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HOUSE OF REPRESENTATIVES - FLOOR VERSION STATE OF OKLAHOMA 2nd Session of the 60th Legislature (2026) COMMITTEE SUBSTITUTE FOR HOUSE BILL NO.
ENGROSSED HOUSE BILL NO.
Schreiber of the House and Gollihare of the Senate 9 COMMITTEE SUBSTITUTE An Act relating to workers' compensation;
Schreiber of the House and Gollihare of the Senate 5 7 An Act relating to workers' compensation;
HB4202 HFLR Page 1 BOLD FACE denotes Committee Amendments.
If the employer fails or neglects to provide medical treatment within five (5) days after actual knowledge is received of an injury, the injured employee may select a physician or chiropractor to provide medical treatment at the expense of the employer;
If the employer fails or neglects to provide medical treatment within five (5) days after actual knowledge is received of ENGR.
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NO.
4202 Page 1 an injury, the injured employee may select a physician or chiropractor to provide medical treatment at the expense of the employer;
HB4202 HFLR Page 2 BOLD FACE denotes Committee Amendments.
If an employee refuses to submit himself or herself to examination, his or her right to prosecute any proceeding under the Administrative Workers' Compensation Act shall be suspended, and no compensation shall be payable for the period of such refusal.
If an employee refuses ENGR.
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4202 Page 2 to submit himself or herself to examination, his or her right to prosecute any proceeding under the Administrative Workers' Compensation Act shall be suspended, and no compensation shall be payable for the period of such refusal.
HB4202 HFLR Page 3 BOLD FACE denotes Committee Amendments.
The Fee Schedule shall establish the maximum rates that medical providers shall be reimbursed for medical care provided to injured employees including, but not limited to, charges by physicians, chiropractors, dentists, counselors, hospitals, ambulatory and outpatient facilities, clinical laboratory services, diagnostic testing services, and ambulance services, and charges for durable medical equipment, prosthetics, orthotics, and supplies.
The Fee Schedule shall establish the maximum rates that ENGR.
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4202 Page 3 medical providers shall be reimbursed for medical care provided to injured employees including, but not limited to, charges by physicians, chiropractors, dentists, counselors, hospitals, ambulatory and outpatient facilities, clinical laboratory services, diagnostic testing services, and ambulance services, and charges for durable medical equipment, prosthetics, orthotics, and supplies.
The Commission shall give due consideration to additional requirements for physicians treating an injured worker under the Administrative Workers' Compensation Act, including, but not limited to, HB4202 HFLR Page 4 BOLD FACE denotes Committee Amendments.
The Commission shall give due consideration to additional requirements for physicians treating an injured worker under the Administrative Workers' Compensation Act, including, but not limited to, communication with claims representatives, case managers, attorneys, and representatives of employers, and the additional time required to complete forms for the Commission, insurance carriers, and employers.
communication with claims representatives, case managers, attorneys, and representatives of employers, and the additional time required to complete forms for the Commission, insurance carriers, and employers.
ENGR.
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4202 Page 4 3.
No reimbursement shall be allowed for any magnetic resonance imaging (MRI) unless the MRI is provided by an entity that meets Medicare requirements for the payment of MRI services or is accredited by the HB4202 HFLR Page 5 BOLD FACE denotes Committee Amendments.
No reimbursement shall be allowed for any magnetic resonance imaging (MRI) unless the MRI is provided by an entity that meets Medicare requirements for the payment of MRI services or is accredited by the American College of Radiology, the Intersocietal Accreditation Commission or the Joint Commission on Accreditation of Healthcare Organizations.
American College of Radiology, the Intersocietal Accreditation Commission or the Joint Commission on Accreditation of Healthcare Organizations.
For all other radiology procedures, the reimbursement rate ENGR.
For all other radiology procedures, the reimbursement rate shall be the lesser of the reimbursement rate allowed by the 2010 Oklahoma Fee Schedule and two hundred seven percent (207%) of the Medicare Fee Schedule.
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4202 Page 5 shall be the lesser of the reimbursement rate allowed by the 2010 Oklahoma Fee Schedule and two hundred seven percent (207%) of the Medicare Fee Schedule.
The Commission shall develop a reasonable stop-loss provision of the Fee Schedule to provide for adequate reimbursement for treatment for major burns, severe head and neurological injuries, multiple system HB4202 HFLR Page 6 BOLD FACE denotes Committee Amendments.
The Commission shall develop a reasonable stop-loss provision of the Fee Schedule to provide for adequate reimbursement for treatment for major burns, severe head and neurological injuries, multiple system injuries, and other catastrophic injuries requiring extended periods of intensive care.
injuries, and other catastrophic injuries requiring extended periods of intensive care.
An employer or insurance carrier shall have the right to audit the charges and question the reasonableness and necessity ENGR.
An employer or insurance carrier shall have the right to audit the charges and question the reasonableness and necessity of medical treatment contained in a bill for treatment covered by the stop-loss provision.
