{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6060.5b","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6060.5b","heading":"Clinical genetic testing coverage","body":"A. For the purposes of this section:\n\n1. “Clinical utility” means clinical utility as defined\n\npursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes;\n\n2. “Evidence-based cancer imaging” means appropriate\n\npreventative screening and imaging supported by evidence;\n\n3. “Genetic testing for an inherited mutation” means multi-gene\n\ntesting for an inherited mutation associated with an increased risk\n\nof cancer;\n\n4. “Health benefit plan” means a health benefit plan as defined\n\npursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; and\n\n5. “Health care provider” means any physician, hospital, or\n\nother entity or person that is licensed or otherwise authorized in\n\nthis state to furnish health care services.\n\nB. Any health benefit plan including the Oklahoma Employees\n\nInsurance Plan that is offered, issued, or renewed in this state on\n\nor after the effective date of this act shall provide coverage for:\n\n1. Clinical genetic testing for an inherited gene mutation for\n\nindividuals with a personal or family history of cancer when such\n\ntest provides clinical utility and when ordered or recommended by a\n\nhealth care provider in accordance with medical and scientific\n\nevidence including, but not limited to:\n\na. the most recent version of the National Comprehensive\n\nCancer Network (NCCN) clinical practice\n\nrecommendations that are Category 2A or higher,\n\nb. Centers for Medicare and Medicaid Services national\n\ncoverage determinations or Medicare administrative\n\ncontractor local coverage determinations, or\n\nc. nationally recognized clinical practice guidelines;\n\nand\n\n2. Evidence-based cancer imaging for individuals with an\n\nincreased risk of cancer when such test provides clinical utility\n\nand when ordered or recommended by a health care provider in\n\naccordance with the most recent version of the NCCN clinical\n\npractice recommendations that are Category 2A or higher, or in\n\naccordance with other nationally recognized clinical practice\n\nguidelines.\n\nC. Coverage under this section shall not be subject to any\n\nannual deductibles, copayments, or coinsurance limits as established\n\nfor all covered benefits under the health benefit plan.\n\nD. If application of this section would result in health\n\nsavings account ineligibility under Section 223 of the Internal\n\nRevenue Code of 1986, as amended, the provisions of this section\n\nshall only apply to health savings accounts with qualified high\n\ndeductible health plans with respect to the deductible of such a\n\nplan after the enrollee has satisfied the minimum deductible.\n\nProvided, however, the provisions of this section shall apply to\n\nitems or services that are preventive care pursuant to Section\n\n223(c)(2)(C) of the Internal Revenue Code of 1986, as amended,\n\nregardless of whether the minimum deductible has been satisfied.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"923c1ac656b9fe7440df46d1b41426dabdbf8745481c49cb9581e4408ee27789","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6060.5a","next":"us-ok/okla.-stat.-tit.-36-36-6060.6"},"notice":"GroundRules: Original legal text. Not legal advice."}