Oklahoma 2024 2024 Regular Session

Oklahoma House Bill HB1713 Comm Sub / Bill

Filed 03/01/2023

                     
 
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STATE OF OKLAHOMA 
 
1st Session of the 59th Legislature (2023) 
 
COMMITTEE SUBSTITUTE 
FOR 
HOUSE BILL NO. 1713 	By: Marti 
 
 
 
 
 
COMMITTEE SUBSTITUTE 
 
An Act relating to pharmacies; defining terms; 
creating certain requir ements; creating a penalty; 
providing for codification; and declaring an 
emergency. 
 
 
 
 
BE IT ENACTED BY THE PEOPLE OF THE STATE O F OKLAHOMA: 
SECTION 1.     NEW LAW     A new section of law to be codified 
in the Oklahoma Statutes as Section 6969 of Title 36, unless there 
is created a duplication in numbering, reads as follows: 
A. As used in this section: 
1. "Health benefit plan" means a health benefit plan as defined 
pursuant to Section 6060.4 in Title 36 of the Oklahoma Statutes; 
2. "Pharmacy benefits manager" means a person that performs 
pharmacy benefits management and any other person acting for such 
person under a contractual or employment relation ship in the 
performance of pharmacy bene fits management for a managed -care 
company, not-for-profit hospital, medical services organization,   
 
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insurance company, third -party payor, or a health program 
administered by a state agency; and 
3. "White bagged drugs" means the distribution of physician 
administered medication from a pharmacy, typically a specialty 
pharmacy, to the physician's office, hospital, or clinic for 
administration. 
B. All health benefit plans and pharmacy benefits managers in 
this state shall not refuse to authorize, approve, or pay a 
participating provider for providing covered physician-administered 
drugs to covered persons. 
C. All white bagged drugs distributed in this state shall meet 
supply chain security controls set forth by the fede ral Drug Supply 
Chain Security Act as am ended. 
D. A health benefit plan or a pharmacy ben efits manager of a 
plan shall not require a covered patient to self -administer an 
injectable drug against a health care provider 's recommendation in 
accordance with the manufacturer's approved guidelines. 
E. Health benefit plans shall not require a covere d patient to 
pay additional fees for white bagged drugs beyond cost -sharing 
obligations as outlined in the individual 's plan. 
F. Providers and health care facilities shall be permitted to 
dispense and administer a covered physician -administered drug based 
on a patient's best interest, provided that the health care facility 
or provider that administers the drug shall agree to the terms and   
 
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conditions of network partici pation and accept, as payment in full, 
reimbursement for the drug at the health insurer 's negotiated 
contracted rate. The health care facility or provider is prohibited 
from billing or collecting from the patient any amount in excess of 
or in addition to the patient 's cost sharing obligations as outlined 
in the individual's plan. 
G. Any payor in violation of this act shall be fined a minimum 
of Five Thousand Dollars ($5,000.00) per violation, but not more 
than Ten Thousand Dollars ($10,000.00) per violation. Fines related 
to this section shall n ot be used when calculating payors, plans, or 
members loss ratios and losses incurred pursuant to this subsection 
shall not be passed on to the consumer in future rate increas es. 
SECTION 2.  It being immediately necessary for the preservati on 
of the public peace, health or safety, an emergency is hereby 
declared to exist, by reason whereof this act shall take effect and 
be in full force from and after its passa ge and approval. 
 
59-1-7839 MJ 02/28/23