Oklahoma 2024 Regular Session

Oklahoma Senate Bill SB1390 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
	3	+	SB1390 HFLR Page 1
	4	+	BOLD FACE denotes Committee Amendments. 1
	5	+	2
	6	+	3
	7	+	4
	8	+	5
	9	+	6
	10	+	7
	11	+	8
	12	+	9
	13	+	10
	14	+	11
	15	+	12
	16	+	13
	17	+	14
	18	+	15
	19	+	16
	20	+	17
	21	+	18
	22	+	19
	23	+	20
	24	+	21
	25	+	22
	26	+	23
	27	+	24
3	28
4		-	An Act
5		-	ENROLLED SENATE
	29	+	HOUSE OF REPRESENTATIVES - FLOOR VERSION
	30	+
	31	+	STATE OF OKLAHOMA
	32	+
	33	+	2nd Session of the 59th Legislature (2024)
	34	+
	35	+	ENGROSSED SENATE
6	36		BILL NO. 1390 By: McCortney, Prieto, Jett,
7	37		Rogers, Alvord, Hicks, and
8	38		Hamilton of the Senate
9	39
10	40		and
11	41
12		-	McEntire and Williams of
13		-	the House
	42	+	McEntire of the House
14	43
15	44
16	45
17	46
18	47		An Act relating to pharmacy benefits managers;
19	48		amending 36 O.S. 2021, Sections 6960, as amended by
20	49		Section 1, Chapter 3 8, O.S.L. 2022, 6962, as last
21	50		amended by Section 1, Chapter 293, O.S.L. 2023, 6965,
22	51		as amended by Section 2, Chapter 293, O.S.L. 2023,
23	52		Section 3, Chapter 38, O.S.L. 2022, as amended by
24	53		Section 3, Chapter 293, O.S.L. 2023, and 6967 (36
25	54		O.S. Supp. 2023, Sect ions 6960, 6962, 6965, and
26	55		6966.1), which relate to the Patient ’s Right to
27	56		Pharmacy Choice Act; defining terms; modifying
28	57		definitions; prohibiting certain contract terms from
29	58		restricting document disclosure to certain entities;
30	59		modifying certain compliance provisions; conforming
31	60		language; construing provisions; providing for rule
32	61		promulgation; providing for subpoena of certain
33	62		witnesses and records; establishing requirements for
34	63		disclosure of protected health information; providing
35	64		for censure or license re vocation for certain
36	65		noncompliance by a pharmacy benefits manager ;
37	66		providing for certain fines and fees; providing for
38	67		restitution; directing deposit of certain fines,
39	68		fees, and penalties; creating the Attorney General ’s
40	69		Pharmacy Benefits Manager Enforceme nt Revolving Fund;
41	70		establishing fund source; stating purpose;
42	71		establishing provisions relating to public disclosure
43	72		of certain report and cer tain information obtained by
44	73		the Attorney General; updating statutory reference;
45	74		updating statutory language; repealing 36 O.S. 2021,
46	75		Section 6966, which relates to the Patient ’s Right to
47	76
48		-	ENR. S. B. NO. 1390 Page 2
	77	+	SB1390 HFLR Page 2
	78	+	BOLD FACE denotes Committee Amendments. 1
	79	+	2
	80	+	3
	81	+	4
	82	+	5
	83	+	6
	84	+	7
	85	+	8
	86	+	9
	87	+	10
	88	+	11
	89	+	12
	90	+	13
	91	+	14
	92	+	15
	93	+	16
	94	+	17
	95	+	18
	96	+	19
	97	+	20
	98	+	21
	99	+	22
	100	+	23
	101	+	24
	102	+
49	103		Pharmacy Choice Commission; providing for
50	104		codification; and decl aring an emergency.
