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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
SENATE BILL 1390 By: McCortney
AS INTRODUCED
An Act relating to pharmacy benefits managers;
amending 36 O.S. 2021, Section s 6960, as amended by
Section 1, Chapter 38, O.S.L. 2022 , 6962, as amended
by Section 1, Chapter 293, O.S.L. 2023 , 6965, as
amended by Section 2, Chapter 293, O.S.L. 2023 ,
Section 3, Chapter 38, O.S.L. 2022, as amended by
Section 3, Chapter 293, O .S.L. 2023, and 6967 (36
O.S. Supp. 2023, Section s 6960, 6962, 6965, and
6966.1), which relate to the Pati ent’s Right to
Pharmacy Choice Act; defining terms; modifying
definitions; prohibiting certain contract terms from
restricting document disclosure to certain entities;
modifying certain compliance provisions ; conforming
language; construing provisions; providing for rule
promulgation; establis hing requirements for
disclosure of protected health information; modifying
certain fine amount; providing for certain fines an d
fees; creating the Attorney General ’s Pharmacy
Benefits Manager Enforcement Revolving Fund;
establishing fund source; stating p urpose;
establishing provisions relating to public disclosure
of certain report and certain information obtained by
the Attorney General; amending 51 O.S. 2021, Section
24A.3, as amended by Section 11, Chapter 271, O.S.L.
2023 (51 O.S. Supp. 2023, Sect ion 24A.3), which
relates to the Oklahoma Open Records Act; modifying
definition; amending 59 O.S. 2021, Sections 356.1 and
358, which relate to pharmacy benefits managers;
providing for rule promulgation; repealing 36 O.S.
2021, Section 6966, which relates to the Patient’s
Right to Pharmacy Choice Commission; updating
statutory reference; updating statutory language;
providing for codification; and providing an
effective date.
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BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 36 O.S. 2021, Section 6960, as
amended by Section 1, Chapter 38, O.S.L. 2022 (36 O.S. Supp. 2023,
Section 6960), is amended to read as follows:
Section 6960. For purposes of the Patient ’s Right to Pharmacy
Choice Act:
1. “Covered entity” means a nonprofit hospital or medical
service organization, insurer, health benefit plan, health
maintenance organization , health program administered by the s tate
in the capacity of provid ing health coverage, or an employer, labor
union, or other entity organized in the state that provides health
coverage to covered individuals who are employed or reside in the
state. This term does not include a health plan that p rovides
coverage only for accidental injury, specified disease, hospital
indemnity, disability income, or other limited benefit health
insurance policies and contracts that do not include prescription
drug coverage;
2. “Health insurer” means any corporation, association, benefit
society, exchange, partnership or individ ual licensed by the
Oklahoma Insurance Code;
2. 3. “Health insurer payor” means a health insurance company,
health maintenance organization , union, hospital and medical
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services organizatio n or any entity providing or admin istering a
self-funded health benefit plan;
3. 4. “Mail-order pharmacy” means a pharmacy licensed by this
state that primarily dispenses and delivers covered drugs via common
carrier;
4. 5. “Pharmacy benefits manag er” or “PBM” means a person,
business, or other entity that performs pharmacy benefits management
and any other person acting for such person under . The term shall
include a person or entity acting on behalf of a PBM in a
contractual or employm ent relationship in the performance of
pharmacy benefits management for a managed -care company, nonprofit
hospital, medical service organization, insurance company, third -
party payor or a health program administered by a department of thi s
state;
6. “Pharmacy benefits management” means a service provided to
covered entities to facilitate the provision s of prescription drug
benefits to covered individuals within the state , including, but not
limited to, negotiating pricing a nd other terms with drug
manufacturers and provide rs. Pharmacy benefits management may
include any or all of the following servi ces:
a. claims processing, retail network management , and
payment of claims to pharmacies for prescription drugs
dispensed to covered individuals ,
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b. clinical formulary developm ent and management
services,
c. rebate contracting and administration,
d. certain patient compliance, therapeutic intervention ,
and generic substitution programs, or
e. disease management programs;
5. 7. “Provider” means a pharmacy, as defined in Section 353.1
of Title 59 of the Oklahoma Statutes or an agent or representative
of a pharmacy;
6. 8. “Retail pharmacy network ” means retail pharmacy p roviders
contracted with a PBM in which the pharmacy primari ly fills and
sells prescriptions via a retail, store front location;
7. 9. “Rural service area” means a five-digit ZIP code in which
the population density is less than one thousa nd (1,000) individuals
per square mile;
8. 10. “Spread pricing” means a prescription drug pricing model
utilized by a pharmacy b enefits manager in which the PBM charges a
health benefit plan a contracted pri ce for prescription drugs that
differs from the amount the PBM directl y or indirectly pays the
pharmacy or pharmacist for pr oviding pharmacy services;
9. 11. “Suburban service area” means a five-digit ZIP code in
which the population density is between one thousand (1,000) and
three thousand (3,000) in dividuals per square mile ; and
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10. 12. “Urban service area” means a five-digit ZIP code in
which the population density is great er than three thousand (3,000)
individuals per square mile.
