SB1047 - Oklahoma Surprise Medical Billing Act

• Out-of-network providers and facilities are prohibited from surprise billing covered persons for emergency care or nonemergency services rendered by out-of-network providers at in-network facilities.

• Health insurance carriers must reimburse out-of-network providers and facilities at the minimum benefit standard (80th percentile of allowed amounts) or mutually agreed amounts within 30 days for electronic claims or 45 days for nonelectronic claims.

• Covered persons incur the same cost-sharing obligations for emergency care from out-of-network providers as they would for in-network providers, and out-of-network providers must refund any overpayments within 30 days.

• The Insurance Commissioner must establish rules for verifying the minimum benefit standard; providers may request verification within 30 days of payment, and the Commissioner must respond within 15 days.

• Carriers that underpay the minimum benefit standard are subject to penalties calculated as the difference between the standard and billed amount, with 50% paid to the provider and 50% to the Oklahoma Health Insurance High Risk Pool; the act becomes effective November 1, 2025.