51	105
52	106
53	107
54		-	SUBJECT: Pharmacy benefits manager
55	108
56	109		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
57		-
58	110		SECTION 1. AMENDATORY 36 O.S. 2021, Section 6960, as
59	111		amended by Section 1, Chapter 38, O.S.L. 2022 (36 O.S. Supp. 2023,
60	112		Section 6960), is amended to read as follows:
61		-
62	113		Section 6960. For purposes of the Patient ’s Right to Pharmacy
63	114		Choice Act:
64		-
65	115		1. “Covered entity” means a nonprofit hospital or medical
66	116		service organization, insurer, health benefit plan, health
67	117		maintenance organization, health program administered by the state
68	118		in the capacity of providing health coverage, or an employer, labor
69	119		union, or other group of persons t hat provides health coverage to
70	120		persons in this state. This term does not include a health plan
71	121		that provides coverage only for accidental injury, specified
72	122		disease, hospital indemnity, disability income, or other limited
73	123		benefit health insurance policies and contracts that do not include
74	124		prescription drug coverage;
75		-
76	125		2. “Health insurer” means any corporation, association, benefit
77	126		society, exchange, partnership or individual licensed by the
78	127		Oklahoma Insurance Code;
79		-
80	128		2. 3. “Health insurer payor ” means a health insurance company,
81	129		health maintenance organization, union, hospital and medical
	130	+
	131	+	SB1390 HFLR Page 3
	132	+	BOLD FACE denotes Committee Amendments. 1
	133	+	2
	134	+	3
	135	+	4
	136	+	5
	137	+	6
	138	+	7
	139	+	8
	140	+	9
	141	+	10
	142	+	11
	143	+	12
	144	+	13
	145	+	14
	146	+	15
	147	+	16
	148	+	17
	149	+	18
	150	+	19
	151	+	20
	152	+	21
	153	+	22
	154	+	23
	155	+	24
	156	+
82	157		services organization or any entity providing or administ ering a
83	158		self-funded health benefit plan;
84		-
85	159		3. 4. “Mail-order pharmacy” means a pharmacy licensed by this
86	160		state that primarily dispenses and delivers covered drugs via common
87	161		carrier;
88		-
89	162		4. 5. “Pharmacy benefits manager ” or “PBM” means a person,
90	163		business, or other entity that performs pharmacy benefits management
91		-
92		-	ENR. S. B. NO. 1390 Page 3
93	164		and any other person acting for such person under . The term shall
94	165		include a person or entity acting on behalf of a PBM in a
95	166		contractual or employment relationship in the performance of
96	167		pharmacy benefits management for a managed-care managed care
97	168		company, nonprofit hospital, medical service organization, insurance
98	169		company, third-party payor or a health program administered by a
99	170		department of this state;
100		-
101	171		6. “Pharmacy benefits management ” means a service provided to
102	172		covered entities to facilitate the provisions of prescription drug
103	173		benefits to covered individuals with in this state including, but not
104	174		limited to, negotiating pricing and other terms with drug
105	175		manufacturers and providers. Pharmacy benefits m anagement may
106	176		include any or all of the following services:
107		-
108	177		a. claims processing, retail network management, and
109	178		payment of claims to pharmacies for prescription drugs
110	179		dispensed to covered individuals,
111	180
	181	+	SB1390 HFLR Page 4
	182	+	BOLD FACE denotes Committee Amendments. 1
	183	+	2
	184	+	3
	185	+	4
	186	+	5
	187	+	6
	188	+	7
	189	+	8
	190	+	9
	191	+	10
	192	+	11
	193	+	12
	194	+	13
	195	+	14
	196	+	15
	197	+	16
	198	+	17
	199	+	18
	200	+	19
	201	+	20
	202	+	21
	203	+	22
	204	+	23
	205	+	24
	206	+
112	207		b. administration or management of pharmacy discount
113	208		cards or programs,
114		-
115	209		c. clinical formulary development and management
116	210		services,
117		-
118	211		d. rebate contracting and administratio n,
119		-
120	212		e. patient compliance, therapeutic intervention, and
