Health insurance; requiring coverage of certain genetic testing and cancer imaging; providing exclusions. Effective date.

An Act
ENROLLED SENATE
BILL NO. 109 By: Stanley, Hicks, and Nice of
the Senate

and

Miller, Roe, Townley, West
(Tammy), Hefner, Ranson,
Provenzano, Munson,
Schreiber, Pittman, and
Fugate of the House

An Act relating to health insurance; defining terms;
requiring coverage of certain genetic testing and
cancer imaging; specifying terms of coverage;
providing certain exclusions; providing for
codification; and providing an effective date.

SUBJECT: Cancer testing

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 6060.5b of Title 36, unless
there is created a duplication in numbering, reads as follows:

A. For the purposes of this section:

1. “Clinical utility” means clinical utility as defined
pursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes;

2. “Evidence-based cancer imaging” means appropriate
preventative screening and imaging supported by evidence;

3. “Genetic testing for an inherited mutation” means multi-gene
testing for an inherited mutation associated with an increased risk
of cancer;

ENR. S. B. NO. 109 Page 2
4. “Health benefit plan” means a health benefit plan as defined
pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; and

5. “Health care provider” means any physician, hospital, or
other entity or person that is licensed or otherwise authorized in
this state to furnish health care services.

B. Any health benefit plan including the Oklahoma Employees
Insurance Plan that is offered, issued, or renewed in this state on
or after the effective date of this act shall provide coverage for:

1. Clinical genetic testing for an inherited gene mutation for
individuals with a personal or family history of cancer when such
test provides clinical utility and when ordered or recommended by a
health care provider in accordance with medical and scientific
evidence including, but not limited to:

a. the most recent version of the National Comprehensive
Cancer Network (NCCN) clinical practice
recommendations that are Category 2A or higher,

b. Centers for Medicare and Medicaid Services national
coverage determinations or Medicare administrative
contractor local coverage determinations, or

c. nationally recognized clinical practice guidelines;
and

2. Evidence-based cancer imaging for individuals with an
increased risk of cancer when such test provides clinical utility
and when ordered or recommended by a health care provider in
accordance with the most recent version of the NCCN clinical
practice recommendations that are Category 2A or higher, or in
accordance with other nationally recognized clinical practice
guidelines.

C. Coverage under this section shall not be subject to any
annual deductibles, copayments, or coinsurance limits as established
for all covered benefits under the health benefit plan.

D. If application of this section would result in health
savings account ineligibility under Section 223 of the Internal

ENR. S. B. NO. 109 Page 3
Revenue Code of 1986, as amended, the provisions of this section
shall only apply to health savings accounts with qualified high
deductible health plans with respect to the deductible of such a
plan after the enrollee has satisfied the minimum deductible.
Provided, however, the provisions of this section shall apply to
items or services that are preventive care pursuant to Section
223(c)(2)(C) of the Internal Revenue Code of 1986, as amended,
regardless of whether the minimum deductible has been satisfied.

SECTION 2. This act shall become effective November 1, 2025.

ENR. S. B. NO. 109 Page 4
Passed the Senate the 21st day of May, 2025.

Presiding Officer of the Senate

Passed the House of Representatives the 22nd 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: _________________________________