Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB1860 Compare Versions

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4		-	An Act
5		-	ENROLLED SENATE
	29	+	HOUSE OF REPRESENTATIVES - FLOOR VERSION
	30	+
	31	+	STATE OF OKLAHOMA
	32	+
	33	+	2nd Session of the 58th Legislature (2022)
	34	+
	35	+	ENGROSSED SENATE
6	36		BILL NO. 1860 By: McCortney, Taylor, Bullard,
7	37		Burns, Garvin, Stanley,
8	38		Pemberton, Standridge,
9	39		Stephens, Rader, Coleman,
10	40		Pederson, Simpson, Kidd,
11	41		Murdock, Jech, Leewright,
12	42		and Rogers of the Senate
13	43
14	44		and
15	45
16	46		McEntire, Olsen, Hasenbeck,
17		-	Pae, Grego, Sims, and
18		-	Randleman of the House
	47	+	Pae, and Grego of the House
19	48
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22	51		An Act relating to the Patient’s Right to Pharmacy
23	52		Choice Act; amending 36 O.S. 2021, Sections 6960,
24	53		6961, 6962, and 6963, which relate to definitions,
25	54		retail pharmacy network access standards, compliance
26	55		review, and health insurer monitoring; defining
27	56		terms; modifying definition; expanding retail
28	57		pharmacy network access standards; prohibiting
29	58		pharmacy benefits managers fro m requiring patient use
30	59		affiliated pharmacy; providing for expansion of
31	60		pharmacy network participation; prohibitin g provider
32	61		contracts from limiting the ability of a pharmacy to
33	62		disclose certain health car e and cost informatio n;
34	63		providing health insurers perform ing pharmacy
35	64		benefits management activities be responsible for
36	65		certain conduct; modifyin g patient choices of in-
37	66		network pharmacy; providing that pharmacy benefits
38	67		managers not require or incentivize individuals
39	68		through certain means; construing provision;
40	69		repealing 36 O.S. 2021, Section 6964, which relates
41	70		to Pharmacy and Therapeutics Committee s; updating
42	71		statutory reference; and providing an effective date.
43	72
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46		-	~~SUBJECT~~: ~~Pharmacy Choice~~
	75	+	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKL AHOMA:
47	76
48		-	ENR. S. B. NO. 1860 Page 2
49		-
50		-	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKL AHOMA:
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51	102
52	103		SECTION 1. AMENDATORY 36 O.S. 2021, Section 6960, is
53	104		amended to read as follows:
54		-
55	105		Section 6960. For purposes of the Patient ’s Right to Pharmacy
56	106		Choice Act:
57		-
58	107		1. “Health insurer” means any corporation, association, benefit
59	108		society, exchange, partn ership or individual licensed by the
60	109		Oklahoma Insurance Code;
61		-
62	110		2. “Mail-order pharmacy” means a pharmacy licensed by this
63	111		state that primarily dispenses and delivers covered drugs via common
64	112		carrier;
65		-
66	113		3. “Pharmacy benefits management” means any or all of t he
67	114		following activities:
68		-
69	115		a. provider contract negotiation and/or provider network
70	116		administration including decisions related to provider
71	117		network participation status,
72		-
73	118		b. drug rebate contract negoti ation or drug rebate
74	119		administration, and
75		-
76	120		c. claims processing which may include claim billing and
77	121		payment services;
78		-
79	122		4. “Pharmacy benefits manager ” or “PBM” means a person or
80	123		entity that performs pharmacy benefits management activities and any
81	124		other person or entity acting for such a person or entity performing
82	125		pharmacy benefits management activities. under a contractual or
83	126		employment relationship in the performance of pharmacy benefits
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84	154		management for a managed -care company, nonprofit hospital, medical
85	155		service organization, insurance company, third-party payor or a
86	156		health program administered by a department of this state
87	157		Notwithstanding any other provision within the Patient’s Right to
88	158		Pharmacy Choice Act, a self-funded plan administered by an employe r
89	159		or organized labor union who negotiates and executes all provi der
90	160		contracts directly with a pharmacy or the pharmacy’s contracted
91		-
92		-	ENR. S. B. NO. 1860 Page 3
93	161		pharmacy services administrative organization, and a pharmacy
94	162		provider who does not use a pharmacy services administrative
95	163		organization shall not be deemed a pharmacy benefits manager of its
96	164		own group health plan and shall not be restricted in its ability to
97	165		design and manage its own group health plan ;
98		-
99	166		4. “Pharmacy and therapeutics committee ” or “P&T committee”
100	167		means a committee at a ho spital or a health insurance plan that
101	168		decides which drugs will appear on that entity’s drug formulary;
102		-
103	169		5. “Retail pharmacy” or “provider” means a pharmacy, as defined
104	170		in Section 353.1 of Title 59 of the Oklahoma Statutes , licensed by
105	171		the State Board of P harmacy or an agent or representative of a
106	172		pharmacy;
107		-
108	173		5. 6. “Retail pharmacy network” means retail pharmacy providers
109	174		contracted with a PBM in which the pharmacy primarily fills and
110	175		sells prescriptions via a retail, storefront location;
111	176
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112	203		6. 7. “Rural service area” means a five-digit ZIP code in whic h
113	204		the population density is less than one thousand (1,000) individuals
114	205		per square mile;
115		-
116	206		8. “Specialty drug” means prescription medication that requires
117	207		special handling, administration, or monit oring and is used for the
118	208		treatment of patients with serious health conditions requiring
119	209		complex therapies. Specialty drugs shall also include drugs that
120	210		are limited in distribution by the manu facturer and may be purchased
121	211		only at specialty pharmacies;
122		-
123	212		7. 9. “Suburban service area” means a five-digit ZIP code in
124	213		which the population density is between one thousand (1,000) and
125	214		three thousand (3,000) individuals per sq uare mile; and
126		-
127	215		8. 10. “Urban service area” means a five-digit ZIP code in
128	216		which the population density is greater than three thousand (3,000)
129	217		individuals per square mile.
