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HB4040 • 2026

State Department of Health; creating the Oklahoma Rural Health Transformation Program; creating revolving fund; emergency.

State Department of Health; creating the Oklahoma Rural Health Transformation Program; creating revolving fund; emergency.

Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Caldwell (Trey)
Last action
2026-04-22
Official status
Approved by Governor 04/22/2026
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

State Department of Health; creating the Oklahoma Rural Health Transformation Program; creating revolving fund; emergency.

State Department of Health; creating the Oklahoma Rural Health Transformation Program; creating revolving fund; emergency.

What This Bill Does

  • State Department of Health; creating the Oklahoma Rural Health Transformation Program; creating revolving fund; emergency.
  • Bill Summaries/Fiscal Impact for HB 4040 (House): Proposed Committee Substitute (full committee) 1 (4/13/2026) Bill Summaries/Fiscal Impact for HB 4040 (House): Committee Substitute (4/14/2026)

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Plain English: HB4040 FULLPCS1 Trey Caldwell-JM 4/11/2026 1:43:56 pm AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Trey Caldwell Adopted: _____________________________ ______________________________________ Reading Clerk COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend HB4040 Of the printed Bill Page Section Lines Of the Engrossed Bill By deleting the content of the entire measure, and by inserting in lieu thereof the following language: Req.

  • HB4040 FULLPCS1 Trey Caldwell-JM 4/11/2026 1:43:56 pm AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Trey Caldwell Adopted: _____________________________ ______________________________________ Reading Clerk COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend HB4040 Of the printed Bill Page Section Lines Of the Engrossed Bill By deleting the content of the entire measure, and by inserting in lieu thereof the following language: Req.
  • No.
  • 17291 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 60th Legislature (2026) PROPOSED COMMITTEE SUBSTITUTE FOR HOUSE BILL NO.
  • 4040 By: Caldwell (Trey) and Kane of the House and Hall and Haste of the Senate PROPOSED COMMITTEE SUBSTITUTE An Act relating to the State Department of Health; creating the Oklahoma Rural Health Transformation Program; stating purpose; designating the State Department of Health as lead agency; allowing for the Department to partner with other agencies; creating reporting requirements; creating the Oklahoma Rural Health Transformation Revolving Fund; establishing fund at the State Department of Health; deeming the funds appropriated; providing expenditure and budgeting requirements and limitations; requiring a minimum balance in the fund at the end of the project; allowing for use of memoranda of understanding; limiting scope of such memoranda; providing for codification; and declaring an emergency.

Bill History

  1. 2026-04-22 House

    Approved by Governor 04/22/2026

  2. 2026-04-16 Senate

    JCR adopted

  3. 2026-04-16 Senate

    Measure and Emergency passed: Ayes: 45 Nays: 0

  4. 2026-04-16 Senate

    Engrossed measure signed, returned to House

  5. 2026-04-16 House

    Referred for enrollment

  6. 2026-04-16 House

    Enrolled, signed, to Senate

  7. 2026-04-16 Senate

    Enrolled measure signed, returned to House

  8. 2026-04-16 House

    Sent to Governor

  9. 2026-04-15 Senate

    Direct to Calendar

  10. 2026-04-14 House

    General Order

  11. 2026-04-14 House

    JCR adopted

  12. 2026-04-14 House

    Third Reading, Measure and Emergency passed: Ayes: 91 Nays: 3

  13. 2026-04-14 House

    Referred for engrossment

  14. 2026-04-14 House

    Engrossed, signed, to Senate

  15. 2026-04-14 Senate

    First Reading

  16. 2026-04-13 House

    JCR; Do pass, amended by committee substitute Joint Committee on Appropriations and Budget

  17. 2026-04-13 House

    Emergency added

  18. 2026-02-03 House

    Second Reading referred to Joint Committee on Appropriations and Budget

  19. 2026-02-02 House

    First Reading

  20. 2026-02-02 House

    Authored by Representative Caldwell (Trey), Kane

  21. 2026-02-02 House

    Authored by Senator Hall (principal Senate author)

  22. 2026-02-02 House

    Coauthored by Senator(s) Haste

Official Summary Text

State Department of Health; creating the Oklahoma Rural Health Transformation Program; creating revolving fund; emergency.
Bill Summaries/Fiscal Impact for HB 4040 (House): Proposed Committee Substitute (full committee) 1 (4/13/2026)
Bill Summaries/Fiscal Impact for HB 4040 (House): Committee Substitute (4/14/2026)

