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HOUSE OF REPRESENTATIVES - FLOOR VERSION
STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
COMMITTEE SUBSTITUTE
FOR
HOUSE BILL NO. 1713 By: Marti of the House
and
Garvin of the Senate
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 sect ion 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 benefits management for a managed -care
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company, not-for-profit hospital, medical services organization,
insurance company, third -party payor, or a health program
administered by a state agency; and
3. "White bagged drugs" means the distribution o f 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 amended.
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
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or provider that administers the drug shall agree to the terms and
conditions of network partici pation and accept, as payme nt 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 not 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 t he preservation
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.
COMMITTEE REPORT BY: COMMITTEE ON INSURANCE, dated 03/01/2023 - DO
PASS, As Amended and Coauthored.