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An Act
ENROLLED SENATE
BILL NO. 438 By: Coleman of the Senate
and
Sneed of the House
An Act relating to health insurance; amending 36 O.S.
2021, Section 1219.6, which relates to methods of
payments to providers; requiring notice of certain
fee; requiring certain instructions; updating
statutory language; and providing an effective date.
SUBJECT: Health care payment methods
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 36 O.S. 2021, Section 1219.6, is
amended to read as follows:
Section 1219.6. A. As used in this section:
1. “Health maintenance organization” means an entity that is
organized for the purpose of providing or arranging health care,
which has been granted a certificate of authority by the Insurance
Commissioner as a health maintenance organization pursuant to the
Health Maintenance Organization Act of 2003;
2. “Credit card payment” means a type of electronic funds
transfer in which a health insurance plan or health insurer or its
contracted vendor issues a single-use series of numbers associated
with the payment of health care services performed by a health care
provider and chargeable to a predetermined dollar amount, whereby
the health care provider is responsible for processing the payment
by a credit card terminal or Internet portal. Such term shall
ENR. S. B. NO. 438 Page 2
include virtual or online credit card payments, whereby no physical
credit card is presented to the health care provider and the single-
use credit card expires upon payment processing;
3. “Electronic funds transfer payment” means a payment by any
method of electronic funds transfer other than through the Automated
Clearing House Network (ACH), as codified in 45 CFR C.F.R., Sections
162.1601 and 162.1602;
4. “Health care provider” means any physician, dentist,
pharmacist, optometrist, psychologist, registered optician, licensed
professional counselor, physical therapist, chiropractor, hospital
or other entity or person that is licensed or otherwise authorized
in this state to furnish health care services;
5. “Health care provider agent” means a person or entity that
contracts with a health care provider establishing an agency
relationship to process bills for services provided by the health
care provider under the terms and conditions of a contract between
the agent and health care provider. Such contracts may permit the
agent to submit bills, request reconsideration and receive
reimbursement;
6. “Health care services” means the examination or treatment of
persons for the prevention of illness or the correction or treatment
of any physical or mental condition resulting from illness, injury
or other human physical problem and includes, but is not limited to:
a. hospital services which include the general and usual
services and care, supplies and equipment furnished by
hospitals,
b. medical services which include the general and usual
services and care rendered and administered by doctors
of medicine, doctors of dental surgery and doctors of
podiatry, and
c. other health care services which include appliances
and supplies; nursing care by a registered nurse or a
licensed practical nurse; care furnished by such other
licensed practitioners; institutional services
including the general and usual care, services,
ENR. S. B. NO. 438 Page 3
supplies and equipment furnished by health care
institutions and agencies or entities other than
hospitals; physiotherapy; ambulance services; drugs
and medications; therapeutic services and equipment
including oxygen and the rental of oxygen equipment;
hospital beds; iron lungs; orthopedic services and
appliances including wheelchairs, trusses, braces,
crutches and prosthetic devices including artificial
limbs and eyes; and any other appliance, supply or
service related to health care;
7. “Health insurance plan” means any hospital or medical
insurance policy or certificate; qualified higher deductible health
plan; health maintenance organization subscriber contract; contract
providing benefits for dental care whether such contract is pursuant
to a medical insurance policy or certificate; stand-alone dental
plan, health maintenance provider contract or managed health care
plan; and
8. “Health insurer” means any entity or person that issues
health insurance plans, as defined in this section.
B. Any health insurance plan issued, amended or renewed on or
after January 1, 2020, between a health insurer or its contracted
vendor or a health maintenance organization and a health care
provider for the provision of health care services to a plan
enrollee shall not contain restrictions on methods of payment from
the health insurer or its vendor or the health maintenance
organization to the health care provider in which the only
acceptable payment method is a credit card payment.
C. If initiating or changing payments to a health care provider
using a credit card, a health insurance plan, health insurer or its
contracted vendor, or health maintenance organization shall:
1. Notify the health care provider of any fees associated with
a particular payment method; and
2. Advise the health care provider of the available methods of
payment and provide clear instructions on how to select a preferred
method of payment.
ENR. S. B. NO. 438 Page 4
D. If initiating or changing payments to a health care provider
using electronic funds transfer payments, including virtual credit
card payments, a health insurance plan, health insurer or its
contracted vendor, or health maintenance organization shall:
1. Notify the health care provider if of any fees that are
associated with a particular payment method; and
2. Advise the provider of the available methods of payment and
provide clear instructions to the health care provider as to how to
select an alternative payment method.
D. E. A health insurance plan, health insurer or its contracted
vendor, or health maintenance organization that initiates or changes
payments to a health care provider through the Automated Clearing
House Network, as codified in 45 CFR C.F.R., Sections 162.1601 and
162.1602, shall not charge a fee solely to transmit the payment to a
health care provider unless the health care provider has consented
to the fee. A health care provider agent may charge reasonable fees
when transmitting an Automated Clearing House Network payment
related to transaction management, data management, portal services
and other value-added services in addition to the bank transmittal.
E. F. The provisions of this section shall not be waived by
contract, and any contractual clause in conflict with the provisions
of this section or that purport to waive any requirements of this
section are void.
F. G. Violations of this section shall be subject to
enforcement by the Insurance Commissioner.
SECTION 2. This act shall become effective November 1, 2025.
ENR. S. B. NO. 438 Page 5
Passed the Senate the 12th day of March, 2025.
Presiding Officer of the Senate
Passed the House of Representatives the 28th day of April, 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: _________________________________