Oklahoma SB 1067 Ambulance Reimbursement Bulletin
Summary
The Oklahoma Insurance Department issued a bulletin regarding Senate Bill 1067, which modifies ambulance service reimbursement rules. Health insurers must adhere to specific rates for out-of-network providers, with a submission deadline for local government rates.
What changed
The Oklahoma Insurance Department has issued Bulletin No. 2025-11 to inform health insurance companies and ambulance service providers about changes introduced by Senate Bill 1067, effective January 1, 2026. The bill amends 36 O.S. § 6050.3, authorizing local governmental entities or their contracted providers to submit ambulance service rates to the Department annually by December 31. If these rates are not submitted, out-of-network ambulance service providers will be reimbursed at the lesser of 325% of the current CMS rate or their billed charges. Cost-sharing for enrollees must not exceed in-network levels.
Health insurers operating in Oklahoma must implement these new reimbursement and cost-sharing requirements by January 1, 2026. They need to ensure their systems are updated to reflect the new minimum reimbursement rates for out-of-network providers and to correctly apply cost-sharing. Compliance officers should ensure that their organizations are aware of the December 31 submission deadline for local government-approved rates to avoid the lower reimbursement cap. Failure to comply could lead to disputes over reimbursement and potential regulatory scrutiny.
What to do next
- Ensure local government-approved ambulance service rates are submitted to the Oklahoma Insurance Department by December 31, 2025.
- Update reimbursement systems to comply with the new minimum reimbursement rate (lesser of 325% CMS rate or billed charges) for out-of-network providers if local rates are not submitted.
- Verify that cost-sharing for enrollees does not exceed in-network levels for covered ambulance services.
Source document (simplified)
Page 1 of 2 BULLETIN NO. 2025-11 TO: All Health Insurance Companies, HMOs, and Other Interested Parties RE: Senate Bill 1067 (2025 Session) FROM: Glen Mulready, Insurance Commissioner DATE: November 6, 2025 Disclaimer: The purpose of this bulletin is to inform ambulance service providers and all health insurers licensed in Oklahoma of specific legislative changes for 2025. The Department's intent is to help licensees be aware of changes that establish substantive mandates or require implementation changes. This bulletin is not intended to include every legislative change made in 2025. Please refer to the Oklahoma Supreme Court Network (OSCN) webpage to view all changes. Senate Bill 1067 relates to ambulance service reimbursement, amending language and creating a new law found at 36 O.S. § 6050.3. The bill authorizes, but does not mandate, local governmental entities or ambulance service providers operating on behalf of local governmental entities to annually submit to the Insurance Department the ambulance service rates set or approved, whether in contract or ordinance, by the local government entity. Ambulance service rates should be submitted on or before December 31 to okambulancedata@oid.ok.gov via the form found at https://www.oid.ok.gov/consumers/insurance-basics/health-insurance/ambulance-rate-reporting/ Ambulance rates set or approved by the local government entity that are not submitted to the Insurance Department shall be the lesser of three hundred twenty-five percent (325%) of the current published CMS rate for ambulance services for the same services provided in the same geographic area, or the ambulance service provider’s billed charges. The minimum allowable reimbursement rate under any health care benefit plan issued by a health care insurer to an out-of-network ambulance service provider for providing covered ambulance services shall be at the rates set or approved, whether in contract or ordinance, on May 1, 2025, submitted by a local governmental entity in the jurisdiction in which the covered ambulance services originate or ambulance service provider operating on its behalf, if the local governmental entity has submitted such rates. All copayments, coinsurance, deductibles, and other cost-sharing feature amounts applicable to the amounts calculated and submitted to the Insurance Department shall not exceed the in-network
copayment, coinsurance, deductible, and other cost-sharing features for the covered ambulance services received by the enrollee. SB 1067 becomes effective January 1, 2026. Questions concerning this bulletin should be directed to the Oklahoma Insurance Department’s Legal Division at 405-521-2746 or by email to Tyler.Trammell@oid.ok.gov.
Named provisions
Related changes
Source
Classification
Who this affects
Taxonomy
Browse Categories
Get Insurance alerts
Weekly digest. AI-summarized, no noise.
Free. Unsubscribe anytime.
Get alerts for this source
We'll email you when OK Insurance Bulletins publishes new changes.