121	213		generic substitution programs,
122		-
123	214		f. administration or management of mail -order pharmacy
124	215		programs, or
125		-
126	216		g. disease management programs;
127		-
128	217		5. 7. “Provider” means a pharmacy, as defined in Section 353.1
129	218		of Title 59 of the Oklahoma Statutes or an agent or representative
130	219		of a pharmacy;
131		-
132	220		6. 8. “Retail pharmacy network ” means retail pharmacy provider s
133	221		contracted with a PBM in which the pharmacy primarily fills and
134	222		sells prescriptions via a retail, storefront locat ion;
135		-
136		-	ENR. S. B. NO. 1390 Page 4
137		-
138	223		7. 9. “Rural service area” means a five-digit ZIP code in which
139	224		the population density is less than one thousand (1,000) individuals
140	225		per square mile;
141		-
142	226		8. 10. “Spread pricing” means a prescription drug pricing model
143	227		utilized by a pharmacy benefits man ager in which the PBM charges a
144	228		health benefit plan a contracted price for prescription drugs that
145	229		differs from the amount the PBM directly or indirectly pays the
146	230		pharmacy or pharmacist for providing pharmacy services;
147	231
	232	+	SB1390 HFLR Page 5
	233	+	BOLD FACE denotes Committee Amendments. 1
	234	+	2
	235	+	3
	236	+	4
	237	+	5
	238	+	6
	239	+	7
	240	+	8
	241	+	9
	242	+	10
	243	+	11
	244	+	12
	245	+	13
	246	+	14
	247	+	15
	248	+	16
	249	+	17
	250	+	18
	251	+	19
	252	+	20
	253	+	21
	254	+	22
	255	+	23
	256	+	24
	257	+
148	258		9. 11. “Suburban service area ” means a five-digit ZIP code in
149	259		which the population density is between one thousand (1,000) and
150	260		three thousand (3,000) individuals per square mil e; and
151		-
152	261		10. 12. “Urban service area” means a five-digit ZIP code in
153	262		which the population density is greater than thr ee thousand (3,000)
154	263		individuals per square mile.
155		-
156	264		SECTION 2. AMENDATORY 36 O.S. 2021, Section 6962, as
157	265		last amended by Section 1, Chapter 293, O.S.L. 2023 (36 O.S. Supp.
158	266		2023, Section 6962), is amended to read as follows:
159		-
160	267		Section 6962. A. The Attorney General shall review and approve
161	268		retail pharmacy network access for all pharmacy benefits managers
162	269		(PBMs) to ensure compliance with Section 6961 of this title.
163		-
164	270		B. A PBM, or an agent of a PBM, shall not:
165		-
166	271		1. Cause or knowingly permit the use of advertisement,
167	272		promotion, solicitation, representation, proposal or offer that is
168	273		untrue, deceptive or misleading;
169		-
170	274		2. Charge a pharmacist or pharmacy a fee related to the
171	275		adjudication of a claim including without limitation a fee for:
172		-
173	276		a. the submission of a claim,
174		-
175	277		b. enrollment or participation in a retail pharmacy
176	278		network, or
177		-
178		-
179		-	ENR. S. B. NO. 1390 Page 5
180	279		c. the development or management of claims processing
181	280		services or claims payment services related to
182	281		participation in a retail pharmacy network;
	282	+
	283	+	SB1390 HFLR Page 6
	284	+	BOLD FACE denotes Committee Amendments. 1
	285	+	2
	286	+	3
	287	+	4
	288	+	5
	289	+	6
	290	+	7
	291	+	8
	292	+	9
	293	+	10
	294	+	11
	295	+	12
	296	+	13
	297	+	14
	298	+	15
	299	+	16
	300	+	17
	301	+	18
	302	+	19
	303	+	20
	304	+	21
	305	+	22
	306	+	23
	307	+	24
183	308
184	309		3. Reimburse a pharmacy or pharmacist in the state an amount
185	310		less than the amount that the PBM reimburses a pharmacy owned by or
186	311		under common ownership with a PBM f or providing the same covered
187	312		services. The reimbursement amount paid to the pharmacy shall be
188	313		equal to the reimbur sement amount calculated on a per -unit basis
189	314		using the same generic product identifier or generic code number
190	315		paid to the PBM-owned or PBM-affiliated pharmacy;
191		-