130		-
131	218		SECTION 2. AMENDATORY 36 O.S. 2021, Section 6961, is
132	219		amended to read as follows:
133		-
134		-
135		-	ENR. S. B. NO. 1860 Page 4
136	220		Section 6961. A. Pharmacy be nefits managers (PBMs) shall
137	221		comply with the following r etail pharmacy network access standards:
138		-
139	222		1. At least ninety percent (90%) of covered individuals
140	223		residing in an each urban service area live within t wo (2) miles of
141	224		a retail pharmacy participating in the PBM’s retail pharmacy
142	225		network;
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144	253		2. At least ninety percent (90%) of covered individuals
145	254		residing in an each urban service area live within five (5) miles of
146	255		a retail pharmacy designated as a preferred participating pharmacy
147	256		in the PBM’s retail pharmacy network;
148		-
149	257		3. At least ninety percent (90%) of covered individuals
150	258		residing in a each suburban service area l ive within five (5) miles
151	259		of a retail pharmacy participating in the PBM’s retail pharmacy
152	260		network;
153		-
154	261		4. At least ninety perc ent (90%) of covered individuals
155	262		residing in a each suburban service area live within seven (7) miles
156	263		of a retail pharmacy designated as a preferred participating
157	264		pharmacy in the PBM’s retail pharmacy network;
158		-
159	265		5. At least seventy percent (70%) of covered individuals
160	266		residing in a each rural service area live within fifteen (15) mile s
161	267		of a retail pharmacy participating in the PBM ’s retail pharmacy
162	268		network; and
163		-
164	269		6. At least seventy percent (70%) of covered individuals
165	270		residing in a each rural service area li ve within eighteen (18)
166	271		miles of a retail pharmacy designated as a preferred pa rticipating
167	272		pharmacy in the PBM’s retail pharmacy netw ork.
168		-
169	273		B. Mail-order pharmacies shall not be used to meet access
170	274		standards for retail pharmacy ne tworks.
171		-
172	275		C. Pharmacy benefits managers shall not r equire patients to use
173	276		pharmacies that are directly or i ndirectly owned by the or
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174	304		affiliated with a pharmacy benefits manager, including all regular
175	305		prescriptions, refills or specialty drugs regardless of d ay supply.
176		-
177		-
178		-	ENR. S. B. NO. 1860 Page 5
179	306		D. Pharmacy benefits managers shall no t in any manner on any
180	307		material, including but not limit ed to mail and ID cards, include
181	308		the name of any pharm acy, hospital or other providers unless it
182	309		specifically lists all pharmacies, hospitals and prov iders
183	310		participating in the preferred and nonprefer red pharmacy and health
184	311		networks.
185		-
186	312		SECTION 3. AMENDATORY 36 O.S. 2021, Section 6962, is
187	313		amended to read as follows:
188		-
189	314		Section 6962. A. The Oklahoma Insurance Department shall
190	315		review and approve retail pharmacy net work access for all pharmacy
191	316		benefits managers (PBMs) to ensure compliance with Section 4 of this
192	317		act 6961 of this title.
