Oklahoma House Bill HB1598

Oklahoma 2024 Regular Session

• Introduced: 2/6/23
• Refer: 2/7/23

Caption

Insurance; retail pharmacy network access standards; State standards for network access; Federal standards for network access; effective date.

Impact

The legislation would require that at least 90% of individuals living in urban areas reside within two miles of a participating pharmacy, while 70% of individuals in rural areas must be within fifteen miles of a pharmacy in the network. This federal standard is aimed at improving access to pharmacy services across various geographic locations, which could have significant implications for healthcare delivery and accessibility in Oklahoma, particularly in underserved rural communities.

Summary

House Bill 1598, introduced by Representative Martinez, aims to amend the pharmacy network access standards currently in place for Pharmacy Benefits Managers (PBMs) in Oklahoma. The bill proposes to remove existing state standards and replace them with federal standards outlined in 42 CFR 423.120(a)(1). This change is intended to ensure that consumers in urban and suburban areas have adequate access to retail pharmacies within specified distances, while also setting similar standards for rural areas to ensure access to medications.

Contention

While the bill seems to aim for better access to pharmacy services, there are concerns about the implications of shifting from state to federal standards. Critics may argue that the federal standards might not adequately address the unique healthcare needs of Oklahoma residents, especially in rural areas where access is already a challenge. Furthermore, the legislation disallows mail-order pharmacies from being counted towards meeting access standards, which could limit options for some patients accustomed to receiving their medications through mail services. Overall, the shift towards federal standards raises questions about the adequacy and responsiveness of pharmacy access in different service areas.