192	316		4. Deny a provider the opportunity to participate in any
193	317		pharmacy network at preferred particip ation status if the provider
194	318		is willing to accept the terms and conditions that the PBM has
195	319		established for other providers as a condition o f preferred network
196	320		participation status;
197		-
198	321		5. Deny, limit or terminate a provider ’s contract based on
199	322		employment status of any employee who has an active license to
200	323		dispense, despite probation status, with the State Board of
201	324		Pharmacy;
202		-
203	325		6. Retroactively den y or reduce reimbursement for a covered
204	326		service claim after returning a paid claim response as part of the
205	327		adjudication of the claim, unless:
206		-
207	328		a. the original claim was submitted fraudulently, or
208		-
209	329		b. to correct errors identified in an audit, so long as
210	330		the audit was conducted in compliance with Sections
211	331		356.2 and 356.3 of Title 59 of the Oklahoma Statutes;
212	332
	333	+	SB1390 HFLR Page 7
	334	+	BOLD FACE denotes Committee Amendments. 1
	335	+	2
	336	+	3
	337	+	4
	338	+	5
	339	+	6
	340	+	7
	341	+	8
	342	+	9
	343	+	10
	344	+	11
	345	+	12
	346	+	13
	347	+	14
	348	+	15
	349	+	16
	350	+	17
	351	+	18
	352	+	19
	353	+	20
	354	+	21
	355	+	22
	356	+	23
	357	+	24
	358	+
213	359		7. Fail to make any payment due to a pharmacy or pharmacist for
214	360		covered services properly rendered in the event a PBM terminates a
215	361		provider from a pharmac y benefits manager network;
216		-
217	362		8. Conduct or practice spread pricing, as defined in Section 1
218	363		of this act Section 6960 of this title, in this state; or
219		-
220		-
221		-	ENR. S. B. NO. 1390 Page 6
222	364		9. Charge a pharmacist or pharmacy a fee related to
223	365		participation in a retail pharmacy network including but not limited
224	366		to the following:
225		-
226	367		a. an application fee,
227		-
228	368		b. an enrollment or participation fee,
229		-
230	369		c. a credentialing or re-credentialing fee,
231		-
232	370		d. a change of ownership fee, or
233		-
234	371		e. a fee for the development or management of claims
235	372		processing services or claims payment services.
236		-
237	373		C. The prohibitions under this section shall apply to contracts
238	374		between pharmacy benefits manager s and providers for participation
239	375		in retail pharmacy networks.
240		-
241	376		1. A PBM contract shall:
242		-
243	377		a. not restrict, directly or indirectly, any pharma cy
244	378		that dispenses a prescription drug from informing, or
245	379		penalize such pharmacy for informing, an individual of
246	380		any differential between the individual ’s out-of-
247	381		pocket cost or coverage with respect to acquisition of
	382	+
	383	+	SB1390 HFLR Page 8
	384	+	BOLD FACE denotes Committee Amendments. 1
	385	+	2
	386	+	3
	387	+	4
	388	+	5
	389	+	6
	390	+	7
	391	+	8
	392	+	9
	393	+	10
	394	+	11
	395	+	12
	396	+	13
	397	+	14
	398	+	15
	399	+	16
	400	+	17
	401	+	18
	402	+	19
	403	+	20
	404	+	21
	405	+	22
	406	+	23
	407	+	24
	408	+
248	409		the drug and the amount an individual wo uld pay to
249	410		purchase the drug directly, and
250		-
251	411		b. ensure that any entity that provides pharmacy benefits
252	412		management services under a contract with any such
253	413		health plan or health insurance coverage does not,
254	414		with respect to such plan or coverage, restrict,
255	415		directly or indirectly, a pharmacy that dispenses a
256	416		prescription drug from informing, or penalize such
257	417		pharmacy for informing, a covered individual of any
258	418		differential between the individual ’s out-of-pocket
259	419		cost under the plan or coverage with respect to
260	420		acquisition of the drug and the amount an individual
261	421		would pay for acquisition of the drug without using
262	422		any health plan or health insurance coverage.