SECTION 2. AMENDATORY 36 O.S. 2021, Section 6962, as
amended by Section 1, Chapter 293, O.S.L. 2023 (36 O.S. Supp. 2023,
Section 6962), is amended to read as follows:
Section 6962. A. The Attorney General shall review and approve
retail pharmacy network access for all p harmacy benefits managers
(PBMs) to ensure complian ce with Section 6961 of this title.
B. A PBM, or an agent of a PBM, shall not:
1. Cause or knowingly permit the use of advertisement,
promotion, solicitation, representation, propo sal or offer that is
untrue, deceptive or misleading;
2. Charge a pharmacist or phar macy a fee related to the
adjudication of a claim including without limitation a fee for:
a. the submission of a claim,
b. enrollment or participation in a retail pharmacy
network, or
c. the development or management of claims processing
services or claims payment services related to
participation in a retail pharmacy network;
3. Reimburse a pharmacy or pharmacist in the state an amount
less than the amount that the PBM re imburses a pharmacy owned by or
under common ownership with a PBM for providing the s ame covered
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services. The reimbursement amount paid to the pharmacy shall be
equal to the reimbursement amount calculated on a per-unit basis
using the same generic product identifier or generic code number
paid to the PBM-owned or PBM-affiliated pharmacy;
4. Deny a provider the opportunity to participate in any
pharmacy network at preferred participation status if the provider
is willing to accept the terms and condition s that the PBM has
established for other providers as a condition of preferred networ k
participation status;
5. Deny, limit or terminate a provider’s contract based on
employment status of any employee who has an active license to
dispense, despite probation status, wi th the State Board of
Pharmacy;
6. Retroactively deny or re duce reimbursement for a covered
service claim after returning a paid claim response as part of the
adjudication of the claim, unless:
a. the original claim was submitted fraudulentl y, or
b. to correct errors identified in an audit, so long as
the audit was conducted in compliance with Sections
356.2 and 356.3 of Title 59 of the Oklahoma Statutes;
7. Fail to make any payment due to a pharmacy or pharmacist for
covered services properly re ndered in the event a PBM terminates a
provider from a pharmacy benef its manager network;
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8. Conduct or practice spread pricing, as defined in Section 1
of this act Section 6960 of this title , in this state; or
9. Charge a pharmacist or pharmacy a f ee related to
participation in a re tail pharmacy network including but not limited
to the following:
a. an application fee,
b. an enrollment or participation fee,
c. a credentialing or re-credentialing fee,
d. a change of ownership fee, or
e. a fee for the development or management of claims
processing services or claims payment services.
C. The prohibitions under this section shall apply to contracts
between pharmacy benefits managers and providers for participation
in retail pharmacy networks.
1. A PBM contract shall:
a. not restrict, directly or indirectly, any pharmacy
that dispenses a presc ription drug from informing, or
penalize such pharmacy for informing, an individual of
any differential between the individual’s out-of-
pocket cost or coverage with respect to acquisition of
the drug and the amount an individual would pay to
purchase the drug directly, and
b. ensure that any entity that provides pharmacy benefits
management services under a contract with any such
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health plan or health insurance cover age does not,
with respect to such plan or coverage, restrict,
directly or indirectly, a ph armacy that dispenses a
prescription drug from inf orming, or penalize such
pharmacy for informing, a covered individual of any
differential between the individual ’s out-of-pocket
cost under the plan or coverage with respect to
acquisition of the drug and the amount an individual
would pay for acquisition of the drug without using
any health plan or health insurance coverage.
