Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB468 Compare Versions

Only one version of the bill is available at this time.

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53	53	STATE OF OKLAHOMA
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55	55	1st Session of the 58th Legislature (2021)
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57	57	SENATE BILL 468 By: Hicks
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63	63	AS INTRODUCED
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65	65	An Act relating to health insurance; prohibiting a
66	66	health insurer from modifying covera ge of
67	67	prescription drug in certain circumstance; construing
68	68	clause; providing for certain civ il penalty;
69	69	providing for codification; and providing an
70	70	effective date.
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75	75	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
76	76	SECTION 1. NEW LAW A new section of law to be codif ied
77	77	in the Oklahoma Statutes as Section 6850.2 of Title 36, unless there
78	78	is created a duplication in numb ering, reads as follows:
79	79	A. An insurer, as defined in Section 6 054 of Title 36 of the
80	80	Oklahoma Statutes, shall not modify an insured’s coverage of a
81	81	prescription drug, as defined in Section 367.2 of T itle 59 of the
82	82	Oklahoma Statutes, if the following conditions are met :
83	83	1. The prescription drug had been previously preauthorized for
84	84	coverage by the insu rer or was listed on the formulary of the
85	85	insurer at the time the insured was prescribed the drug by his or
86	86	her practitioner, as defined in Section 6054 of Title 36 of the
87	87	Oklahoma Statutes;
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139	139	2. The insured has already received the prescription drug ; and
140	140	3. A practitioner continues to prescribe the drug to the
141	141	insured.
142	142	Modification prohibited pursuant to this section shall include,
143	143	but is not limited to, raising the premium, copayment, coi nsurance
144	144	or deductible, denying or otherwise failing to provide cont inued
145	145	coverage of the prescription drug, moving the drug to a more
146	146	restrictive coverage category or tier, or replacing a brand -name
147	147	drug for a generic drug after the insured has qualified for the
148	148	brand-name drug pursuant to this section.
149	149	B. Nothing in this section shall be construed to prohibit a n
150	150	insurer from modifying coverage of a prescription drug if:
151	151	1. The federal Food and Drug Ad ministration has issued a
152	152	statement calling into question the clinical safety of the drug; or
153	153	2. The manufacturer of the drug has notified the federal Food
154	154	and Drug Administration of a manufacturing discontinuance or
155	155	potential discontinuance of the drug a s required by 21 U.S.C. 356c.
156	156	C. Any insurer that violates the provisions of this section
157	157	shall be subject to a civil penalty in an amount to be determined by
158	158	the Insurance Commissioner.
159	159	SECTION 2. This act shall become effective November 1, 2021.
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161	161	58-1-465 CB 1/19/2021 12:48:48 PM