193		-
194	318		B. A PBM, or an agent of a PBM, shall not:
195		-
196	319		1. Cause or knowingly permit the use of advertisement,
197	320		promotion, solicitation, represent ation, proposal or o ffer that is
198	321		untrue, deceptive or misleading;
199		-
200	322		2. Charge a pharmacist or pharmacy a fee related to the
201	323		adjudication of a claim, including without limitation a fee for:
202		-
203	324		a. the submission of a claim,
204		-
205	325		b. enrollment or participation in a re tail pharmacy
206	326		network, or
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208	354		c. the development or management of claims proces sing
209	355		services or claims payment services related to
210	356		participation in a retail pharmacy network;
211		-
212	357		3. Reimburse a pharmacy or pharmacist in the state an amount
213	358		less than the amount th at the PBM reimburse s a pharmacy owned by or
214	359		under common ownership with a PBM for providing the same covered
215	360		services. The reimb ursement amount paid to the pharmacy shall be
216	361		equal to the reimbursement amount calculated on a per-unit basis
217	362		using the same generic product iden tifier or generic code number
218	363		paid to the PBM-owned or PBM-affiliated pharmacy;
219		-
220		-
221		-	ENR. S. B. NO. 1860 Page 6
222	364		4. Deny a pharmacy the opport unity to participate in any form
223	365		of pharmacy network at preferred participation status , whether in-
224	366		network, preferred, or otherwise, if the pharmacy is willing to
225	367		accept the terms and conditions that th e PBM has established for
226	368		other pharmacies as a condit ion of preferred network for
227	369		participation status in the network or networks of the pharmacy ’s
228	370		choice;
229		-
230	371		5. Deny, limit or termi nate a pharmacy’s contract based on
231	372		employment status of any employee who h as an active license to
232	373		dispense, despite probation st atus, with the State Board of
233	374		Pharmacy;
234		-
235	375		6. Retroactively deny or reduce reimbursement for a cove red
236	376		service claim after return ing a paid claim res ponse as part of the
237	377		adjudication of the claim, unless:
238	378
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239	405		a. the original claim was submitted fraudulently, or
240		-
241	406		b. to correct errors identified in an audit, so long as
242	407		the audit was conducted in compliance wit h Sections
243	408		356.2 and 356.3 of Title 59 of the Okla homa Statutes;
244	409		or
245		-
246	410		7. Fail to make any payment due to a pharmacy or pharmacist for
247	411		covered services properly rendered in the event a PBM terminates a
248	412		pharmacy or pharmacist from a pharmacy benefits manager network.
249		-
250	413		C. The prohibitions under this section s hall apply to contracts
251	414		between pharmacy benefits manag ers and pharmacists or pharmacies
252	415		providers for participation in retail pharmacy networks.
253		-
254	416		1. A PBM provider contract shall not prohibit, restrict , or
255	417		penalize a pharmacy or pharmac ist in any way for d isclosing to an
256	418		individual any health care information that the pharmacy or
257	419		pharmacist deems appropriate reg arding:
258		-
259	420		a. not restrict, directly or indirectly, any pharmacy
260	421		that dispenses a prescription drug f rom informing, or
261	422		penalize such pharmacy for infor ming, an individual of
262	423		any differential between the in dividual’s out-of-
263	424		pocket cost or coverage with respect to acquisition of
264		-
265		-	ENR. S. B. NO. 1860 Page 7
266	425		the drug and the amount an individual would pay to
267	426		purchase the drug directly the nature of treatment,
268	427		risks, or alternatives to t he prescription drug being
269	428		dispensed, and
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270	455
271	456		b. ensure that any entity that provides pharmacy benefits
272	457		management services under a contract with any such
273	458		health plan or health insurance coverage does not,
274	459		with respect to such plan or cover age, restrict,
275	460		directly or indirectly, a pharmacy that dispenses a
276	461		prescription drug from informing, or penalize such
277	462		pharmacy for informing, a covered individual of any
278	463		differential between the individual ’s out-of-pocket
279	464		cost under the plan or coverage wi th respect to
280	465		acquisition of the drug and the amount an individual
281	466		would pay for acquisition of the drug without using
282	467		any health plan or health insurance coverage the
283	468		availability of alternate therapies, consultations , or
284	469		tests,
285		-
286	470		c. the decision of utilizat ion reviewers or sim ilar
287	471		persons to authorize or deny services, and
288		-
289	472		d. the process that is used to authorize or deny
290	473		healthcare services and struc tures used by the health
291	474		insurer.
292		-
293	475		2. Provider contracts shall not prohibit a ph armacy or
294	476		pharmacist from disc ussing information r egarding the total cost of
295	477		pharmacist services for a prescription drug or from selling a more
296	478		affordable alternative to the co vered person if such alternative is
297	479		available.
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299	507		A pharmacy benefits manager ’s contract with a participating
300	508		pharmacist or pharmacy 3. Provider contracts shall not prohibit,
301	509		restrict or limit disclosure of information to the Insurance
302	510		Commissioner, law enfo rcement or state and federal governmental
303	511		officials investigating or examining a complaint or conducting a
304	512		review of a pharmacy be nefits manager’s compliance with the
305	513		requirements under the Patient’s Right to Pharmacy Choice Act.