263		-
264		-
265		-	ENR. S. B. NO. 1390 Page 7
266	423		2. A pharmacy benefits manager ’s contract with a provider shall
267	424		not prohibit, restrict or limit disclosure of information and
268	425		documents to the Attorney General, law enforcement or state and
269	426		federal governmental officials inve stigating or examining a
270	427		complaint or conducting a review of a pharmacy benefits manager ’s
271	428		compliance with the requirements under the Patien t’s Right to
272	429		Pharmacy Choice Act, Pharmacy Audit Integrity Act, and Section s 357
273	430		through 360 of Title 59 of the Okla homa Statutes.
	431	+	D. A pharmacy benefits manager shall:
274	432
275		-	D. A pharmacy benefits manager shall:
	433	+	SB1390 HFLR Page 9
	434	+	BOLD FACE denotes Committee Amendments. 1
	435	+	2
	436	+	3
	437	+	4
	438	+	5
	439	+	6
	440	+	7
	441	+	8
	442	+	9
	443	+	10
	444	+	11
	445	+	12
	446	+	13
	447	+	14
	448	+	15
	449	+	16
	450	+	17
	451	+	18
	452	+	19
	453	+	20
	454	+	21
	455	+	22
	456	+	23
	457	+	24
276	458
277	459		1. Establish and maintain an electronic claim inquiry
278	460		processing system using the Nat ional Council for Prescription Drug
279	461		Programs’ Programs current standards to communicate information to
280	462		pharmacies submitting claim inquiries;
281		-
282	463		2. Fully disclose to insurers, self -funded employers, unions or
283	464		other PBM clients the existence of the respective aggregate
284	465		prescription drug discounts, rebates received from drug
285	466		manufacturers and pharmacy audit recoupments;
286		-
287	467		3. Provide the Attorney General, insurers, self -funded employer
288	468		plans and unions unrestricted audit rights of and access to the
289	469		respective PBM pharmaceutical manufacturer and provider contracts,
290	470		plan utilization data, plan pricing data, pharmacy utilization data
291	471		and pharmacy pricing data;
292		-
293	472		4. Maintain, for no less than three (3) years, documentation of
294	473		all network development activities includin g but not limited to
295	474		contract negotiations and any denials to providers to join networks.
296	475		This documentation shall be made available to the Attorney General
297	476		upon request; and
298		-
299	477		5. Report to the Attorney General, on a quarterly basis for
300	478		each health insurer payor, on the following information:
301		-
302	479		a. the aggregate amount of rebates received by the PBM,
303		-
304	480		b. the aggregate amount of rebates distributed to the
305	481		appropriate health insurer payor,
306	482
	483	+	SB1390 HFLR Page 10
	484	+	BOLD FACE denotes Committee Amendments. 1
	485	+	2
	486	+	3
	487	+	4
	488	+	5
	489	+	6
	490	+	7
	491	+	8
	492	+	9
	493	+	10
	494	+	11
	495	+	12
	496	+	13
	497	+	14
	498	+	15
	499	+	16
	500	+	17
	501	+	18
	502	+	19
	503	+	20
	504	+	21
	505	+	22
	506	+	23
	507	+	24
307	508
308		-	ENR. S. B. NO. 1390 Page 8
309	509		c. the aggregate amount of rebates passed on to the
310	510		enrollees of each heal th insurer payor at the point of
311	511		sale that reduced the applicable deductible,
312	512		copayment, coinsure or other cost shar ing amount of
313	513		the enrollee,
314		-
315	514		d. the individual and aggregate amount paid by the health
316	515		insurer payor to the PBM for pharmacy services
317	516		itemized by pharmacy, drug product and service
318	517		provided, and
319		-
320	518		e. the individual and aggregate amount a PBM paid a
321	519		provider for pharmacy services itemized by pharmacy,
322	520		drug product and service provided.
