Oklahoma Right to Shop Act; definitions; shared savings incentive program and insurance carrier obligations; effective date.
Summary
HB1119 amends the Oklahoma Right to Shop Act to expand and clarify the state’s shared savings incentive program for health insurance enrollees. The bill revises key definitions, including “allowed amount,” “average allowed amount,” “comparable health care service,” and “shared savings incentive,” and changes several provisions from permissive language to mandatory language for insurance carriers. Under the bill, carriers would be required to offer a shared savings incentive program that rewards enrollees for choosing lower-cost covered health care services, including services obtained from non-network providers when the negotiated price is below the carrier’s average allowed amount.
The bill also sets out how incentives and enrollee cost-sharing must be calculated. It requires carriers to ensure that an enrollee’s financial liability does not exceed in-network deductible, copay, and coinsurance amounts when using a qualifying non-network provider, and it requires incentives to be paid as cash or credited toward deductible and out-of-pocket limits. Carriers must notify enrollees, publish service and provider lists and incentive amounts on their websites, provide average allowed amount information on request, make quarterly incentive payments, and file annual reports with the Insurance Department. Participation remains voluntary for enrollees, and the bill takes effect November 1, 2025.
Impact
HB1119 would materially affect Title 36 insurance law by strengthening and expanding the Oklahoma Right to Shop Act’s requirements for health insurers. It would impose affirmative obligations on carriers to offer shared savings programs, disclose pricing and incentive information, and administer payments and reporting to the Insurance Department. The bill would also affect how insurers calculate enrollee cost-sharing and incentives for comparable health care services, including services from out-of-network providers that agree to lower negotiated prices. Affected parties include insurance carriers, enrollees in health benefit plans, health care providers, and the Insurance Department.
Sentiment
Based on the bill text and available context, the measure appears to be framed positively as a consumer-choice and cost-transparency bill, with an emphasis on helping enrollees save money by shopping for lower-cost care. There are no committee transcripts or recorded votes provided, so there is no documented debate or opposition in the available materials. The overall posture of the bill suggests support for market-based health care cost controls and stronger insurer participation requirements.
Contention
The main points of potential contention are the bill’s shift from discretionary to mandatory carrier obligations and the administrative burden it places on insurers. Carriers would be required to offer the program, provide detailed disclosures, make quarterly payments, and submit annual reports, which could raise compliance and operational concerns. Another possible issue is the treatment of non-network providers and the requirement that insurers cap enrollee liability at in-network levels when a lower-priced negotiated rate is available, which may draw scrutiny from insurers and provider groups. No specific objections are documented in the provided history.
Revenue and taxation; Bringing Sitcoms Home from Hollywood Pilot Program Act; short title; definitions; incentives; procedures; revolving fund; effective date.
Health care; creating the Oklahoma Rebate Pass-Through and Pharmacy Benefits Manager Meaningful Transparency Act of 2025; definitions; requirements; effective date.