306		-
307		-
308		-	ENR. S. B. NO. 1860 Page 8
309	514		3. 4. A pharmacy benefits manager shall establish and maintain
310	515		an electronic claim inquiry processing sys tem using the National
311	516		Council for Prescription Drug Programs’ current standards to
312	517		communicate information to pharmacies submitting claim inquiries.
313		-
314	518		SECTION 4. AMENDATORY 36 O.S. 2021, Section 6963, is
315	519		amended to read as follows:
316		-
317	520		Section 6963. A. A hea lth insurer shall be respon sible for
318	521		monitoring all activities carried out by, or on behalf of, the
319	522		health insurer under the Patient ’s Right to Pharmacy Choice Act, and
320	523		for ensuring that all requirements of this act Section 6958 et seq.
321	524		of this title are met.
322		-
323	525		B. Whenever a health insurer performs pharmacy benefits
324	526		management on its own behalf or contracts with another person or
325	527		entity to perform activities required under this act pharmacy
326	528		benefits management, the health insurer shall be responsible for
327	529		monitoring the activities and conduct of that person or entity with
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328	557		whom the health insurer contracts and for ensuring that the
329	558		requirements of this act Section 6958 et seq. of this title are met.
330		-
331	559		C. An individual may be notifi ed at the point of sale when the
332	560		cash price for the purchase of a prescription d rug is less than the
333	561		individual’s copayment or coinsurance price for the purchase of the
334	562		same prescription drug.
335		-
336	563		D. A health insurer or pharmacy benefits manager (PBM) shall
337	564		not restrict an individual’s choice of in-network provider for
338	565		prescription drugs.
339		-
340	566		E. 1. An individual’s A patient’s choice of in-network
341	567		provider may include a retail an in-network pharmacy or a, whether
342	568		that pharmacy is in a preferred or nonpreferred ne twork, a retailer
343	569		pharmacy, mail-order pharmacy, or any other pharmacy . A health
344	570		insurer or PBM shall not r estrict such a patient’s choice of in-
345	571		network pharmacy providers. Such A health insurer or PBM shall not
346	572		require or incentivize using individuals by:
347		-
348	573		a. using any discounts in cost-sharing or a reduction in
349	574		copay, or the number of copays, or any other patie nt-
350	575		copay equivalent to individuals to receive
351		-
352		-	ENR. S. B. NO. 1860 Page 9
353	576		prescription drugs from an individual’s choice of in-
354	577		network pharmacy, or
355		-
356	578		b. using financial incentiv es to differentiate between
357	579		in-network pharmacies, whether that pharmacy is in a
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	582	+	BOLD FACE denotes Committee Amendments. 1
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358	607		preferred or nonpreferred network, a retail pharmacy,
359	608		mail order pharmacy, or any other type of pharmacy.
360		-
361	609		2. Nothing in this subsection shall be construed to prohibit a
362	610		person or entity participating in pharmacy benefits m anagement
363	611		activities from directing a patient to use a specific pharmacy for
364	612		the purchase of a specialty drug as de fined in paragraph 8 of
365	613		Section 1 of this act in the event the patient’s chosen in-network
366	614		pharmacy is unable to purchase and dispense the specialty drug.
367		-
368	615		F. A health insurer, pha rmacy or PBM shall adh ere to all
369	616		Oklahoma laws, statutes and rules when mail ing, shipping and/or
370	617		causing to be mailed or shipped prescription drugs into the State of
371	618		Oklahoma this state.
372		-
373	619		SECTION 5. REPEALER 36 O.S. 2021, Section 6964, is
374	620		hereby repealed.
375		-
376	621		SECTION 6. This act shall become eff ective November 1, 202 2.
377	622
378		-
379		-	ENR. S. B. NO. 1860 Page 10
380		-	Passed the Senate the 22nd day of March, 2022.
381		-
382		-
383		-
384		-	Presiding Officer of the Senate
385		-
386		-
387		-	Passed the House of Representatives the 18th day of April, 2022.
388		-
389		-
390		-
391		-	Presiding Officer of the House
392		-	of Representatives
393		-
394		-	OFFICE OF THE GOVERNOR
395		-	Received by the Office of the Governor this _______ _____________
396		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
397		-	By: _______________________________ __
398		-	Approved by the Governor of the State of Oklahoma this _____ ____
399		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
400		-
401		-	_________________________________
402		-	Governor of the State of Oklahoma
403		-
404		-
405		-	OFFICE OF THE SECRETARY OF STATE
406		-	Received by the Office of the Secretary of State this __________
407		-	day of __________________, 20 _______, at _______ o'clock _______ M.
408		-	By: _______________________________ __
	623	+	COMMITTEE REPORT BY: COMMITTEE ON PUBLIC HEALTH, dated 04/06/2022 -
	624	+	DO PASS, As Coauthored.