OK| Oklahoma Insurance Department Bulletin 2025-04 summarizes new legislative mandates for health insurers, stemming from House Bills 1808 and 1811, which take effect November 1, 2025. The primary regulatory updates focus on improving transparency in prescription drug prior authorizations, accessibility of drug plan formularies, and changes to prior authorization procedures for ongoing treatment of chronic conditions.
Noted Facts:
- HB 1808 requires health plans to publish understandable prescription drug prior authorization criteria and detailed plan formularies on their websites, and to submit secure links for these formularies to the Insurance Commissioner, with updates annually via the SERFF portal.
- It establishes notification and review protocols for prior authorization changes, including prompt decisions on urgent and nonurgent drugs, extended prior authorization validity for chronic conditions, and penalties for noncompliance up to $5,000 per violation.
- HB 1811 shortens the window for health care providers to request continued authorization for inpatient care of chronic conditions from 72 hours to 24 hours before current approvals lapse.