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SENATE FLOOR VERSION - SB1566 SFLR Page 1
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SENATE FLOOR VERSION
February 16, 2026
COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 1566 By: Stanley of the Senate
and
Stinson of the House
[ Medicaid - behavior analysis treatment - medical
necessity criteria - requirements - telehealth -
effective date ]
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 56 O.S. 2021, Section 1011.12, is
amended to read as follows:
Section 1011.12. A. The Oklahoma Health Care Authority, in
conjunction with the Department of Mental Health and Substance Abuse
Services, the State Department of Health and the State Department of
Education shall examine the feasibility of a state plan amendment to
the Oklahoma Medicaid Program state Medicaid program for applied
behavior analysis treatment of autism spectrum disorders disorder.
B. On or before December 31, 2016, the Authority and partnering
agencies shall submit a report to the President Pro Tempore of the
Senate, the Speaker of the House of Representatives and the Governor
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estimating the potential costs to the state, clinical findings,
reviews of pilot projects and research from other states on the
effects of applied behavioral analysis treatment on autism spectrum
disorders disorder.
C. Beginning July 1, 2017, and subject to the availability of
funding, the Authority and partnering agencies shall draft a state
plan amendment for applied behavior analysis treatment of autism
spectrum disorders disorder. The provisions of this subsection
shall only apply if the report required by subsection B of this
section demonstrates applied behavioral analysis treatment to be
evidence-based and essential to qualifying participants in the
Oklahoma Medicaid Program state Medicaid program.
D. The medical necessity criteria for applied behavior analysis
services covered under the state Medicaid program shall include a
definitive diagnosis of an autism spectrum disorder by one of the
following health care providers, who shall be licensed in this state
and who shall be trained in the diagnosis of autism:
1. Pediatric neurologist or neurologist;
2. Developmental pediatrician;
3. Psychologist which may include, but is not limited to, a
psychologist working in a school;
4. Psychiatrist or neuropsychiatrist;
5. Other licensed physician experienced in the diagnosis and
treatment of autism spectrum disorder; or
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6. Interdisciplinary team composed of a licensed psychologist,
physician, physician assistant (PA), or Advanced Practice Registered
Nurse (APRN).
E. The Authority or a contracted entity shall not impose a
general policy that requires all Medicaid members receiving covered
applied behavior analysis services to be re-diagnosed with or
receive subsequent clinical assessments for autism spectrum disorder
as a condition of continuation of coverage after the member has
already been diagnosed with autism spectrum disorder by a health
care provider as described in subsection D of this section. An
initial diagnosis of autism spectrum disorder shall remain accepted
indefinitely unless otherwise clinically indicated including, but
not limited to, by a significant behavioral or developmental change.
Nothing in this subsection shall be construed to prohibit a member
or member’s parent or legal guardian from requesting a subsequent
assessment or a qualified provider from conducting a subsequent
assessment if he or she deems it necessary.
F. 1. All applied behavior analysis services provided by a
contracted provider to a Medicaid member shall be performed by duly
qualified professionals as determined by the Authority.
2. A registered behavior technician (RBT), board-certified
assistant behavior analyst (BCABA), or other professional whose
credentials are less than a board-certified behavior analyst (BCBA),
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as determined by the Authority, may only provide applied behavior
analysis services to members in person.
3. A BCBA may use telehealth to provide applied behavior
analysis services to members or to supervise the provision of
applied behavior analysis services by a BCABA or other professional
described in paragraph 2 of this subsection. The Authority or a
contracted entity shall not require a BCBA to be located in this
state or within a certain distance of the state border to perform
such services or supervision; provided, however, the BCBA shall be
licensed in this state under Section 1928 of Title 59 of the
Oklahoma Statutes or licensed or credentialed in his or her state of
residence.
G. As used in this section:
1. “Applied behavior analysis” means the design, implementation
and evaluation of environmental modifications, using behavioral
stimuli and consequences, to produce socially significant
improvement in human behavior, including the use of direct
observation, measurement and functional analysis of the relationship
between environment and behavior;
2. “Autism spectrum disorder” means any of the pervasive
developmental disorders or autism spectrum disorders as defined by
the most recent edition of the Diagnostic and Statistical Manual of
Mental Disorders (DSM) or the edition that was in effect at the time
of diagnosis;
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3. “Behavioral health treatment” means counseling and treatment
programs, including applied behavior analysis, that are:
a. necessary to develop, maintain or restore, to the
maximum extent practicable, the functioning of an
individual, and
b. provided by a board-certified behavior analyst or by a
licensed doctoral-level psychologist so long as the
services performed are commensurate with the
psychologist’s university training and supervised
experience; and
4. “Treatment for autism spectrum disorder” means evidence-
based care and related equipment prescribed or ordered for an
individual diagnosed with an autism spectrum disorder by a licensed
physician or a licensed doctoral-level psychologist who determines
the care to be medically necessary, including, but not limited to:
a. behavioral health treatment,
b. pharmacy care,
c. psychiatric care,
d. psychological care, and
e. therapeutic care.
SECTION 2. This act shall become effective November 1, 2026.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
February 16, 2026 - DO PASS AS AMENDED BY CS