2. A pharmacy benefits manager ’s contract with a provider shall
not prohibit, restrict or limit disclosure of information and
documents to the Attorney General, law enforcement or state and
federal governmental officials investigating or examining a
complaint or conducting a review of a pharmacy benefits manager ’s
compliance with the requirements under the Patient’s Right to
Pharmacy Choice Act, Pharmacy Audit Integrity A ct, and Section 357
et seq. of Title 59 of the Okl ahoma Statutes.
D. A pharmacy benefits manager shall:
1. Establish and maintain an electronic claim inquiry
processing system using the National Council for Prescription Drug
Programs’ current standards to communicate information to pharmacies
submitting claim inquiries;
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2. Fully disclose to insurer s, self-funded employers, unions or
other PBM clients the existence of the re spective aggregate
prescription drug discounts, rebates rece ived from drug
manufacturers and pharmacy audit recoupments;
3. Provide the Attorney General, insurers, self-funded employer
plans and unions unrestricted audit rights of and access to the
respective PBM pharmaceutical manufacturer and provider contracts,
plan utilization data, plan pricing data, pharmacy utilization data
and pharmacy pricing data;
4. Maintain, for no less than three (3) years, documentation of
all network development activities including but not limited to
contract negotiations and any denials to providers to join networks.
This documentation shall be made available to the Attorney General
upon request;
5. Report to the Attorney General, on a quarterly basis for
each health insurer pay or, on the following information:
a. the aggregate amount of rebates received by t he PBM,
b. the aggregate amount of rebates distributed to the
appropriate health in surer payor,
c. the aggregate amount of rebates passed on to the
enrollees of each healt h insurer payor at the point of
sale that reduced the applicable deductible,
copayment, coinsure or other cost sharing amount of
the enrollee,
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d. the individual and agg regate amount paid by t he health
insurer payor to the PBM for pharmacy services
itemized by pharmacy, drug product and service
provided, and
e. the individual and aggreg ate amount a PBM paid a
provider for pharmacy services itemized by pharmacy,
drug product and service provide d.
E. Nothing in the Patient’s Right to Pharmacy Choice Act shall
prohibit an employer from incentivizing their employees to use an
employer-owned pharmacy; provided, the employe e may use another in-
network pharmacy of his or her choice.
F. Nothing in the Patient’s Right to Pharmacy Choice Act shall
prohibit the Attorney General from requesting and obtaining detailed
data, including raw data, in response to the information provided by
a PBM in the quarterly reports required by this section.
G. The Attorney General may promulgate rules to imple ment the
provisions of the Patient’s Right to Pharmacy Choice A ct.
SECTION 3. AMENDATORY 36 O.S. 2021, Section 6965, as
amended by Section 2, Chapter 2 93, O.S.L. 2023 (36 O.S. Supp. 2023,
Section 6965), is amended to read as follo ws:
Section 6965. A. The Attorney General shall have power and
authority to examine and investigat e the affairs of every pharmacy
benefits manager (PBM) engaged in pharmacy benefits manag ement in
this state in order to determine whet her such entity is in
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compliance with the Patient ’s Right to Pharmacy Choic e Act, Pharmacy
Audit Integrity Act, and Section 357 et seq. of Title 59 of the
Oklahoma Statutes.
B. All PBM files and records shall be subject to examination by
the Attorney General or by duly appointed designees. The Attorney
General, authorized employees and examiners shall have access to any
of a PBM’s files and records that may relate to a particular
complaint under investiga tion or to an inquiry or examin ation by the
Attorney General.
C. Every officer, director, employee or agent of the PB M, upon
receipt of any inquiry fr om the Attorney General shall, within
twenty (20) days from the date the inquiry is sent, furnish the
Attorney General with an adequate response to the i nquiry.
