Oklahoma Senate Bill SB1564

Oklahoma 2026 Regular Session

• Introduced: 2/2/26
• Refer: 2/3/26
• Report Pass: 2/16/26
• Refer: 2/16/26

Caption

Medicaid; requiring adoption of certain billing code for specified claims; requiring certain reimbursement. Effective date. Emergency.

Summary

SB 1564 would require the Oklahoma Health Care Authority and all of its contracted Medicaid entities to recognize and reimburse HCPCS code G0330 for facility fees tied to dental surgeries performed under general anesthesia in operating rooms, including ambulatory surgical centers, when the patient is an individual with an intellectual or developmental disability. The bill is aimed at ensuring that these claims are processed consistently under the state Medicaid program and that the specified facility costs are covered. The measure also directs the Authority to set a reimbursement rate that is reasonable and reflects the actual cost of providing the service, and it requires all contracted entities to pay at least that amount. The bill includes an effective date of July 1, 2026, and contains an emergency clause, indicating the Legislature intended it to take effect immediately upon passage and approval.

Impact

If enacted, SB 1564 would amend Title 63 of the Oklahoma Statutes by adding a new section governing Medicaid reimbursement for a narrow category of dental surgery facility fees. It would bind the Oklahoma Health Care Authority and Medicaid managed care or other contracted entities to use HCPCS code G0330 for the covered claims and to reimburse at no less than the state-set rate, likely increasing or standardizing payments for these services for eligible patients and providers.

Sentiment

The available legislative history suggests generally favorable support for the bill. It passed the Senate Health & Human Services Committee on a 11-1 vote with a do pass amended recommendation, indicating broad agreement on the need to address reimbursement for these Medicaid-covered dental surgeries, though not unanimous support. The bill was then referred to Appropriations, reflecting that fiscal considerations remained part of the process.

Contention

The main point of potential contention is fiscal impact: the bill requires reimbursement at a rate reflecting actual cost, which could increase Medicaid spending and affect state and contracted-entity budgets. Another likely issue is the narrow scope of the mandate, which focuses specifically on dental surgeries under general anesthesia for individuals with intellectual or developmental disabilities; supporters likely view this as necessary access and provider-payment reform, while any dissent may center on cost, administrative requirements, or whether the bill should be broader or handled through agency rulemaking rather than statute.