Senate HHS committee advances Medicaid "food as medicine" plan, approves a slate of licensing and health bills

Senate Health and Human Services Committee — Oklahoma City, Oct. 12, 2025 — The Senate Health and Human Services Committee on Oct. 12 voted to advance a bill to allow the state to pursue a Medicaid 1115 waiver that would permit a "food as medicine" component in prescription benefits and approved a package of largely technical and licensing bills affecting multiple professional boards, managed-care requirements and other health-related measures.

The committee approved Senate Bill 806, the Medicaid 1115 waiver measure, on a unanimous 12-0 vote after sponsor Senator Pugh described the proposal as a way to add food-based interventions to prescription benefits and to link nutrition supports to clinical care. "Giving someone an insurance card doesn't make them healthier," Senator Pugh said, arguing the waiver would let the state and managed-care plans test programs that combine nutrition and medical treatment.

Why it matters: Supporters said the bill would create a statutory framework for pilots that pair clinical care with food interventions — for example, medically tailored groceries or produce prescriptions — and could be implemented through the state's existing managed-care contracts if approved by the Centers for Medicare & Medicaid Services (CMS). Senator Pugh said the bill does not request immediate appropriations and that any financial incentives would be implemented through managed-care arrangements.

Committee action and other measures: The committee moved a series of bills that change appointment processes for occupational and professional boards so governors are not required to select appointees solely from lists provided by private associations; clarify licensing and telemedicine language; and modify compact and licensure provisions affecting dental hygienists and other clinical professionals. Several of those measures drew little debate and passed unanimously or with lopsided margins; others prompted more sustained discussion.

Notable debate and dissents: Senator Hicks opposed the set of bills that remove mandatory list requirements from appointment statutes, saying he has "been consistently opposed" to measures he believes shift authority toward the governor and away from professional associations that help identify candidates. The dental licensure compact (described in committee as a multi-state compact supported by the Department of Defense) drew objections from Senator McIntosh and the Oklahoma State Board of Dentistry and allied groups over whether the compact would allow states to levy fees and whether it sufficiently protects clinical hand-skills standards. The committee passed that compact measure on a 7-4 vote.

The committee also approved bills to:

- Modify appointment procedures for the Board of Alcohol and Drug Counselors and other boards so the governor may consider, but is not required to appoint from, association-provided lists; sponsors cited licensee counts (about 3,900 for alcohol and drug counselors, 2,600 for speech-language pathologists and audiologists, and roughly 607 for psychologists) when arguing the change would broaden the pool of eligible appointees.

- Update osteopathic board statutory language (sponsor called forward Beth Vincent, deputy director of the Osteopathic Board, to explain removal of a telemedicine license line that the agency no longer uses).

- Change the Oklahoma Medicaid Drug Utilization Review Board appointment list from six names to three, per the Oklahoma State Medical Association's request; that bill passed without recorded opposition.

- Move the Office of Client Advocacy and ombudsman references to reflect their transfer to the Attorney General's office and correct cross-references to the State Council on Aging.

- Approve a bill affecting managed-care organizations (MCOs) and primary-care spending that remains under negotiation; sponsors said they intend to continue working with MCOs, the Health Care Authority and primary-care physicians on implementation details.

Votes at a glance (committee roll-call outcomes and brief descriptions):

- Senate Bill 8 06 — Medicaid 1115 waiver for "food as medicine" component: Do pass; 12 ayes, 0 nays. Sponsor: Senator Pugh. (No immediate fiscal appropriation; statutory framework only.)

- Senate Bill 10 42 — Removes mandatory association-list appointment requirement (Board of Alcohol and Drug Counselors and similar boards): Do pass; 10 ayes, 3 nays. Sponsor: Senator Daniels (presentation noted the change applies to multiple boards).

- Senate Bill 10 45 — Same appointment-list change for a related professional board (psychologists): Do pass; 9 ayes, 4 nays. Sponsor: Senator Daniels.

- Senate Bill 9 29 — Clarifies osteopathic board practices and updates telemedicine licensing language: Do pass; 11 ayes, 0 nays. Sponsor: Senator Hace. (Agency explained the telemedicine-license language was obsolete.)

- Senate Bill 9 27 — Changes appointment submissions for the Medicaid Drug Utilization Review Board (OSMA submits three names instead of six): Do pass; 11 ayes, 0 nays. Sponsor: Senator Hicks.

- Senate Bill 9 36 — Title-off version addressing youth vaping enforcement and retailer penalties (title struck for further work): Do pass; 11 ayes, 0 nays. Sponsor: Senator Dawson.

- Senate Bill 8 08 — Clarifies authority for physical therapists under direct-employer contracts: Do pass; 12 ayes, 0 nays. Sponsor: Senator Reinhardt.

- Senate Bill 5 40 — Dental/dental-hygiene compact (reciprocity/compact to ease license mobility): Do pass; 7 ayes, 4 nays. Sponsor: (committee presentation indicated this was a Department of Defense–requested compact); the measure prompted questions about interstate fee authority and clinical assessment requirements.

- Senate Bill 8 73 2 — University hospital authority cleanup (property descriptions, trauma-certification certification language): Do pass; 11 ayes, 0 nays. Sponsor: Senator Rosino.

- Senate Bill 9 47 — Technical cleanup moving Office of Client Advocacy/ombudsman references to the Attorney General's office and correcting State Council on Aging references: Do pass; 10 ayes, 0 nays, 1 constitutional-privilege not voting. Sponsor: Senator Rosino.

- Step-therapy / rare-disease amendment (title-off; restricts prior authorization limits where FDA-approved clinical guidance is lacking): Do pass; 11 ayes, 0 nays. Sponsor: committee discussion indicated this will limit step-therapy restrictions for rare-disease drugs to not exceed FDA precedent.

What the committee did not do: Several bills had titles struck for further drafting or to negotiate language with stakeholders, including the vaping penalties measure (title off to continue working with retailers) and certain MCO primary-care enforcement mechanics.

Context and next steps: If the Medicaid 1115 waiver language is included in a finalized bill and approved by the legislature, Oklahoma would still need CMS approval of any 1115 waiver amendment to implement food-as-medicine services. Sponsors told the committee they are continuing discussions with the Health Care Authority, managed-care organizations, and community partners that have piloted similar programs. Several technical licensing and compact measures will move to the next stage of the legislative process following committee passage.

Ending note: Committee members repeatedly emphasized continuing stakeholder work on implementation details for health-care financing and licensure changes; sponsors asked colleagues to support the measures while they refine statutory language on subsequent committee or floor action.