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HOUSE OF REPRESENTATIVES - FLOOR VERSION
STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
HOUSE BILL 3379 By: McEntire, Deck, and West
(Tammy) of the House
and
Howard of the Senate
AS INTRODUCED
An Act relating to prescriptions; creating the
Oklahoma Health Care Safety Net and Affordable
Prescriptions Accessibility Act ; defining terms;
prohibiting certain discriminatory actions related to
reimbursement of certain entities; prohibiting
certain discriminatory actions by a manufacturer or
distributor related to certain entities ; providing
for enforcement by the Attorney General and Insurance
Commissioner; providing for violations; providing for
federal preemption; providing for codification; and
providing an effective date .
BE IT ENACTED BY THE PEOPLE OF T HE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Se ction 5400 of Title 36, unless there
is created a duplication in numbering, r eads as follows:
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This act shall be known and may be cited as the "Oklahoma Health
Care Safety Net and Affordable Prescriptions Accessibility Act ".
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Se ction 5401 of Title 36, unless there
is created a duplication in numbering, reads as follows:
As used in this act:
1. "340B drug" means a drug that has been subject to any offer
for reduced prices by a manufacturer purs uant to Section 256b of
Title 42 of the United States Code and is purchased by a covered
entity as defined in Section 256b(a)(4) of Title 42 of the United
States Code;
2. "340B entity" means an entity participating or authorized to
participate in the federal 340B drug discount program, as described
in Section 256b of Title 42 of the United States Code, including its
pharmacy, or any pharmacy contracted with the participating entity
to dispense drugs purchased through the 340B drug discount program;
3. "Pharmacy" means a pharmacy licensed by the Oklahoma State
Board of Pharmacy, except that patients who are provided pharmacy
care shall be physically located in the state; and
4. "Pharmacy benefit manager " means a person that performs
pharmacy benefits management and any other person acting fo r such
person under a contractual or employment relationship in the
performance of pharmacy benefits m anagement for a managed care
company, nonprofit hospital, medical service orga nization, insurance
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company, third-party payor or a health program administe red by a
department of this state .
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 5402 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. 1. With respect to reimbursement to a 340B entity for 340B
drugs, a health insurance issuer, pharmacy benefit manager, other
third-party payor, or its agent shall not:
a. reimburse a 340B entity for 340B drugs at a rate lower
than that paid for the same drug to entitie s that are
not 340B entities or lower reimbursement for a claim
on the basis that the claim is for a 340B drug,
b. impose any terms or conditions on any 340B entity with
respect to any of the following that differ from such
terms or conditions applied to n on-340B entities on
the basis that the entity participates in the federal
340B drug discount program set fo rth in Section 256b
of Title 42 of the United St ates Code or that a drug
is a 340B drug including, without limitation, any of
the following:
(1) fees, charges, clawbacks, or other adjustments or
assessments. For purposes of this subsection,
the term "other adjustments" includes placing any
additional requirements, restrictions, or
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unnecessary burdens upon the 340B entity that
result in administrative costs or fees to the
340B entity that are not placed upon other
entities that do not participate in the 340B dru g
discount program, including affiliate pharmacies
of the health insurance issuer, pharmacy benefit
manager, or other third-party payor,
(2) dispensing fees that are less than the dispensing
fees for non-340B entities,
(3) restrictions or requirements r egarding
participation in standard or pref erred pharmacy
networks,
(4) requirements relating to the frequency or scope
of audits of inventory manag ement systems,
(5) requirements that a claim for a drug include any
identification, billing modifier, attestation, or
other indication that a drug is a 340B drug in
order to be processed or resubmitted unless it is
required by the Centers for Medicare and Medicaid
Services or the Oklahoma Health Care Authority
for the administration of the Oklahoma Medicaid
program, or
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(6) any other restrictions, conditions, practices, or
policies that are not imposed on non-340B
entities.