323		-
324	521		E. Nothing in the Patient ’s Right to Pharmacy Choice Act shal l
325	522		prohibit the Attorney General from requesting and obtaining detailed
326	523		data, including raw data, in response to the information provided by
327	524		a PBM in the quarterly reports required by this section. The
328	525		Attorney General may alter the frequency of the report s required by
329	526		this section at his or her discretion.
330		-
331	527		F. The Attorney General may promulgate rules to implement the
332	528		provisions of the Patient ’s Right to Pharmacy Choice Act , Pharmacy
333	529		Audit Integrity Act, and Sections 357 through 360 of Title 59 of the
334	530		Oklahoma Statutes.
335	531
	532	+	SB1390 HFLR Page 11
	533	+	BOLD FACE denotes Committee Amendments. 1
	534	+	2
	535	+	3
	536	+	4
	537	+	5
	538	+	6
	539	+	7
	540	+	8
	541	+	9
	542	+	10
	543	+	11
	544	+	12
	545	+	13
	546	+	14
	547	+	15
	548	+	16
	549	+	17
	550	+	18
	551	+	19
	552	+	20
	553	+	21
	554	+	22
	555	+	23
	556	+	24
	557	+
336	558		SECTION 3. AMENDATORY 36 O.S. 2021, Section 6965, as
337	559		amended by Section 2, Chapter 293, O.S.L. 2023 (36 O.S. Supp. 2023,
338	560		Section 6965), is amended to read as follows:
339		-
340	561		Section 6965. A. The Attorney General shall ha ve power and
341	562		authority to examine and investigate the affairs of every pharmacy
342	563		benefits manager (PBM) engaged in ph armacy benefits management in
343	564		this state in order to determine whether such entity is in
344	565		compliance with the Patient ’s Right to Pharmacy Cho ice Act, Pharmacy
345	566		Audit Integrity Act, and Section s 357 through 360 of Title 59 of the
346	567		Oklahoma Statutes.
347		-
348	568		B. The Attorney General shall have the power and authority to
349	569		subpoena witnesses and records, whether prior to or during an
350	570		investigation or prosecut ion of a complaint, from any relevant
351		-
352		-	ENR. S. B. NO. 1390 Page 9
353	571		entity or persons to ensure compliance with the Patient ’s Right to
354	572		Pharmacy Choice Act, Pharmacy Audit Integrity Act, and Sections 357
355	573		through 360 of Title 59 of the Oklahoma Statutes .
356		-
357	574		C. All PBM files and records sha ll be subject to examination by
358	575		the Attorney General or by duly appointed designees. The Attorney
359	576		General, authorized employees and examiners shall have access to any
360	577		of a PBM’s files and records that may relate to a particular
361	578		complaint under investigati on or to an inquiry or examination by the
362	579		Attorney General.
363		-
364	580		C. D. Every officer, director, employee or agent of the PBM,
365	581		upon receipt of any inquiry from the Attorney General , shall, within
	582	+
	583	+	SB1390 HFLR Page 12
	584	+	BOLD FACE denotes Committee Amendments. 1
	585	+	2
	586	+	3
	587	+	4
	588	+	5
	589	+	6
	590	+	7
	591	+	8
	592	+	9
	593	+	10
	594	+	11
	595	+	12
	596	+	13
	597	+	14
	598	+	15
	599	+	16
	600	+	17
	601	+	18
	602	+	19
	603	+	20
	604	+	21
	605	+	22
	606	+	23
	607	+	24
	608	+
366	609		twenty (20) days from the date the inquiry is sent, furnish the
367	610		Attorney General with an adequate response to the inquiry.
