OK HB1577

Oklahoma Health Care Authority shall provide Medicaid coverage for medically necessary donor human milk-derived products for infants under 12 months gestationally corrected age in inpatient or outpatient settings, subject to federal approval.

Coverage applies when a licensed physician, physician assistant, or Advanced Practice Registered Nurse determines medical necessity due to birth weight below 1,500 grams, gestational age of 34 weeks or less at birth, or congenital or acquired conditions requiring donor human milk products.

Donor human milk-derived products must adhere to quality standards established by the Oklahoma Health Care Authority Board.

Reimbursement for inpatient services shall be provided separately from existing hospital payments, and the Board shall promulgate rules to implement the program while permitted to adopt temporary policies posted on the Authority's website.

The Act becomes effective November 1, 2025, and the Authority must seek necessary federal approval to implement the coverage requirement.