Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB821 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	+	1st Session of the 58th Legislature (2021)
	34	+
	35	+	ENGROSSED SENATE
6	36		BILL NO. 821 By: McCortney, Murdock, Kidd,
7	37		Pemberton, Stephens, Garvin,
8	38		Stanley, Bullard, Rogers,
9	39		Standridge, Hicks, Weaver,
10	40		Jett, Dugger, Simpson,
11	41		Hamilton, Hall, Jech, Taylor ,
12	42		Boren, Pederson, Allen,
13	43		Coleman, Burns, Bergstrom ,
14	44		Dossett (J.J.) and Dossett
15	45		(J.A.) of the Senate
16	46
17	47		and
18	48
19	49		McEntire, Moore, Frix, Greg o,
20	50		Pae, Boles, Davis, Marti,
21	51		Dempsey, Hilbert, Olsen,
22	52		Phillips, Johns, Humphrey,
23		-	Sterling, Fugate, West
24		-	(Tammy), Kerbs, Vancuren,
25		-	Gann, Smith, McBride,
26		-	Hasenbeck, Roe, Dobrinski,
27		-	Kendrix, Caldwell (Chad ),
28		-	Ranson, Hardin (David),
	53	+	Sterling, Fugate, West (Tammy),
	54	+	Kerbs, Vancuren, Gann, Smith,
	55	+	McBride, Hasenbeck, Roe,
	56	+	Dobrinski, Kendrix, Caldwell
	57	+	(Chad), Ranson, Hardin (David),
29	58		Fetgatter, O'Donnell, Virgin,
30		-	May, Roberts (Dustin),
31		-	Newton, Lowe (Dick), Talley,
32		-	Randleman, West (Josh),
33		-	McCall, Townley, Conley,
34		-	Burns, Boatman, Cornwell,
35		-	Bashore, Strom, Miller,
36		-	Lawson, Luttrell, Cul ver,
37		-	Russ, Ford, Sims, McDugle,
38		-	Walke, Cruz, Wallace, Echols,
39		-	Nichols, Provenzano,
	59	+	May, Roberts (Dustin), Newton,
	60	+	Lowe (Dick), Talley, Randleman,
	61	+	West (Josh), McCall, Townley,
	62	+	Conley, Burns, Boatman,
	63	+	Cornwell, Bashore, Strom,
	64	+	Miller, Lawson, Luttrell,
	65	+	Culver, Russ, Ford, Sims,
	66	+	McDugle, Walke, Cruz, Wallace,
	67	+	Echols, Nichols, Provenzano,
40	68		Patzkowsky, Manger, Bush,
41	69		Worthen, Bennett, Crosswhite
42	70		Hader, West (Kevin),
43	71		Rosecrants, Williams, Sneed,
44		-	Caldwell (Trey), Baker ~~and~~
45		-	~~Lepak of~~ the House
	72	+	Caldwell (Trey) and Baker of
	73	+	the House
46	74
47	75
48		-	ENR. S. B. NO. 821 Page 2
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52	103		An Act relating to the Patient ’s Right to Pharmacy
53	104		Choice Act; amending Section 3, Chapter 426, O.S.L.
54	105		2019 (36 O.S. Supp. 2020, Section 6960), which
55	106		relates to definitions; adding d efinitions of
56	107		pharmacy benefits management and retail pharmacy;
57	108		modifying definitions; amending Section 4, Chapter
58	109		426, O.S.L. 2019 (36 O.S. Supp. 2020, Section 6961),
59	110		which relates to retail pharmacy network access
60	111		standards; specifying access standards; modifying
61	112		prohibition on pharmacy benefit managers; amending
62	113		Section 5, Chapter 426, O.S.L. 2019 (36 O.S. Supp.