D. When making an examination under this sectio n, the Attorney
General may retain subject matter experts, attorneys, appra isers,
independent actuaries, independent certified public accountants or
an accounting firm or individual holding a permit to practice public
accounting, certified financial examiners o r other professionals and
specialists as examiners, the cost of w hich shall be borne by the
PBM that is the subject of the examination.
E. 1. Protected health information, or “PHI”, held by a PBM
shall be provided at the request of the Attor ney General for the
purpose of conducting investigations into potential violations of
state laws and regulations related to the PBM. Disclosure of
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protected health information shall be l imited to the extent
necessary for the investigation and enforcement of state law.
2. All disclosures of protected health information shal l be
made in compliance with al l applicable federal and sta te privacy
laws, including the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), and other relevant laws protecting the privacy
and confidentiality of health information.
3. Any protected health information obtained for an
investigation shall be handled and maintained per applicable federal
and state privacy laws and regulations, including HIP AA.
4. Unauthorized disclosure of protected health information
obtained during an investigation is strictly prohibited and subject
to legal penalties.
SECTION 4. AMENDATORY Section 3, Chapter 38, O.S .L.
2022, as amended by Section 3, Chapter 293, O.S.L. 2023 (36 O.S.
Supp. 2023, Section 6966.1), is amended t o read as follows:
Section 6966.1. A. 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 the Patient’s Right to Pharmacy
Choice Act, Section 6958 et seq. o f this title.
B. 1. If the Attorney General finds, after notice and
opportunity for hearing, that a pharmacy benefits manager (PBM)
violated one or more provisions of the Patient’s Right to Pharmacy
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Choice Act, the Pharmacy Audit Integrity Act or the provisions of
Sections 357 through 360 of Title 59 of the Oklahoma Statues, the
Attorney General may recommend instruct the Insurance Commissioner
that the PBM be censured, or his or her license may be suspended or
revoked and a penalty or remedy authorized by this act may be
imposed. If the Attorney General makes such recommendation
instruction, the Commissioner shall take the recommended action
enforce such action within thirty (30) days.
2. In addition to or in lieu of any censure, suspension or
revocation of a license by the Commissioner, a PBM the Attorney
General may be subject to levy a civil or administrative fine of not
less than One Hundred Dollars ($100.00) One Thousand Dollars
($1,000.00) and not greater than Ten Thousand Dollars ($10,000.00)
for each violation of the provisions of the Patient’s Right to
Pharmacy Choice Act, the Pharmacy Audit Integri ty Act or the
provisions of Sections 357 through 360 of Title 59 of the Oklahoma
Statues, Statutes. following notice and an opportunity for a hearing
For purposes of this subsection, each day that a PBM fails to comply
with an investigation or inquiry may be considered a separate
violation.
3. The Attorney General may order restitution for economic loss
suffered by pharmacies or patients for violatio ns of this
subsection.
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C. Notwithstanding whether the license of a PBM has been
issued, suspended, revoked, surrendered or lapsed by operation of
law, the Attorney General is hereby authorized to enforce the
provisions of the Patient ’s Right to Pharmacy Cho ice Act and impose
any penalty or remedy authorized under the act against a PBM under
investigation for or charg ed with a violation of the P atient’s Right
to Pharmacy Choice Act, the Pharmacy Audit Integrity Act, the
provisions of Sections 357 through 360 of Title 59 of the Oklahoma
Statues or any provisi on of the insurance laws of this state.
D. Each day that a PBM conducts business in this sta te without
a license from the Insurance Department shall be deemed a violation
of the Patient’s Right to Pharmacy Choice Act.
E. 1. All hearings conducted by the Office of the Attorney
General pursuant to this section shall be public and held in
accordance with the Administrative Procedures Act.
2. Hearings shall be held at the office of the Attorney General
or any other place the Attorney General may deem convenient.
3. The Attorney General, upon written request from a PBM
affected by the hearing, shall cause a f ull stenographic record of
the proceedings to be made by a competent court reporter . This
record shall be at the expense of the PBM.
4. The ordinary fees and costs of the hearing examiner
appointed pursuant to Section 319 of this title may be assessed by
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the hearing examiner against the respondent unless the respon dent is
the prevailing party.
