OK HB1577

Oklahoma Health Care Authority must provide Medicaid coverage for medically necessary donor human milk-derived products for infants with gestationally corrected age under 12 months, in both inpatient and outpatient settings

Coverage requires a physician, physician assistant, or Advanced Practice Registered Nurse order certifying medical necessity due to: birth weight under 1,500 grams or below healthy levels, gestational age at birth of 34 weeks or less, or any congenital/acquired condition requiring donor milk for treatment

Reimbursement for donor human milk products in inpatient settings must be provided separately from existing hospital payment rates

Oklahoma Health Care Authority Board must promulgate rules and set quality standards for covered donor milk products, with authority to adopt interim policies posted on its website during the rulemaking process

Effective date is November 1, 2025, subject to any necessary federal approval