63	114		2020, Section 6962), which relates to compliance
64	115		review; modifying certain contract restrictions;
65	116		updating statutory reference; amending Section 6,
66	117		Chapter 426, O.S.L. 2019 (36 O.S. Supp. 2020, Section
67	118		6963), which relates to health insurer monitoring;
68	119		modifying certain prohibitions on health insurers and
69	120		pharmacy benefit managers ; conforming language;
70	121		repealing Section 7, Chapter 426, O.S.L. 2019 (36
71	122		O.S. Supp. 2020, Section 6964), which relates to
72	123		health insurer formularies; and providing an
73	124		effective date.
74	125
75	126
76	127
77		-	SUBJECT: Patient's Right to Pharmac y Choice Act
78	128
79	129		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
80		-
81	130		SECTION 1. AMENDATORY Section 3, Chapter 426, O.S.L.
82	131		2019 (36 O.S. Supp. 2020, Section 6960), is amended to read as
83	132		follows:
84		-
85	133		Section 6960. For purposes of the Patient ’s Right to Pharmacy
86	134		Choice Act:
87		-
88	135		1. “Health insurer” means any corporation, association, benefit
89	136		society, exchange, partnership or individual lic ensed by the
90	137		Oklahoma Insurance Code;
91	138
92		-	ENR. S. B. NO. 821 Page 3
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93	164
94	165		2. “Mail-order pharmacy” means a pharmacy licensed by this
95	166		state that primarily dispenses and delivers covered drugs via common
96	167		carrier;
97		-
98	168		3. “Pharmacy benefits management ” means any or all of the
99	169		following activities:
100		-
101	170		a. provider contract negotiation and/or provider network
102	171		administration including decisions related to provider
103	172		network participation status,
104		-
105	173		b. drug rebate contract negotiation or drug rebate
106	174		administration, and
107		-
108	175		c. claims processing which may include cla im billing and
109	176		payment services;
110		-
111	177		4. “Pharmacy benefits manager ” or “PBM” means a person or
112	178		entity that performs pharmacy benefits management activities and any
113	179		other person or entity acting for such a person or entity performing
114	180		pharmacy benefits manageme nt activities under a contractual or
115	181		employment relationship in the performance of pharmacy benefits
116	182		management for a managed -care company, nonprofit hospital, medical
117	183		service organization, insurance company, third -party payor or a
118	184		health program administe red by a department of this state ;
119		-
120	185		4. “Pharmacy and therapeutics committee ” or “P&T committee”
121	186		means a committee at a hospital or a health insurance plan that
122	187		decides which drugs will appear on that entity ’s drug formulary;
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123	214
124	215		5. “Retail pharmacy” or “provider” means a pharmacy, as defined
125	216		in Section 353.1 of Title 59 of the Oklahoma Statutes licensed by
126	217		the State Board of Pharmacy or an agent or representative of a
127	218		pharmacy;
128		-
129	219		5. 6. “Retail pharmacy network ” means retail pharmacy providers
130	220		contracted with a PBM in which the pharmacy primarily fills and
131	221		sells prescriptions via a retail, storefront location;
132		-
133		-
134		-	ENR. S. B. NO. 821 Page 4
135	222		6. 7. “Rural service area” means a five-digit ZIP code in which
136	223		the population density is less than one thousand (1,000) individuals
137	224		per square mile;
138		-
139	225		7. 8. “Suburban service area ” means a five-digit ZIP code in
140	226		which the population density is between one thousand (1,000) and
141	227		three thousand (3,000) individuals per square mile; and
142		-
143	228		8. 9. “Urban service area” means a five-digit ZIP code in which
144	229		the population density is greater than three thousand (3,000)
145	230		individuals per square mile.
146		-
147	231		SECTION 2. AMENDATORY Section 4, Chapter 426, O.S.L.