F. Any PBM whose license has been censured, suspended, revoked
or denied renewal or who has had a fine levied against him or her
shall have the right of appeal from the final order of the Attorney
General, pursuant to Section 318 et seq. of Title 75 of the Oklahoma
Statutes.
G. If the Attorney General determines, based upon an
investigation of complaints, that a PBM has engaged in violations of
the provisions of the Patient’s Right to Pharmacy Choice Act,
Pharmacy Audit Integrity Act, and Sectio n 357 et seq. of Title 59 of
the Oklahoma Statutes with such frequency as to indicate a general
business practice, and that the PBM should be subjected to closer
supervision with respect to thos e practices, the Attorney General
may require the PBM to file a report a t any periodic interval the
Attorney General deems necessary.
H. 1. The Attorney General shall have the authority to c ollect
all fines, penalties, restitution, and interest thereon pursuant to
the provisions of the Patient’s Right to Pharmacy Choice Act,
Pharmacy Audit Integrity Act, and the provisions of Section 357 et
seq. of Title 59 of the Oklahoma Statutes, or any other charge,
cause of action, prelitigation settlement , or other settlement that
requires the recovery of money as a result of violations of the
Patient’s Right to Pharmacy Choice Act. Funds collected b y the
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Attorney General pursuant to the Patient’s Right to Pharmacy Choice
Act shall be deposited into the Attorney General’s Pharmacy Benefits
Manager Enforcement Revolving Fund .
2. Costs of investigation, litigation, attorney f ees, and other
expenses incurred shall be re tained by the Office of the Attorney
General. Remaining funds shall be distributed to phar macists,
patients, or other injured parties as determined by the Attorney
General.
3. The Attorney General shall promulgate rules for the
distribution of fund s pursuant to this subsection.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6966.2 of Title 36, unless there
is created a duplication in numbering, reads as follows:
There is hereby created in the State Tr easury a revolving fund
for the Office of the Attorney General, to be designat ed the
“Attorney General’s Pharmacy Benefits Manager Enforcement Revolving
Fund”. The fund shall be a continuing fund, not subject to fiscal
year limitations, and shall consist of any monies designated to the
fund by law, including those levied for activities related to
enforcement of the Patient ’s Right to Pharmacy Ch oice Act, the
Pharmacy Audit Integ rity Act, and the provisions of Sections 3 57
through 360 of Title 59 of the Okl ahoma Statutes. All monies
accruing to the credit of the fund are hereby appropriated and may
be budgeted and expended by the Attorney General for the purposes
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provided in this section. Expenditures from the fund shall be made
upon warrants issued by the State Treasurer against claims filed as
prescribed by law with the Director of the Office of Management and
Enterprise Services for approval and payment.
SECTION 6. AMENDATORY 36 O.S. 2021, Section 6967, is
amended to read as fol lows:
Section 6967. A. Documents, evidence, materials, records,
reports, complaints or other information in the possession or
control of the Attorney General or Insurance Department or the Right
to Pharmacy Choice Commission that are obtained by, created by or
disclosed to the Attorney General or Insurance Commissioner,
Pharmacy Choice Commission or any other person in the course of an
evaluation, examinat ion, investigation or review made pursuant to
the provisions of the Pat ient’s Right to Pharmacy Choic e Act, the
Pharmacy Integrity Audit Integrity Act or Sections 357 through 360
of Title 59 of the Oklahoma Statutes , except as provided in
subsection C of this section , shall be confidential by law and
privileged, shall not be subject to open records request, shall not
be subject to subpoe na and shall not be s ubject to discovery or
admissible in evidence in any private civil action if obtained from
the Attorney General, Insurance Commissioner, the Pharmacy Choice
Commission or any employees or representatives of the Attorney
General or Insurance Commissioner.
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B. Nothing in this section shall prevent the discl osure of a
final order issued against a pharmacy benefits manager by the
Insurance Commissioner or Pharmacy Choice Commission. Such orders
shall be open records.
C. Nothing in this section shall prevent t he Attorney General
from making public, in the form of an examination report, any
findings from an examination pursuant to Section 6965 of this title.
It shall be the Attorney General ’s sole discretion to determine
whether it is in the public’s interest to publish these findings.
