Oklahoma 2023 Regular Session

Oklahoma House Bill HB1598 Compare Versions

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

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28	28	STATE OF OKLAHOMA
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30	30	1st Session of the 59th Leg islature (2023)
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32	32	HOUSE BILL 1598 By: Martinez
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38	38	AS INTRODUCED
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40	40	An Act relating to insurance; amending 36 O.S. 2021,
41	41	Section 6961, which relates to retail pharmacy
42	42	network access standards; remov ing the State
43	43	standards for network access; adding the Federal
44	44	standards for network access; and providing an
45	45	effective date.
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52	52	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
53	53	SECTION 1. AMENDATORY 36 O.S. 2021, Section 6961, is
54	54	amended to read as follows :
55	55	Section 6961. A. Pharmacy benefits managers (PBMs) shall
56	56	comply with the following retail pharmacy network access standards:
57	57	1. At least ninety percent (90%) of covered individuals
58	58	residing in an urban service a rea live within two (2) miles of a
59	59	retail pharmacy participating in the PBM 's retail pharmacy network;
60	60	2. At least ninety percent (90%) of covered individuals
61	61	residing in an urban service area live wit hin five (5) miles of a
62	62	retail pharmacy designated as a preferred participating pharmacy in
63	63	the PBM's retail pharmacy network;
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65	65	Req. No. 5138 Page 2 1
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90	90	3. At least ninety percent (90%) of covered individuals
91	91	residing in a suburban service area live within five (5) miles of a
92	92	retail pharmacy participating in the PBM 's retail pharmacy network;
93	93	4. At least ninety percent (90%) of covered individuals
94	94	residing in a suburban service area live within seven (7) miles of a
95	95	retail pharmacy designated as a preferred participating pharmacy i n
96	96	the PBM's retail pharmacy network;
97	97	5. At least seventy percent (70%) of covered individuals
98	98	residing in a rural service area live within fifteen (15) miles of a
99	99	retail pharmacy participating in the PBM 's retail pharmacy network;
100	100	and
101	101	6. At least seventy percent (70%) of covered individuals
102	102	residing in a rural service area live within eighteen (18) miles of
103	103	a retail pharmacy designated as a preferred participating pharmacy
104	104	in the PBM's retail pharmacy network. For all retail pharmacy
105	105	networks managed by p harmacy benefits managers (PBMs) in the State
106	106	of Oklahoma, each PBM shall comply with the pharmacy network access
107	107	standards set forth under Federal law at 42 CFR 423.120(a)(1)
108	108	(Standards for convenient access to network pharmacies) as the same
109	109	may be amended from time to time.
110	110	B. Mail-order pharmacies shall not be used to meet access
111	111	standards for retail pharmacy networks.
112	112	C. Pharmacy benefits managers shall not require patients to use
113	113	pharmacies that are directly or indirectly owned by the pharmacy
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140	140	benefits manager, including all regular prescriptions, refi lls or
141	141	specialty drugs regardless of day supply.
142	142	D. Pharmacy benefits managers shall not in any manner on any
143	143	material, including but not limited to mail and ID cards, include
144	144	the name of any pharmacy , hospital or other providers unless it
145	145	specifically lists all pharmacies, hospitals and providers
146	146	participating in the prefe rred and nonpreferred pharmacy and health
147	147	networks.
148	148	SECTION 2. This act shall become effective November 1, 2023.
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150	150	59-1-5138 TJ 12/19/22