Req. No. 7839 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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, Req. No. 7839 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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 Req. No. 7839 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 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