368		-
369	611		D. E. When making an examination under this section, the
370	612		Attorney General may retain subject matter experts, attorneys,
371	613		appraisers, independent actuaries, independent certified public
372	614		accountants or an accounting firm or individual holding a permit to
373	615		practice public accounting, certified financial examiners or other
374	616		professionals and specialists as examiners, the cost of which shall
375	617		be borne by the PBM that is the subject of the examination.
376		-
377	618		F. 1. Protected health information held by a PBM shall be
378	619		provided at the request of the Attorney General for the purpos e of
379	620		conducting investigations into potential violations of state laws
380	621		and regulations related to the PBM. Disclosure of protected health
381	622		information shall be limited to the extent necessary for the
382	623		investigation and enforcement of state law.
383		-
384	624		2. All disclosures of protected health information shall be
385	625		made in compliance with all applicable federal and state privacy
386	626		laws, including the Health Insurance Portability and Accountability
387	627		Act of 1996 (HIPAA), and other relevant laws protecting the privacy
388	628		and confidentiality of health information.
389		-
390	629		3. Any protected health information obtained for an
391	630		investigation shall be handled and maintained per applicable federal
392	631		and state privacy laws and regulations, including HIPAA.
393	632
	633	+	SB1390 HFLR Page 13
	634	+	BOLD FACE denotes Committee Amendments. 1
	635	+	2
	636	+	3
	637	+	4
	638	+	5
	639	+	6
	640	+	7
	641	+	8
	642	+	9
	643	+	10
	644	+	11
	645	+	12
	646	+	13
	647	+	14
	648	+	15
	649	+	16
	650	+	17
	651	+	18
	652	+	19
	653	+	20
	654	+	21
	655	+	22
	656	+	23
	657	+	24
394	658
395		-	ENR. S. B. NO. 1390 Page 10
396	659		4. Unauthorized disclosure of protected health information
397	660		obtained during an investigation is strictly prohibited and subject
398	661		to legal penalties.
399		-
400	662		G. 1. If the Attorney General, after notice and opportunity
401	663		for hearing, finds that any PBM operating within th is state has not
402	664		fully cooperated with an investigation or inquiry conducted by the
403	665		Attorney General related to compliance with the Patient ’s Right to
404	666		Pharmacy Choice Act, Pha rmacy Audit Integrity Act, and Sections 357
405	667		through 360 of Title 59 of the Oklahoma Statutes, the Attorney
406	668		General may instruct the Insurance Commissioner that the PBM be
407	669		censured or his or her license be revoked. If the Attorney General
408	670		makes such instruction, the Insurance Commissioner shall enforce the
409	671		instructed action within thirty (30) days.
410		-
411	672		2. In addition to or in lieu of any censure, suspension, or
412	673		revocation by the Insurance Commissioner, the Attorney General may
413	674		levy a civil fine not less than O ne Hundred Dollars ($100.00) and
414	675		not greater than Ten Thousand Dollars ($10,000.00) for each
415	676		violation of this subse ction and assess any other penalty or remedy
416	677		authorized by this act. For purposes of this section, each day a
417	678		PBM fails to comply with an i nvestigation or inquiry may be
418	679		considered a separate violation.
419		-
420	680		SECTION 4. AMENDATORY Sect ion 3, Chapter 38, O.S.L.
421	681		2022, as amended by Section 3, Chapter 293, O.S.L. 2023 (36 O.S.