c. require a 340B entity to revers e, resubmit, or clarify
a claim after the initial adjudication unless these
actions are in the normal course of pharmacy business
and not related to 340B drug pricing,
d. discriminate against a 340B entity in a manner that
prevents or interferes with any p atient's choice to
receive such drugs from the 340B entity, including the
administration of such drugs. For purposes of this
subsection, it is considered a discriminatory prac tice
that prevents or interferes with a patient 's choice to
receive drugs at a 3 40B entity if a health insurance
issuer, pharmacy benefit manager, or other third -party
payor places any additional requirements,
restrictions, or unnecessary burdens upon the 340B
entity that results in administrative costs or fees to
the 340B entity, inc luding but not limited to ,
requiring a claim for a drug to include any
identification, billing modifier, attestation , or
other indication that a drug is a 340B drug in order
to be processed or resubmitted unless it is required
by the Centers for Medicare a nd Medicaid Services or
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the Oklahoma Health Care Authority in administration
of the Oklahoma Medicaid program,
e. include any other provision in a contract between a
health insurance issuer, pharmacy benefit manager, or
other third-party payor and a 340B e ntity that
discriminates against the 340B entity or prevents or
interferes with an individual 's choice to receive a
prescription drug from a 340B entity, including the
administration of the drug, in person or via direct
delivery, mail, or other form of shi pment, or creation
of a restriction or additional charge on a patient who
chooses to receive drugs from a 340B entity ,
f. require or compel the submission of ingredient costs
or pricing data pertaining to 340B drugs to any health
insurance issuer, pharmacy benefit manager, or other
third-party payor,
g. exclude any 340B entity from the health insurance
issuer, pharmacy benefit manager, or other third -party
payor network on the basis that the 340B entity
dispenses drugs subject to an agreement under Section
256b of Title 42 of the United State Code , or refusing
to contract with a 340B entity for reasons other than
those that apply equally to non -340B entities.
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B. Nothing in this section applies to the Oklahoma Medicaid
program as payor when Medicaid provides reimbursement for covered
outpatient drugs as defined in section 1396r -8(k) of Title 42 of the
United States Code.
SECTION 4. NEW LAW A new section o f law to be codified
in the Oklahoma Statutes as Section 5403 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. A manufacturer or distributor shall not deny, restrict,
prohibit, or otherwise interfere with, either direc tly or
indirectly, the acquisition of a 340B drug by, or delivery of a 340B
drug to, a pharmacy that is under contract with a 340B entity and is
authorized under such contract to receive and dispense 340B drugs on
behalf of the covered entity unless such r eceipt is prohibited by
the United States Department of Health and Human Services.
B. A manufacturer or distributor shall not interfere with a
pharmacy contracted with a 340B entity.
SECTION 5. NEW LAW A new section of law to be co dified
in the Oklahoma Statutes as Section 5404 of Title 36, unless there
is created a duplication in numbering, reads as follows:
The Attorney General may make rules and regulations interpreting
the provisions of this act, and shall make recommendations t o the
Oklahoma Insurance Commissioner for enforcement with the
jurisdiction of the Insurance Commissioner.
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The Insurance Commissioner may censure, suspend, revoke , or
refuse to issue or renew a license of or levy a civil penalty
against any person licensed under the insurance laws of this state
for any violation of this act.
In addition to or in lieu of any applicable censure, suspension
or revocation of a license, a manufacturer, distributor, health
insurance issuer, pharmacy benefit manager, other third -party payor,
or its agent may be subject to a civil fine of not less than One
Hundred Dollars ($100.00) and not greater than Ten Thousand Dollars
($10,000.00) for each violation of the provisions of this act.
A violation occurs each time a prohibited act is committed.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 5405 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. Nothing in this section is to be construed or applied to be
less restrictive than federal law for a person or entity regulated
by this act.
B. Nothing in this act is to be construed or applied to be in
conflict with any of the following:
1. Applicable federal law and related regulations ; or
2. Other laws of this state if the state law is compatible with
applicable federal law.
C. Limited distribution of a drug required under section 355-1
of Title 21 of the Unite d States Code is not to be construed as a
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violation of this section.
SECTION 7. This act shall become effective November 1, 2024.
COMMITTEE REPORT BY: COMMITTEE ON APPR OPRIATIONS AND BUDGET, dated
02/29/2024 - DO PASS, As Coauthored.