Oklahoma 2022 2022 Regular Session

Oklahoma House Bill HB2124 Amended / Bill

Filed 02/25/2021

                     
 
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HOUSE OF REPRESENTATIVES - FLOOR VERSION 
 
STATE OF OKLAHOMA 
 
1st Session of the 58th Legislature (2021) 
 
COMMITTEE SUBSTITUTE 
FOR 
HOUSE BILL NO. 2124 	By: McEntire Townley, Frix, 
Grego and Moore of the 
House 
 
   and 
 
  McCortney, Stephens, Hicks 
and Taylor of the Senate 
 
 
 
 
 
 
COMMITTEE SUBSTITUTE 
 
An Act relating to professions and occupations; 
amending Section 1, Chapter 263, O.S.L. 2014, as 
amended by Section 7, Chapter 285, O.S.L. 2016 (59 
O.S. Supp. 2020, Section 357), which relates to 
definitions; defining term; amending Section 2, 
Chapter 263, O.S.L. 2014 (59 O.S. Supp. 2020, Section 
358), which relates to pharmacy benefits management 
licensure; modifying the licensing entity; providing 
for the levying of charges, fees, civil penalties or 
restitution; declaring an emergency; and providing 
for contingent effect. 
 
 
 
 
 
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: 
SECTION 1.     AMENDATORY     Section 1, Chapter 263, O.S.L. 
2014, as amended by Section 7, Chapter 285, O.S.L. 2016 ( 59 O.S. 
Supp. 2020, Section 357), is amended to read as follows:   
 
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Section 357.  As used in this act: 
1.  "Commission" or "Pharmacy Choice Commission" means the 
Patient's Right to Pharmacy Choice Commission established by Section 
6966 of Title 36 of the Okla homa Statutes; 
2. "Covered entity" means a nonprofit hospital or medical 
service organization, insurer, health coverage plan or health 
maintenance organization; a health program administered by the state 
in the capacity of provider of health coverage; or an employer, 
labor union, or other entity organized in the state that provides 
health coverage to covered individuals who are employed or reside in 
the state.  This term does not include a health plan that provides 
coverage only for accidental injury, spec ified disease, hospital 
indemnity, disability income, or other limited benefit health 
insurance policies and contracts that do not include prescription 
drug coverage; 
2. 3. "Covered individual" means a member, participant, 
enrollee, contract holder or pol icy holder or beneficiary of a 
covered entity who is provided health coverage by the covered 
entity.  A covered individual includes any dependent or other person 
provided health coverage through a policy, contract or plan for a 
covered individual; 
3. 4. "Department" means the Oklahoma Insurance Department;   
 
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4. 5. "Maximum allowable cost" or "MAC" means the list of drug 
products delineating the maximum per -unit reimbursement for 
multiple-source prescription drugs, medical product or device; 
5. 6. "Multisource drug product reimbursement" (reimbursement) 
means the total amount paid to a pharmacy inclusive of any reduction 
in payment to the pharmacy, excluding prescription dispense fees; 
6. 7. "Pharmacy benefits management" means a service provided 
to covered entities to facilitate the provision of prescription drug 
benefits to covered individuals within the state, including 
negotiating pricing and other terms with drug manufacturers and 
providers.  Pharmacy benefits management may include any or all of 
the following services: 
a. claims processing, retail network management and 
payment of claims to pharmacies for prescription drugs 
dispensed to covered individuals, 
b. clinical formulary development and management 
services, 
c. rebate contracting and administrati on, 
d. certain patient compliance, therapeutic intervention 
and generic substitution programs, or 
e. disease management programs; 
7. 8. "Pharmacy benefits manager" or "PBM" means a person, 
business or other entity that performs pharmacy benefits managemen t.  
The term includes a person or entity acting for a PBM in a   
 
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contractual or employment relationship in the performance of 
pharmacy benefits management for a managed care company, nonprofit 
hospital, medical service organization, insurance company, third -
party payor, or a health program administered by an agency of this 
state; 
8. 9. "Plan sponsor" means the employers, insurance companies, 
unions and health maintenance organizations or any other entity 
responsible for establishing, maintaining, or administ ering a health 
benefit plan on behalf of covered individuals; and 
9. 10. "Provider" means a pharmacy licensed by the State Board 
of Pharmacy, or an agent or representative of a pharmacy, including, 
but not limited to, the pharmacy's contracting agent, whi ch 
dispenses prescription drugs or devices to covered individuals. 
SECTION 2.     AMENDATORY     Section 2, Chapter 263, O.S.L. 
2014 (59 O.S. Supp. 2020, Section 358), is amended to read as 
follows: 
Section 358.  A.  In order to provide p harmacy benefits 
management or any of the services included under the definition of 
pharmacy benefits management in this state, a pharmacy benefits 
manager or any entity acting as one in a contractual or employment 
relationship for a covered entity shall f irst obtain a license from 
the Pharmacy Choice Commission of the Oklahoma Insurance Department, 
and the Department Commission may charge a fee for such licensure.   
 
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B.  The Department Pharmacy Choice Commission shall establish, 
by regulation, licensure proce dures, required disclosures for 
pharmacy benefits managers (PBMs) and other rules as may be 
necessary for carrying out and enforcing the provisions of this act.  
The licensure procedures shall, at a minimum, include the completion 
of an application form th at shall include the name and address of an 
agent for service of process, the payment of a requisite fee, and 
evidence of the procurement of a surety bond. 
C.  The Department Pharmacy Choice Commission may subpoena 
witnesses and information.  Its complianc e officers may take and 
copy records for investigative use and prosecutions.  Nothing in 
this subsection shall limit the Office of the Attorney General from 
using its investigative demand authority to investigate and 
prosecute violations of the law. 
D.  The Department Pharmacy Choice Commission may suspend, 
revoke or refuse to issue or renew a license for noncompliance with 
any of the provisions hereby established or with the rules 
promulgated by the Department Commission; for conduct likely to 
mislead, deceive or defraud the public or the Department Commission; 
for unfair or deceptive business practices or for nonpayment of a 
renewal fee or fine.  The Department Commission may also levy 
administrative charges, fees, civil penalties, restitution or fines 
for each count of which a licensee has been convicted in a 
Department Commission hearing.   
 
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SECTION 3.  It being immediately necessary for the preservation 
of the public peace, health or safety, an emergency is hereby 
declared to exist, by reaso n whereof this act shall take effect and 
be in full force from and after its passage and approval. 
SECTION 4.  The provisions of this act shall be contingent upon 
the enactment of Enrolled House Bill No. 2123 of the 1st Session of 
the 58th Oklahoma Legislature. 
 
COMMITTEE REPORT BY: COMMITTEE ON PUBLIC HEALTH, dated 02/24/2021 - 
DO PASS, As Amended and Coauthored.