoma Statutes to the state-designated
entity for integration into the Oklahoma Health Care Transparency
Initiative database created under this section including, but not
limited to, data collected regarding hospital discharge and
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emergency department records for the uninsured, birth and death
records, and disease registry data.
2. The data submitted under paragraph 1 of this subsection
shall be assigned a unique identifier and may be used in accordance
with the Oklahoma Health Care Transparency Initiative Act of 2026.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.4 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Data and other information submitted under Section 5 of this
act shall be treated as confidential and shall be exempt from
disclosure as a record under the Oklahoma Open Records Act as
defined in Section 24A.3 of Title 51 of the Oklahoma Statutes and
are not subject to subpoena except to the extent provided in the
Oklahoma Insurance Code.
B. Data and other information submitted under Section 5 of this
act may only be collected, stored, used, disclosed, or released in
compliance with applicable state and federal data privacy and
security law and data governance policies established by the state-
designated entity for health information exchange, and where such
data or other information constitute protected health information,
in compliance with the Health Insurance Portability and
Accountability Act (HIPAA).
C. Data and other information in the Oklahoma Health Care
Transparency Initiative may, to the extent consistent with data
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governance policies established by the state-designated entity, be
available:
1. When disclosed in a form and manner that ensures the privacy
and security of protected health information as required by state
and federal laws, as a resource to insurers, employers, purchasers
of health care, researchers, state agencies, and health care
providers to allow for assessment of health care utilization,
expenditures, and performance in this state, including, but not
limited to, as a resource for hospital community health needs
assessments; and
2. To state programs regarding health care quality and costs
for use in improving health care in the state, subject to state and
federal privacy laws or limiting access to limited data sets.
D. Data and other information in the Oklahoma Health Care
Transparency Initiative shall not be used to disclose trade secrets
of submitting entities.
E. Notwithstanding any other section of law, the Oklahoma
Health Care Transparency Initiative shall not be used to publicly
disclose any data or other information that contains direct personal
identifiers or that is reasonably likely to identify a covered
individual when combined with other available information.
F. The Oklahoma Health Care Transparency Initiative Act of 2026
shall not be construed to supersede, limit, amend, or abrogate any
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data privacy or security law, rule, or policy and shall be
implemented in a manner consistent with HIPAA.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.5 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Except for state or federal agencies that are submitting
entities, a submitting entity that fails to submit data as required
by the Oklahoma Health Care Transparency Initiative Act of 2026 or
the rules promulgated by the Oklahoma Health Care Authority Board
may be subject to a fine assessed by the Insurance Department.
B. The Insurance Commissioner shall adopt a schedule of fines
not to exceed One Thousand Dollars ($1,000.00) per day for each day
the violation occurs, to be determined by the severity of the
violation.
C. A fine assessed under this section may be remitted or
mitigated upon such terms and conditions as the Insurance
Commissioner considers proper and consistent with public health and
safety.
D. Of the proceeds from fines remitted under this section, the
Insurance Department shall retain a portion of such proceeds
necessary to cover the cost to the Department of administering the
assessment and collection of such fines, and the Department shall
remit the remainder of the proceeds to the Oklahoma Health Care
Authority. The Authority may only use proceeds from fines assessed
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under this section to fund operations of the Oklahoma Health Care
Transparency Initiative.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6575 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. There is hereby created within the Oklahoma Insurance
Department, the Health Care Cost Transparency Board.
B. The Board shall utilize information derived from the All-
Payor Claims Database established pursuant to the Oklahoma Health
Care Transparency Initiative to evaluate statewide health care
spending trends, utilization patterns, and cost growth across payer
types operating in this state.
C. The Health Care Cost Transparency Board shall consist of
sixteen (16) members, as follows:
1. The Insurance Commissioner, or designee, who shall serve as
chair;
2. The Chief Executive Officer of the Oklahoma Health Care
Authority, or designee;
3. The Commissioner of the State Department of Health, or
designee;
4. One representative of a licensed commercial health insurer,
appointed by the Insurance Commissioner;
5. One representative of employers or large purchasers of
health care, appointed by the Governor;
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6. One representative of a hospital or health system, appointed
by the Oklahoma Hospital Association;
7. One representative of a rural health organization, appointed
by the Health Care Workforce Training Commission;
8. One representative recommended by the Oklahoma Academy of
Family Physicians;
9. One representative recommended by the Oklahoma Chapter of
the American Academy of Pediatrics;
10. One independent primary care provider practicing in
Oklahoma;
11. One consumer advocate, appointed by the Governor;
12. One health care economist or data analytics expert,
appointed by the Speaker of the Oklahoma House of Representatives;
13. One member appointed by the President Pro Tempore of the
Oklahoma State Senate;
14. One representative recommended by the Oklahoma Primary Care
Association;
15. One representative recommended by the Oklahoma Osteopathic
Association; and
16. One representative recommended by the state-designated
entity and serving as an active director of the state-designated
entity Board.
D. Members appointed to the Board shall serve three-year
staggered terms and may be reappointed.