148	232		2019 (36 O.S. Supp. 2020, Section 6961), is amended to read as
149	233		follows:
150		-
151	234		Section 6961. A. Pharmac y benefits managers (PBMs) shall
152	235		comply with the following retail pharmacy network access standards:
153		-
154	236		1. At least ninety percent (90%) of covered individuals
155	237		residing in an each urban service area live within two (2) miles of
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156	265		a retail pharmacy participatin g in the PBM’s retail pharmacy
157	266		network;
158		-
159	267		2. At least ninety percent (90%) of covered individuals
160	268		residing in an each urban service area live within five (5) miles of
161	269		a retail pharmacy designated as a preferred participating pharmacy
162	270		in the PBM’s retail pharmacy network;
163		-
164	271		3. At least ninety percent (90%) of covered individuals
165	272		residing in a each suburban service area live within five (5) miles
166	273		of a retail pharmacy participating in the PBM ’s retail pharmacy
167	274		network;
168		-
169	275		4. At least ninety percent (90%) of covere d individuals
170	276		residing in a each suburban service area live within seven (7) miles
171	277		of a retail pharmacy designated as a preferred participating
172	278		pharmacy in the PBM’s retail pharmacy network;
173		-
174	279		5. At least seventy percent (70%) of covered individuals
175	280		residing in a each rural service area live within fifteen (15) miles
176		-
177		-	ENR. S. B. NO. 821 Page 5
178	281		of a retail pharmacy participating in the PBM ’s retail pharmacy
179	282		network; and
180		-
181	283		6. At least seventy percent (70%) of covered individuals
182	284		residing in a each rural service area live within eighteen (18)
183	285		miles of a retail pharmacy designated as a preferred participating
184	286		pharmacy in the PBM’s retail pharmacy network.
185		-
186	287		B. Mail-order pharmacies shall not be used to meet access
187	288		standards for retail pharmacy networks.
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189	316		C. Pharmacy benefits managers shall n ot require patients to use
190	317		pharmacies that are directly or indirectly owned by the or
191	318		affiliated with a pharmacy benefits manager , including all regular
192	319		prescriptions, refills or specialty drugs regardless of day supply.
193		-
194	320		D. Pharmacy benefits managers shal l not in any manner on any
195	321		material, including but not limited to mail and ID cards, include
196	322		the name of any pharmacy, hospital or other providers unless it
197	323		specifically lists all pharmacies, hospitals and providers
198	324		participating in the preferred and nonpr eferred pharmacy and health
199	325		networks.
200		-
201	326		SECTION 3. AMENDATORY Section 5, Chapter 426, O.S.L.
202	327		2019 (36 O.S. Supp. 2020, Section 6962), is amended to read as
203	328		follows:
204		-
205	329		Section 6962. A. The Oklahoma Insurance Department shall
206	330		review and approve retail pharmacy network access for all pharmacy
207	331		benefits managers (PBMs) to ensure compliance with Section 4 of this
208	332		act 6961 of this title.
209		-
210	333		B. A PBM, or an agent of a PBM, shall not:
211		-
212	334		1. Cause or knowingly permit the use of advertisement,
213	335		promotion, solicitation, representation, proposal or offer that is
214	336		untrue, deceptive or misleading;
215		-
216	337		2. Charge a pharmacist or pharmacy a fee related to the
217	338		adjudication of a claim , including without limitation a fee for:
218		-
219	339		a. the submission of a claim,
220	340
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223	367		b. enrollment or participation in a retail pharmacy
224	368		network, or
225		-
226	369		c. the development or management of claims processing
227	370		services or claims payment services related to
228	371		participation in a retail pharmacy network;
229		-
230	372		3. Reimburse a pharmacy or pharmacist in the state an amount
231	373		less than the amount that the PBM reimburses a pharmacy owned by or
232	374		under common ownership with a PBM for providing the same covered
233	375		services. The reimbursement amount paid to the pharmacy shall be
234	376		equal to the reimbursement amount calculated on a per-unit basis
235	377		using the same generic product identifier or generic code number
236	378		paid to the PBM-owned or PBM-affiliated pharmacy;
237		-
238	379		4. Deny a pharmacy the opportunity to participate in any form
239	380		of pharmacy network at preferred participation status , whether in-
240	381		network, preferred or otherwise, if the pharmacy is willing to
241	382		accept the terms and conditions that the PBM has established for
242	383		other pharmacies as a condition of preferred network for
243	384		participation status in the network or networks of the pharmacy ’s
244	385		choice;
245		-
246	386		5. Deny, limit or terminate a pharmacy ’s contract based on
247	387		employment status of any employee who has an active license to
248	388		dispense, despite probation status, with the State Board of
249	389		Pharmacy;
250	390
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251	417		6. Retroactively deny or reduce reimbursement for a cove red
252	418		service claim after returning a paid claim response as part of the
253	419		adjudication of the claim, unless:
254		-
255	420		a. the original claim was submitted fraudulently, or
256		-
257	421		b. to correct errors identified in an audit, so long as
258	422		the audit was conducted in compliance wit h Sections
259	423		356.2 and 356.3 of Title 59 of the Oklahoma Statutes;
260	424		or
261		-
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263		-	ENR. S. B. NO. 821 Page 7
264	425		7. Fail to make any payment due to a pharmacy or pharmacist for
265	426		covered services properly rendered in the event a PBM terminates a
266	427		pharmacy or pharmacist from a pharmacy benefits manager network.