Only the final examination report shall be made public. Any
documents, evidence, materials, rec ords, reports, complaints, or
other information in possession or control of the Attorney General
obtained through the examination shall be confidential by law and
privileged, shall not be subject to the Oklahoma Open Records Act,
shall not be subject to subpoena, and shall not be subject to
discovery or admissible evidence in any pri vate civil action if
obtained from the Attorney Gene ral.
D. In the course of any hearing made pursuant to the prov isions
of the Patient’s Right to Pharmacy Choice Act, the Phar macy
Integrity Audit Act or Sections 357 through 360 of Title 59 of the
Oklahoma Statutes, nothing in this section shall be construed to
prevent the Insurance Commissioner or any employees or
representatives of the Insurance Comm issioner from presenting
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admissible documents, evidence, ma terials, records, reports or
complaints to the adjudicating authority.
SECTION 7. AMENDATORY 51 O.S. 2021, Section 24A.3, as
amended by Section 11, Chapter 271, O.S.L. 2023 (51 O.S. Supp. 2023,
Section 24A.3), is amended to read as follows:
Section 24A.3. As used in the Oklahoma Open Records A ct:
1. “Record” means all documents including, but not limited to,
any book, paper, photograph, microfilm, data files created by or
used with computer software, computer tape, disk, record, sound
recording, film recording, video record o r other material regardless
of physical form or characteristic, created by, received by, under
the authority of, or coming into the custody, control o r possession
of public officials, public bodies or their rep resentatives in
connection with the transaction of public busin ess, the expenditure
of public funds or the administering of public property . Record
does not mean:
a. computer software,
b. nongovernment personal effe cts,
c. unless public disclosure is req uired by other laws or
regulations, vehicle mov ement records of the Oklahoma
Transportation Authority obtained in connection with
the Authority’s electronic toll collection system,
d. personal financial information, credit r eports or
other financial data ob tained by or submitted to a
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public body for the pu rpose of evaluating credit
worthiness, obtaining a license, permit or for the
purpose of becoming qualified to contract with a
public body,
e. any digital audio/video recordings of the toll
collection and safeguarding activities of the Oklahoma
Transportation Authority,
f. any personal information provided by a guest at any
facility owned or opera ted by the Oklahoma Tourism and
Recreation Department to obtain any service at t he
facility or by a purchaser of a product sold by or
through the Oklahoma Touris m and Recreation
Department,
g. a Department of Defense Form 214 (DD Form 214) filed
with a county clerk including any DD Form 214 filed
before July 1, 2002,
h. except as provided for in Section 2 -110 of Title 47 of
the Oklahoma Statutes :
(1) any record in connection with a Motor Ve hicle
Report issued by the Department of Public Safety,
as prescribed in Section 6-117 of Title 47 of the
Oklahoma Statutes, or
(2) personal information within driver records, as
defined by the Driver’s Privacy Protection Ac t,
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18 United States Code, Sections 2721 through
2725, which are stored and maintained by the
Department of Public Safety,
i. any portion of any document or information prov ided to
an agency or entity of the state or a political
subdivision to obtain li censure under the laws of this
state or a political subdivision that contains an
applicant’s personal address, personal phone number,
personal electronic mail address or other contact
information. Provided, however, lists of persons
licensed, the existenc e of a license of a person, or a
business or commercial address, or other business or
commercial information disclosable under state law
submitted with an application for licen sure shall be
public record, or
j. an investigative file obtained during an inv estigation
conducted by the State Department of Health under this
act the Oklahoma Open Records Act , or
k. information deemed confidential pursuant to the
provisions of the Patient’s Right to Pharmacy Choice
Act;
2. “Public body” shall include, but not be lim ited to, any
office, department, board, bureau, commission , agency, trusteeship,
authority, council, committee, trust or any entity creat ed by a
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trust, county, city, village, town, township, district, s chool
district, fair board, cour t, executive office, advis ory group, task
force, study group or any subdivision thereof, supported in whole or
in part by public funds or entrusted with the ex penditure of public
funds or administering or operating public property , and all
committees, or subcommittees thereof . Except for the records
required by Section 24A.4 of this title, public body does not mean
judges, justices, the Council on Judicial Complaints, the
Legislature or legislators. Public body shall not include an
organization that is exempt from federal inc ome tax under Section
501(c)(3) of the Internal Revenue Code of 1986, as amended, and
whose sole beneficiary is a college or university, or an affiliated
entity of the college or uni versity, that is a member of The
Oklahoma State System of Higher Education . Such organization shall
not receive direct appropriation s from the Oklahoma Legislature.