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E. The Board shall meet at least quarterly and may establish
advisory or technical committees as necessary.
F. The Health Care Cost Transparency Board shall analyze data
derived from the All-Payer Claims Database established pursuant to
this act to:
1. Evaluate statewide health care spending and utilization
patterns;
2. Monitor health care cost growth across payer types;
3. Measure the share of total health care expenditures
allocated to primary care services; and
4. Provide recommendations to the Governor and the Legislature
regarding policies to improve health care affordability,
transparency, and investment in primary care.
G. The Health Care Cost Transparency Board shall work
collaboratively with the state-designated entity to establish the
parameters and definitions used to measure primary care expenditures
in this state.
H. The All-Payer Claims Database established pursuant to the
Oklahoma Health Care Transparency Initiative shall measure statewide
primary care spending using the parameters established by the Board
in collaboration with the state-designated entity.
I. For purposes of measuring primary care expenditures pursuant
to this section, “primary care services” shall be defined using
nationally recognized definitions of primary care spending
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measurement, including but not limited to those utilized by the
Centers for Medicare and Medicaid Services and the Primary Care
Collaborative. The Board may further refine such definitions by
rule provided that such refinements remain consistent with
nationally recognized standards.
J. The Health Care Cost Transparency Board shall submit an
annual report to the:
1. Governor;
2. President Pro Tempore of the Senate; and
3. Speaker of the House of Representatives.
K. The report shall summarize:
1. Statewide health care spending trends;
2. The share of total health care expenditures allocated to
primary care services;
3. Health care cost growth across payer types; and
4. Policy recommendations to improve health care affordability,
transparency, and primary care investment.
L. The first report of the Health Care Cost Transparency Board
shall be due on or before December 1, 2027, and annually thereafter.
SECTION 9. AMENDATORY 51 O.S. 2021, Section 24A.3, as
last amended by Section 1, Chapter 404, O.S.L. 2025 (51 O.S. Supp.
2025, Section 24A.3), is amended to read as follows:
Section 24A.3. As used in the Oklahoma Open Records Act:
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1. "Record" means all documents including, but not limited to,
any book, paper, photograph, microfilm, data files created by or
used with computer software, computer tape, disk, record, sound
recording, film recording, video record or other material regardless
of physical form or characteristic, created by, received by, under
the authority of, or coming into the custody, control or possession
of public officials, public bodies or their representatives in
connection with the transaction of public business, the expenditure
of public funds or the administering of public property. Record
shall also mean applications and other documents related to
licensure matters that are filed of record in a district court,
including, but not limited to, marriage licenses, process server
licenses, closing out sale licenses, transient merchant licenses,
pool hall licenses, and bail bondsmen registration. Record does not
mean:
a. computer software, or
b. nongovernment personal effects, or
c. data or other information submitted to the state-
designated entity for health information exchange
under Section 1-133 of Title 63 of the Oklahoma
Statutes or under the Oklahoma Health Care
Transparency Initiative Act of 2026;
2. "Public body" shall include, but not be limited to, any
office, department, board, bureau, commission, agency, trusteeship,
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authority, council, committee, trust or any entity created by a
trust, county, city, village, town, township, district, school
district, fair board, court, executive office, advisory group, task
force, study group or any subdivision thereof, supported in whole or
in part by public funds or entrusted with the expenditure of public
funds or administering or operating public property, and all
committees, or subcommittees thereof. Except for the records
required by Section 24A.4 of this title, public body does not mean
judges, justices, the Council on Judicial Complaints, the
Legislature or legislators. Public body shall not include an
organization that is exempt from federal income tax under Section
501(c)(3) of the Internal Revenue Code of 1986, as amended, and
whose sole beneficiary is a college or university, or an affiliated
entity of the college or university, that is a member of The
Oklahoma State System of Higher Education. Such organization shall
not receive direct appropriations from the Legislature. The
following persons shall not be eligible to serve as a voting member
of the governing board of the organization:
a. a member, officer, or employee of the Oklahoma State
Regents for Higher Education,
b. a member of the board of regents or other governing
board of the college or university that is the sole
beneficiary of the organization, or
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c. an officer or employee of the college or university
that is the sole beneficiary of the organization;
3. "Public office" means the physical location where public
bodies conduct business or keep records;
4. "Public official" means any official or employee of any
public body as defined herein; and
5. "Law enforcement agency" means any public body charged with
enforcing state or local criminal laws and initiating criminal
prosecutions including, but not limited to: police departments;
state and local fire marshals when investigating potential
violations of federal, state, or local criminal laws or when acting
on behalf of a law enforcement agency; county sheriffs; the
Department of Public Safety; the Oklahoma State Bureau of Narcotics
and Dangerous Drugs Control; the Alcoholic Beverage Laws Enforcement
Commission; and the Oklahoma State Bureau of Investigation.
Passed the House of Representatives the 25th day of March, 2026.
Presiding Officer of the House
of Representatives
Passed the Senate the ___ day of __________, 2026.
Presiding Officer of the Senate