OK SB515

Enrollees who negotiate a price lower than their health plan's average allowed amount for a covered, medically necessary service and pay out of pocket may submit documentation to their insurance carrier to have that payment counted toward their deductible and annual maximum out-of-pocket expense.

Health care providers must accept the enrollee's negotiated payment as payment in full and are prohibited from balance billing the enrollee or health plan for any remaining amount.

Carriers must apply the full out-of-pocket payment to the in-network or out-of-network deductible and maximum out-of-pocket expense, depending on the provider's network status.

Covered health care services include diagnosis, treatment, mental health, substance use disorder services, and durable medical equipment, but exclude pharmaceutical products or services.

Effective November 1, 2025.