The following persons shall not be eligible to serve as a voting
member of the governing board of the organization:
a. a member, officer, or employee of the Oklaho ma State
Regents for Higher Education,
b. a member of the board of regents or other governing
board of the college or university that is the sole
beneficiary of the organization, or
c. an officer or employee of the college or university
that is the sole beneficiary of the organization;
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3. “Public office” means the physical location where public
bodies conduct business or keep reco rds;
4. “Public official” means any official or emplo yee of any
public body as defined herein; and
5. “Law enforcement agency ” means any public body charged with
enforcing state or local criminal laws and initiating crimi nal
prosecutions including, but n ot limited to, police departments,
county sheriffs, the Department of Public Sa fety, the Oklahoma State
Bureau of Narcotics and Dangerous Drugs Control, the Alcoholic
Beverage Laws Enforc ement Commission, and the Oklahoma State Bureau
of Investigation.
SECTION 8. AMENDATORY 59 O.S. 2 021, Section 356.1, i s
amended to read as follows:
Section 356.1. A. For purposes of the Pharmacy Audit Integrity
Act, “pharmacy benefits manager ” or “PBM” means a person, business,
or other entity that performs pharmacy benefits management. The
term includes a person or entity acting for a PBM in a contractual
or employment relationship in the performance of pharmacy benefits
management for a managed care company, nonprofit hospital, medical
service organization, insurance company, third -party payor, or a
health program administered by a department of this state.
B. The purpose of the Pharmacy Audit Integrity Act is to
establish minimum and uniform standar ds and criteria for the audit
of pharmacy records by or on behalf of certain entities.
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C. The Pharmacy Audit Integrity Act shall apply to any audit of
the records of a pharm acy conducted by a managed care company,
nonprofit hospital, medical service organization, insurance company,
third-party payor, pharmacy benefits manager, a health program
administered by a department of this state, or any entity that
represents these companies, groups, or departments.
D. The Attorney General may promulgate rules to i mplement the
provisions of the Pharmacy Audit Integrity Act.
SECTION 9. AMENDATORY 59 O.S. 2021, Section 358, is
amended to read as follows:
Section 358. A. In order to provide pharmacy benefits
management or any of the services included under the definit ion of
pharmacy benefits management in this state, a pharmac y benefits
manager or any entity acting as one in a contractual or employment
relationship for a covered entity shall first obtain a license from
the Oklahoma Insurance Department, and the Departm ent may charge a
fee for such licensure.
B. The Department shall establish, by regulation, licensure
procedures, required disclosures for p harmacy benefits managers
(PBMs) and other rules as may be necess ary for carrying out and
enforcing the provisions of this act the Oklahoma Pharmacy Act . The
licensure procedures shall, a t a minimum, include the completion of
an application form that shall include t he name and address of an
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agent for service of process, the payment of a requisite fee, and
evidence of the procurement of a suret y bond.
C. The Department may subpoena wi tnesses and information. Its
compliance officers may take and copy records for investigative use
and prosecutions. Nothing in this subse ction shall limit the Office
of the Attorney General from using its investi gative demand
authority to investigate and prose cute violations of the law.
D. The Department may suspend, revoke or refuse to issue or
renew a license for noncompliance with any of the provisions hereby
established or with the rules promulgated by the D epartment; for
conduct likely to mislead, de ceive or defraud the public or the
Department; for unfair or deceptive business practices or for
nonpayment of a renewal fee or fine . The Department may also levy
administrative fines for each count of which a PBM has been
convicted in a Department hearing.
E. The Attorney General may promulgate rules to implement the
provisions of Sections 357 et seq. of this title.
SECTION 10. REPEALER 36 O.S. 2021, Section 6966, is
hereby repealed.
SECTION 11. This act shall become eff ective November 1, 2024.
59-2-2558 RD 12/15/2023 1:57:11 PM