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An Act
ENROLLED SENATE
BILL NO. 1443 By: Daniels of the Senate
and
Caldwell (Chad) of the
House
An Act relating to health benefit plans; defining
terms; requiring certain health benefit plans to
consider certain factors when determining certain
payments for certain services; requiring certain
payments to be made in certain situations; providing
for codification; and providing an effective date.
SUBJECT: Health benefit plans
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 7501 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. As used in this act:
1. “Anesthesia services” means the same as defined by the
prevailing medical coding and billing standards in the professional
medical billing community, including the most recent version of the
Current Procedural Terminology (CPT) code books, the Medicare Claims
Processing Manual, and American Society of Anesthesiologists
guidance;
2. “Base unit” means the value for each anesthesia code that
reflects all activities other than anesthesia time including usual
preoperative and postoperative visits, the administration of fluids
and blood incident to anesthesia care, and monitoring services;
ENR. S. B. NO. 1443 Page 2
3. “Health benefit plan” means any plan that provides benefits
for medical or surgical expenses or disease management incurred as a
result of a health condition, accident, or sickness, including an
individual, group, blanket, or franchise insurance policy or
insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage or similar coverage
document that is issued by:
a. an insurance company,
b. a group hospital service corporation,
c. a health maintenance organization,
d. an approved nonprofit health corporation,
e. a small employer health benefit plan, or
f. any other health insurance company whose primary
purpose is to provide benefits for medical or surgical
expenses as a result of a health condition, accident,
sickness, or disease.
Health benefit plan does not include a plan offered by a contracted
entity that covers Medicaid members under the Ensuring Access to
Medicaid Act; and
4. “Physical status modifiers” means classifications set forth
in the American Society of Anesthesiologists (ASA) Physical Status
Classification System.
B. All health benefit plans shall consider the following
factors in determining necessity of services and calculation of
benefit payment amounts for anesthesia services:
1. The assessment of patient physical status, including the use
of physical status modifiers as determined by a participant’s
treating physician or health care provider; and
2. The complexity and urgency of care, as determined by a
participant’s treating physician or health care provider.
ENR. S. B. NO. 1443 Page 3
C. Physical status modifiers shall be paid according to the
corresponding base unit values to the treating physician or health
care provider if the patient is ranked in one of the three following
categories:
1. ASA III: A patient with severe systemic disease. Modifier
P3. Base Unit Value 1;
2. ASA IV: A patient with severe systemic disease that is a
constant threat to life. Modifier P4. Base Unit Value 2; or
3. ASA V: A moribund patient who is not expected to survive
without the operation. Modifier P5. Base Unit Value 3.
SECTION 2. This act shall become effective November 1, 2026.
ENR. S. B. NO. 1443 Page 4
Passed the Senate the 16th day of March, 2026.
Presiding Officer of the Senate
Passed the House of Representatives the 5th day of May, 2026.
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: _________________________________