Oklahoma legislation · 2026 Regular Session
Oklahoma SB1645: Medicaid; establishing certain requirements and procedures for audits of providers; directing establishment of certain appeals. Effective date.
Status: Signed into law, May 5, 2026
What the bill says
An Act relating to the state Medicaid program; defining terms; establishing certain requirements and procedures for audits of Medicaid providers; directing establishment of certain appeals process; providing for review by administrative law judge; authorizing certain judicial review; prohibiting certain adverse action by the Oklahoma Health Care Authority or a contracted entity; stipulating certain requirements for recoupment of funds; limiting applicability of certain provisions; directing promulgation of rules; providing for codification; and providing an effective date…
From the enrolled text, April 29, 2026:
An Act relating to the state Medicaid program; defining terms; establishing certain requirements and procedures for audits of Medicaid providers; directing establishment of certain appeals process; providing for review by administrative law judge; authorizing certain judicial review; prohibiting certain adverse action by the Oklahoma Health Care Authority or a contracted entity; stipulating certain requirements for recoupment of funds; limiting applicability of certain provisions; directing promulgation of rules; providing for codification; and providing an effective date. SUBJECT: Audits of Medicaid providers SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 5051.11 of Title 63, unless there is created a duplication in numbering, reads as follows: A. As used in this section: 1. "Audit" means any review, analysis, or investigation conducted by the Oklahoma Health Care Authority, a contracted entity, or an entity on behalf of the Authority or the contracted entity, of a Medicaid claim submitted by a provider if the review, analysis, or investigation: a. may result in recoupment, withholding, denial, or adjustment of Medicaid payments, and b. involves records, documents, or information other than the filed claim; 2. "Capitated contract" and "contracted entity" have the same meanings as provided by the Ensuring Access to Medicaid Act, Section 4002.2 of Title 56 of the Oklahoma Statutes; 3. "Clerical or recordkeeping error" …