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4202 Page 6 of medical treatment contained in a bill for treatment covered by the stop-loss provision.
The Commission's review of medical and treatment charges pursuant to this section shall be conducted pursuant to the Fee HB4202 HFLR Page 7 BOLD FACE denotes Committee Amendments.
The Commission's review of medical and treatment charges pursuant to this section shall be conducted pursuant to the Fee Schedule in existence at the time the medical care or treatment was provided.
Schedule in existence at the time the medical care or treatment was provided.
The judgment approving the medical and treatment charges pursuant to this section shall be enforceable by the Commission in ENGR.
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The judgment approving the medical and treatment charges pursuant to this section shall be enforceable by the Commission in the same manner as provided in the Administrative Workers' Compensation Act for the enforcement of other compensation payments.
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4202 Page 7 the same manner as provided in the Administrative Workers' Compensation Act for the enforcement of other compensation payments.
When medical care includes prescription drugs dispensed by a physician or other medical care provider and the NDC for the drug HB4202 HFLR Page 8 BOLD FACE denotes Committee Amendments.
When medical care includes prescription drugs dispensed by a physician or other medical care provider and the NDC for the drug product dispensed is for a repackaged drug, then the maximum reimbursement shall be the lesser of the original labeler's NDC and the lowest-cost therapeutic equivalent drug product.
product dispensed is for a repackaged drug, then the maximum reimbursement shall be the lesser of the original labeler's NDC and the lowest-cost therapeutic equivalent drug product.
Payment shall ENGR.
Payment shall be based upon a sum of the allowable fee for each ingredient plus a dispensing fee of Five Dollars ($5.00) per prescription.
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4202 Page 8 be based upon a sum of the allowable fee for each ingredient plus a dispensing fee of Five Dollars ($5.00) per prescription.
If the physician, or an entity in which the physician has a financial interest other than an ownership interest of less than five percent (5%) in a publicly traded company, buys and resells implantable devices to a hospital HB4202 HFLR Page 9 BOLD FACE denotes Committee Amendments.
If the physician, or an entity in which the physician has a financial interest other than an ownership interest of less than five percent (5%) in a publicly traded company, buys and resells implantable devices to a hospital or another physician, the markup shall be limited to ten percent (10%) above cost.
or another physician, the markup shall be limited to ten percent (10%) above cost.
ENGR.
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4202 Page 9 11.
Physicians or chiropractors providing treatment under the Administrative Workers' Compensation Act shall disclose under HB4202 HFLR Page 10 BOLD FACE denotes Committee Amendments.
Physicians or chiropractors providing treatment under the Administrative Workers' Compensation Act shall disclose under penalty of perjury to the Commission, on a form prescribed by the Commission, any ownership or interest in any health care facility, ENGR.
penalty of perjury to the Commission, on a form prescribed by the Commission, any ownership or interest in any health care facility, business, or diagnostic center that is not the physician's or chiropractor's primary place of business.
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4202 Page 10 business, or diagnostic center that is not the physician's or chiropractor's primary place of business.
The consultant shall receive written and oral comment from employers, workers' compensation medical service and insurance HB4202 HFLR Page 11 BOLD FACE denotes Committee Amendments.
The consultant shall receive written and oral comment from employers, workers' compensation medical service and insurance providers, self-insureds, group self-insurance associations of this state and the public.
providers, self-insureds, group self-insurance associations of this state and the public.
The ENGR.
The consultant shall submit a report of its findings and a proposed amended Fee Schedule to the Commission.
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4202 Page 11 consultant shall submit a report of its findings and a proposed amended Fee Schedule to the Commission.
Rules adopted by the Commission shall allow an appeals process for claims in which a treating doctor determines and HB4202 HFLR Page 12 BOLD FACE denotes Committee Amendments.
Rules adopted by the Commission shall allow an appeals process for claims in which a treating doctor determines and documents that a drug not included in the formulary is necessary to treat an injured employee's compensable injury.
documents that a drug not included in the formulary is necessary to treat an injured employee's compensable injury.
The Commission by ENGR.
The Commission by rule shall require the use of generic pharmaceutical medications and clinically appropriate over-the-counter alternatives to prescription medications unless otherwise specified by the prescribing doctor, in accordance with applicable state law.
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4202 Page 12 rule shall require the use of generic pharmaceutical medications and clinically appropriate over-the-counter alternatives to prescription medications unless otherwise specified by the prescribing doctor, in accordance with applicable state law.
COMMITTEE REPORT BY:
Passed the House of Representatives the 11th day of March, 2026.
COMMITTEE ON JUDICIARY AND PUBLIC SAFETY OVERSIGHT, dated 02/26/2026 - DO PASS, As Amended and Coauthored.
Presiding Officer of the House of Representatives Passed the Senate the ___ day of __________, 2026.
HB4202 HFLR Page 13 BOLD FACE denotes Committee Amendments.
Presiding Officer of the Senate ENGR.
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4202 Page 13
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