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53	53	STATE OF OKLAHOMA
54	54
55	55	1st Session of the 59th Legislature (2023)
56	56
57	57	SENATE BILL 145 By: Hicks
58	58
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63	63	AS INTRODUCED
64	64
65	65	An Act relating to prescription drugs; definin g
66	66	terms; prohibiting an insurer from modifying coverage
67	67	under certain conditions with certain exceptions;
68	68	providing for certain civil penalty; requiring
69	69	promulgation of rules; providing for codification;
70	70	and providing an 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 codified
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. As used in this section:
80	80	1. “Insurer” means an insurer as defined pursuant to Section
81	81	6054 of Title 36 of the Oklahoma Statutes;
82	82	2. “Practitioner” means a practitioner as defined pursuant to
83	83	Section 6054 of Title 36 of the Oklahoma Statutes; and
84	84	3. “Prescription drug” or “drug” means a prescription drug as
85	85	defined pursuant to Section 367.2 of Title 59 of the Oklahoma
86	86	Statutes.
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138	138	B. An insurer shall not modify an insured’s coverage of a
139	139	prescription drug if the following conditions are met:
140	140	1. The drug had been previously preauthorized for coverage by
141	141	the insurer or was listed on the formulary o f the insurer at the
142	142	time the insured was prescribed the drug by his or her practitioner;
143	143	2. The insured has already received the drug; and
144	144	3. A practitioner continue s to prescribe the drug to the
145	145	insured.
146	146	C. Modification prohibited under this section shall include,
147	147	but not be limited to :
148	148	1. Increasing the premium, copayment, coinsurance, or
149	149	deductible;
150	150	2. Denying or otherwise failing to provide continued coverage
151	151	of the prescription drug ;
152	152	3. Moving the drug to a more restrictive coverage categ ory or
153	153	tier; or
154	154	4. Replacing the brand-name drug for a generic drug after the
155	155	insured has qualified for the brand-name drug pursuant to this
156	156	section.
157	157	D. Nothing in this secti on shall be construed to prohibit an
158	158	insurer from modifying coverage of a prescription drug if:
159	159	1. The federal Food and Drug Administration has issued a
160	160	statement calling into question the clinical safety of the drug; or
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212	212	2. The manufacturer of the drug has notif ied the federal Food
213	213	and Drug Administration of a manufacturing discontinu ance or
214	214	potential discontinuance of the drug, as required by 21 U.S. C. 356c.
215	215	E. Any insurer that violates the provisions of this sect ion
216	216	shall be subject to a civil penalty in an amount to be determined by
217	217	the Insurance Commissioner . The Insurance Commissioner shall
218	218	promulgate rules to effectuate the provisions of this section.
219	219	SECTION 2. This act shall become effective November 1, 2023.
220	220
221	221	59-1-1218 RD 1/4/2023 3:37:21 PM

Oklahoma 2023 Regular Session

Oklahoma Senate Bill SB145 Compare Versions