267		-
268	428		C. The prohibitions under this section shall apply to contracts
269	429		between pharmacy benefits managers and pharmacists or pharmacies
270	430		providers for participation in retail pharmacy networks.
271		-
272	431		1. A PBM provider contract shall not prohibit, restrict or
273	432		penalize a pharmacy or pharmacist in any way for disclosing to an
274	433		individual any health care information that the pharmacy or
275	434		pharmacist deems appropriate regarding :
276		-
277	435		a. not restrict, directly or indirectly, any pharmacy
278	436		that dispenses a prescription drug f rom informing, or
279	437		penalize such pharmacy for informing, an individual of
280	438		any differential between the individual ’s out-of-
281	439		pocket cost or coverage with respect to acquisition of
282	440		the drug and the amount an individual would pay to
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283	468		purchase the drug directly the nature of treatment,
284	469		risks or alternatives to the prescription drug being
285	470		dispensed, and
286		-
287	471		b. ensure that any entity that provides pharmacy benefits
288	472		management services under a contract with any such
289	473		health plan or health insurance coverage does not,
290	474		with respect to such plan or coverage, restrict,
291	475		directly or indirectly, a pharmacy that dispenses a
292	476		prescription drug from informing, or penalize such
293	477		pharmacy for informing, a covered individual of any
294	478		differential between the individual ’s out-of-pocket
295	479		cost under the plan or coverage with respect to
296	480		acquisition of the drug and the amount an individual
297	481		would pay for acquisition of the drug without using
298	482		any health plan or health insurance coverage the
299	483		availability of alternate therapies, consultations or
300	484		tests,
301		-
302	485		c. the decision of utilization reviewers or similar
303	486		persons to authorize or deny services, and
304		-
305		-
306		-	ENR. S. B. NO. 821 Page 8
307	487		d. the process that is used to authorize or deny
308	488		healthcare services and structures used by the health
309	489		insurer.
310		-
311	490		2. Provider contracts shall not prohibit a ph armacy or
312	491		pharmacist from discussing information regarding the total cost of
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313	519		pharmacist services for a prescription drug or from selling a more
314	520		affordable alternative to the covered person if such alternative is
315	521		available.
316		-
317	522		A pharmacy benefits manager ’s contract with a participating
318	523		pharmacist or pharmacy 3. Provider contracts shall not prohibit,
319	524		restrict or limit disclosure of information to the Insurance
320	525		Commissioner, law enforcement or state and federal governmental
321	526		officials investigating or examining a complaint or conducting a
322	527		review of a pharmacy benefits manager ’s compliance with the
323	528		requirements under the Patient ’s Right to Pharmacy Choice Act.
324		-
325	529		3. 4. A pharmacy benefits manager shall establish and maintain
326	530		an electronic claim inquiry processing sys tem using the National
327	531		Council for Prescription Drug Programs ’ current standards to
328	532		communicate information to pharmacies submitting claim inquiries.
329		-
330	533		SECTION 4. AMENDATORY Section 6, Chapter 426, O.S.L.
