Oklahoma Health Care Authority; federal immigration reporting systems; requiring Authority to report certain applicants to the Attorney General; notification to Immigration and Customs Enforcement; effective date.

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ENGROSSED HOUSE
BILL NO. 4423 By: Hilbert, Archer, Lawson,
Lepak, Wilk, Maynard,
George, Hildebrant, Turner,
Woolley, Adams, Crosswhite
Hader, Duel, Kelley, Gise,
Hays and Staires of the
House

and

Paxton of the Senate

An Act relating to the Oklahoma Health Care
Authority; amending 63 O.S. 2021, Section 5006, which
relates to the Authority's powers and duties;
requiring the Authority to use certain federal
immigration reporting systems; requiring the
Authority to report certain applicants to the Office
of the Attorney General; requiring the Office to
review cases; requiring notification of Immigration
and Customs Enforcement in certain circumstances; and
providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Section 5006, is
amended to read as follows:
Section 5006. A. There is hereby created the Oklahoma Health
Care Authority. The Authority shall have the power and duty to:
1. Purchase health care benefits for Medicaid recipients, and
others who are dependent on the state for necessary medical care, as
specifically authorized by law;

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2. Enter into contracts for the delivery of state-purchased
health care and establish standards and criteria which must be met
by entities to be eligible to contract with the Authority for the
delivery of state-purchased health care;
3. Develop a proposed standard basic health care benefits
package or packages to be offered by health services providers, for
Medicaid recipients;
4. Study all matters connected with the provision of state-
purchased and state-subsidized health care coverage;
5. Develop and submit plans, reports and proposals, provide
information and analyze areas of public and private health care
interaction pursuant to the provisions of the Oklahoma Health Care
Authority Act;
6. Serve as a resource for information on state-purchased and
state-subsidized health care access, cost containment and related
health issues;
7. Administer programs and enforce laws placed under the
jurisdiction of the Authority pursuant to the Oklahoma Health Care
Authority Act, and such other duties prescribed by law;
8. Collaborate with and assist the Insurance Commissioner in
the development of a Uniform Claim Processing System for use by
third-party payors and health care providers;

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9. Collaborate with and assist the State Department of Health
with the development of licensure standards and criteria for pre-
paid prepaid health plans; and
10. Exercise all incidental powers which are necessary and
proper to carry out the purposes of the Oklahoma Health Care
Authority Act.
B. 1. The Oklahoma Health Care Authority shall verify a
Medicaid applicant's status by utilizing the United States
Citizenship and Immigration Services' Systematic Alien Verification
for Entitlements (SAVE) system. An applicant's legal status in the
United States shall be confirmed prior to an applicant receiving
benefits conferred by the Oklahoma Health Care Authority.
2. Upon final determination that an applicant's SAVE status
does not indicate the person is lawfully in the United States, the
Authority shall notify the Office of the Attorney General. The
Office shall review the case and shall notify the United States
Immigration and Customs Enforcement Agency if an applicant's legal
presence in the United States is unverifiable.
3. The Oklahoma Health Care Authority shall post a notice on
its website providing information about Medicaid programs and on its
application portal notifying applicants that their immigration
status will be reviewed and if unverified the United States
Immigration and Customs Enforcement Agency will be notified.

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C. All positions within the Authority shall be unclassified
until approval of the annual business and personnel plan submitted
by January 1, 1995, by the Governor and the Legislature. In the
annual business plan submitted January 1, 1995, the Board shall
include a personnel plan which shall list, describe and justify all
unclassified positions within the Authority and their compensation.
All other employees and positions shall be classified and subject to
the provisions of the Merit System of Personnel Administration as
provided in the Oklahoma Personnel Act.
SECTION 2. This act shall become effective October 1, 2026.
Passed the House of Representatives the 26th day of February,
2026.

Presiding Officer of the House
of Representatives

Passed the Senate the _____ day of __________, 2026.

Presiding Officer of the Senate