A new law went into effect on November 1, 2024, requiring Oklahoma healthcare facilities and providers to comply with price transparency laws in order to collect medical debt. These requirements are not limited to the heathcare providers themselves, but also apply to third parties that are collecting debt on behalf of a healthcare practitioner or entity.
When the Oklahoma legislature passed the bipartisan Transparency in Health Care Prices Act in 2021, it created new requirements for Oklahoma healthcare facilities and providers to make some healthcare prices available to the public. This is in addition to the federal statute mandated in 2010 by the Patient Protection and Affordable Care Act.
The Oklahoma Transparency in Health Care Prices Act, found at 63 O.S. § 1-725.1 et seq., requires providers to publicly provide the prices for their twenty most common healthcare services. If there are not twenty services regularly provided, then the provider shall include their most common services. For facilities, the Act requires each specialty services line to share the prices for the twenty most used:
- diagnosis-related group codes or other codes for inpatient healthcare; and
- outpatient CPT codes or healthcare services procedure codes.
The lists must include the CPT code as well as a plain description, and the documents should be updated at least once a year. Federal law requires hospitals to establish prices each year and publish a list of standard charges for items and services, including diagnosis-related groups. 42 USC § 300gg-18(e).
The Oklahoma law was amended to require compliance in order to collect medical debt. The Oklahoma law now explicitly states that any civil action to collect on medical debt must include the redacted itemized charge that is the basis for the action and proof of compliance with state and federal price transparency laws. The statute has additional requirements of proof in order to enter a default judgment against a consumer and includes the following:
- the original account number;
- the original creditor;
- the amount due;
- itemization of any additional charges;
- date of the last payment or transaction; and
- proof of compliance with the price transparency laws. 12 O.S. § 193.
While the burden is on healthcare entities and providers to publish prices, the new law also impacts debt collectors and collection agencies operating on behalf of the creditor. Healthcare providers and facilities should ensure compliance before moving to collect on debt or selling to a third party.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