331	534		2019 (36 O.S. Supp. 2020, S ection 6963), is amended to read as
332	535		follows:
333		-
334	536		Section 6963. A. A health insurer shall be responsible for
335	537		monitoring all activities carried out by, or on behalf of, the
336	538		health insurer under the Patient ’s Right to Pharmacy Choice Act, and
337	539		for ensuring that all requirements of this act are met.
338		-
339	540		B. Whenever a health insurer performs pharmacy benefit
340	541		management on its own behalf or contracts with another person or
341	542		entity to perform activities required under this act pharmacy
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342	570		benefit management, the health insurer shall be responsible for
343	571		monitoring the activities and conduct of that person or entity with
344	572		whom the health insurer contracts and for ensuring that the
345	573		requirements of this act are met.
346		-
347	574		C. An individual may be notified at the point of sale when the
348	575		cash price for the purchase of a prescription drug is less than the
349		-
350		-	ENR. S. B. NO. 821 Page 9
351	576		individual’s copayment or coinsurance price for the purchase of the
352	577		same prescription drug.
353		-
354	578		D. A health insurer or pharmacy benefits manager (PBM) shall
355	579		not restrict an individual ’s choice of in-network provider for
356	580		prescription drugs.
357		-
358	581		E. An individual’s A patient’s choice of in-network provider
359	582		may include a retail an in-network pharmacy or a, whether that
360	583		pharmacy is in a preferred or nonpreferred network, a retailer
361	584		pharmacy, mail-order pharmacy or any other pharmacy . A health
362	585		insurer or PBM shall not restrict such a patient’s choice of in-
363	586		network pharmacy providers. Such A health insurer or PBM shall not
364	587		require or incentivize using individuals by:
365		-
366	588		1. Using any discounts in cost -sharing or a reduction in copay
367	589		or the number of copays to individuals to receive prescription drugs
368	590		from an individual’s choice of in-network pharmacy from an
369	591		individual’s choice of in-network pharmacy; or
370	592
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371	619		2. Differentiating between in-network pharmacies, wh ether that
372	620		pharmacy is in a preferred or nonpreferred network, a retail
373	621		pharmacy, mail order pharmacy or any other type of pharmacy.
374		-
375	622		The provisions of this subsection shall not apply to any plan
376	623		subject to regulation under Medicare Part D, 42 U.S.C. Sectio n
377	624		1395w-101, et seq.
378		-
379	625		F. A health insurer, pharmacy or PBM shall adhere to all
380	626		Oklahoma laws, statutes and rules when mailing, shipping and/or
381	627		causing to be mailed or shipped prescription drugs into the State of
382	628		Oklahoma this state.
383		-
384	629		SECTION 5. REPEALER Section 7, Chapter 426, O.S.L. 2019
385	630		(36 O.S. Supp. 2020, Section 6964), is hereby repealed.
386		-
387	631		SECTION 6. This act shall become effective November 1, 2021.
388	632
389		-
390		-	ENR. S. B. NO. 821 Page 10
391		-	Passed the Senate the 10th day of March, 2021.
392		-
393		-
394		-
395		-	Presiding Officer of the Senate
396		-
397		-
398		-	Passed the House of Representatives the 20th day of April, 2021.
399		-
400		-
401		-
402		-	Presiding Officer of the House
403		-	of Representatives
404		-
405		-	OFFICE OF THE GOVERNOR
406		-	Received by the Office of the Governor this _______ _____________
407		-	day of ___________________, 20_______, at _______ o'clock _______ M.
408		-	By: _______________________________ __
409		-	Approved by the Governor of the State of Oklahoma this _____ ____
410		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
411		-
412		-	________________________ _________
413		-	Governor of the State of Oklahoma
414		-
415		-
416		-	OFFICE OF THE SECRETARY OF STATE
417		-	Received by the Office of the Secretary of State this _______ ___
418		-	day of __________________, 20 _______, at _______ o'clock _______ M.
419		-	By: _______________________________ __
	633	+	COMMITTEE REPORT BY: COMMITTEE ON PUBLIC HEALTH, dated 04/08/202 1 -
	634	+	DO PASS, As Coauthored.