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An Act
ENROLLED SENATE
BILL NO. 1067 By: Rosino of the Senate
and
Stinson of the House
An Act relating to health insurance; amending Section
3, Chapter 356, O.S.L. 2024 (36 O.S. Supp. 2024,
Section 6050.3), which relates to the Out-of-Network
Ambulance Service Provider Act; authorizing local
governmental entities or ambulance service providers
to submit certain rates to the Insurance Department;
requiring the Department to establish and maintain
certain database; modifying reimbursement rates and
criteria for certain ambulance services; requiring
the Department to submit certain report; providing
for the cessation of certain rates; providing an
exception; and providing an effective date.
SUBJECT: Ambulance service reimbursement
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY Section 3, Chapter 356, O.S.L.
2024 (36 O.S. Supp. 2024, Section 6050.3), is amended to read as
follows:
Section 6050.3. A. A local governmental entity, or ambulance
service provider operating on its behalf, may annually submit to the
Insurance Department, in the form and manner prescribed by the
Insurance Commissioner, the ambulance service rates set or approved,
whether in contract or ordinance, by the local governmental entity.
ENR. S. B. NO. 1067 Page 2
B. By January 1, 2026, the Department shall establish and
maintain on its public website a database listing all submitted
rates.
C. The minimum allowable reimbursement rate under any health
care benefit plan issued by a health care insurer to an out-of-
network ambulance service provider for providing covered ambulance
services shall be at the rates set or approved, whether in contract
or ordinance, on May 1, 2025, submitted by a local governmental
entity in the jurisdiction in which the covered ambulance services
originate.
B. In the absence of the rates as provided in subsection A of
this section, the rate shall be the lesser of:
1. Three hundred twenty-five percent (325%), or ambulance
service provider operating on its behalf, as provided in subsection
A of this section, if the local governmental entity has submitted
such rates.
D. In absence of the rates provided in subsection A of this
section, the rate shall be the lesser of:
1. Three hundred twenty-five percent (325%) of the current
published rate for ambulance services as established by the Centers
for Medicare and Medicaid Services under Title XVIII of the Social
Security Act for the same services provided in the same geographic
area; or
2. The ambulance service provider’s billed charges.
C. E. Payment made in compliance with this section shall be
considered payment in full for the covered ambulance services
provided, except for any copayment, coinsurance, deductible, and
other cost-sharing feature amounts required to be paid by the
enrollee. An ambulance service provider is prohibited from billing
the enrollee for any additional amounts for the paid covered
ambulance services in excess of what the health care insurer pays.
D. F. All copayments, coinsurance, deductible, and other cost-
sharing feature amounts provided by applicable to amounts calculated
in accordance with subsection A of this section shall not exceed the
ENR. S. B. NO. 1067 Page 3
in-network copayment, coinsurance, deductible, and other cost-
sharing features for the covered ambulance services received by the
enrollee.
E. G. In administering and paying claims, a health care insurer
shall comply with Section 1219 of Title 36 of the Oklahoma Statutes
this title.
H. The Department shall review the data from the database and
submit a report by January 1, 2027, to the Governor, the President
Pro Tempore of the Oklahoma State Senate, and the Speaker of the
Oklahoma House of Representatives. The rates provided for in
subsections C and D of this section shall cease to remain in effect
unless the rates are modified by the Oklahoma Legislature prior to
December 31, 2027.
SECTION 2. This act shall become effective January 1, 2026.
ENR. S. B. NO. 1067 Page 4
Passed the Senate the 21st day of May, 2025.
Presiding Officer of the Senate
Passed the House of Representatives the 8th day of May, 2025.
Presiding Officer of the House
of Representatives
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: _________________________________