Current Bill Text

Read the full stored bill text
An Act
ENROLLED HOUSE
BILL NO. 4040 By: Caldwell (Trey) and Kane of
the House

and

Hall and Haste of the
Senate

An Act relating to the State Department of Health;
creating the Oklahoma Rural Health Transformation
Program; stating purpose; designating the State
Department of Health as lead agency; allowing for the
Department to partner with other agencies; creating
reporting requirements; creating the Oklahoma Rural
Health Transformation Revolving Fund; establishing
fund at the State Department of Health; deeming the
funds appropriated; providing expenditure and
budgeting requirements and limitations; requiring a
minimum balance in the fund at the end of the
project; allowing for use of memoranda of
understanding; limiting scope of such memoranda;
providing for codification; and declaring an
emergency.

SUBJECT: State Department of Health

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 3321 of Title 63, unless there
is created a duplication in numbering, reads as follows:

This act shall be known and may be cited as the "Oklahoma Rural
Health Transformation (ORHT) Program".

SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3321.1 of Title 63, unless there
is created a duplication in numbering, reads as follows:

ENR. H. B. NO. 4040 Page 2
The purpose of this act is to ensure the oversight of federal
funds received by the State Department of Health, and other partner
agencies, through the Rural Health Transformation (RHT) Program,
created in Public Law No. 119-21.

SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3321.2 of Title 63, unless there
is created a duplication in numbering, reads as follows:

A. The State Department of Health shall act as the lead agency
for Oklahoma in administering the Rural Health Transformation (RHT)
Program. The Department shall interface with the federal government
on behalf of the State of Oklahoma, and other state agencies, in the
disbursement of funds, and reporting requirements to the federal
government.

B. As the lead agency, the State Department of Health shall
provide a yearly report on the progress of the expenditures,
programs, and outcomes that were listed in the application to the
Centers for Medicare and Medicaid Services (CMS), as well as any
changes that have been adopted, along with the reasons for such
changes. Said report shall be submitted annually, no later than
January 31 throughout the life of the program. Such reports shall
be submitted to the Governor, the Speaker of the Oklahoma House of
Representatives, the President Pro Tempore of the Oklahoma State
Senate, the Appropriations and Budget Chair of the Oklahoma House of
Representatives, the Appropriations Chair of the Oklahoma State
Senate, and the relevant subcommittee chairs for each chamber.
Additionally, the Department shall publish such reports on its
website.

C. No less than quarterly, the Department shall publish on its
website progress reports for all projects, including the expenditure
of funds for each project as of the latest completed calendar
quarter.

SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 3321.3 of Title 63, unless there
is created a duplication in numbering, reads as follows:

A. There is hereby created in the State Treasury a revolving
fund for the State Department of Health to be designated the
"Oklahoma Rural Health Transformation Revolving Fund (ORHT Revolving
Fund)". The fund shall be a continuing fund, not subject to fiscal
year limitations, and shall consist of all monies appropriated to
ENR. H. B. NO. 4040 Page 3
the State Department of Health for the benefit of cash-flowing the
Rural Health Transformation (RHT) Program overseen by the Centers
for Medicare and Medicaid Services (CMS). All monies accruing to
the credit of said fund are hereby appropriated and may be budgeted
and expended by the State Department of Health for the purpose of
funding programs and projects approved by CMS for the RHT Program.
Expenditures from said fund shall be made upon warrants issued by
the State Treasurer against claims filed as prescribed by law with
the Director of the Office of Management and Enterprise Services for
approval and payment.

B. The State Department of Health may enter into memoranda of
understanding with partner agencies for the expenditure of funds
from the ORHT Revolving Fund. Such expenditures are limited to
those necessary to complete projects and programs under the RHT
Program.

C. At the end of the Rural Health Transformation (RHT) Program,
there shall remain a balance in the fund equal to the amount
transferred in Section 74 of Enrolled Senate Bill No. 1177 of the
2nd Session of the 60th Oklahoma Legislature.

SECTION 5. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and after its passage and approval.

ENR. H. B. NO. 4040 Page 4
Passed the House of Representatives the 14th day of April, 2026.

Presiding Officer of the House
of Representatives

Passed the Senate the 16th day of April, 2026.

Presiding Officer of the Senate

OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.

_________________________________
Governor of the State of Oklahoma

OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________