422	682		Supp. 2023, Section 6966.1), is amended to read a s follows:
	683	+
	684	+	SB1390 HFLR Page 14
	685	+	BOLD FACE denotes Committee Amendments. 1
	686	+	2
	687	+	3
	688	+	4
	689	+	5
	690	+	6
	691	+	7
	692	+	8
	693	+	9
	694	+	10
	695	+	11
	696	+	12
	697	+	13
	698	+	14
	699	+	15
	700	+	16
	701	+	17
	702	+	18
	703	+	19
	704	+	20
	705	+	21
	706	+	22
	707	+	23
	708	+	24
423	709
424	710		Section 6966.1. A. The Insurance Commissioner may censure,
425	711		suspend, revoke, or refuse to issue or renew a license of or levy a
426	712		civil penalty against any person licensed under the insurance laws
427	713		of this state for any violation of the Patient ’s Right to Pharmacy
428	714		Choice Act, Section 6958 et seq. of this title.
429		-
430	715		B. 1. If the Attorney General finds, after notic e and
431	716		opportunity for hearing, that a pharmacy benefits manager (PBM)
432	717		violated one or more provisions of the Patient ’s Right to Pharmacy
433	718		Choice Act, the Pharmacy Audit Integrity Act or the provisions of
434	719		Sections 357 through 360 of Title 59 of the Oklahoma Statues
435	720		Statutes, the Attorney General may recommend instruct the Insurance
436	721		Commissioner that the PBM be censured, or his or her license may be
437	722		suspended or revoked and a penalty or remedy authorized by this act
438		-
439		-	ENR. S. B. NO. 1390 Page 11
440	723		may be imposed. If the Attorney General mak es such recommendation
441	724		instruction, the Insurance Commissioner shall take the recommended
442	725		action enforce such action within thirty (30) days .
443		-
444	726		2. In addition to or in lieu of any censure, suspension or
445	727		revocation of a license by the Insurance Commissioner, a PBM the
446	728		Attorney General may be subject to levy a civil or administrative
447	729		fine of not less than One Hundred Dollars ($100.00) and not greater
448	730		than Ten Thousand Dollars ($10,000.00) for each violation of the
449	731		provisions of the Patient ’s Right to Pharmacy Choice Act, the
450	732		Pharmacy Audit Integrity Act or the provisions of Sections 357
	733	+
	734	+	SB1390 HFLR Page 15
	735	+	BOLD FACE denotes Committee Amendments. 1
	736	+	2
	737	+	3
	738	+	4
	739	+	5
	740	+	6
	741	+	7
	742	+	8
	743	+	9
	744	+	10
	745	+	11
	746	+	12
	747	+	13
	748	+	14
	749	+	15
	750	+	16
	751	+	17
	752	+	18
	753	+	19
	754	+	20
	755	+	21
	756	+	22
	757	+	23
	758	+	24
	759	+
451	760		through 360 of Title 59 of the Oklahoma Statues, following no tice
452	761		and an opportunity for a hearing Statutes.
453		-
454	762		3. The Attorney General may order restitution for economic loss
455	763		suffered by pharmacies or patients for violations of the Patient’s
456	764		Right to Pharmacy Choice Act, Pharmacy Audit Integrity Act, or the
457	765		provisions of Sections 357 through 360 of Title 59 of the Oklahoma
458	766		Statutes.
459		-
460	767		C. Notwithstanding whether the license of a PBM has been
461	768		issued, suspended, revoked, surrendered or lapsed by operation of
462	769		law, the Attorney General is hereby authorized to enforce the
463	770		provisions of the Patient’s Right to Pharmacy Choice Act and impose
464	771		any penalty or remedy authorized under the act aga inst a PBM under
465	772		investigation for or charged with a violation of the Patient ’s Right
466	773		to Pharmacy Choice Act, the Pharmacy Audit Integrity A ct, the
467	774		provisions of Sections 357 through 360 of Title 59 of the Oklahoma
468	775		Statues Statutes or any provision of the insurance laws of this
469	776		state.
470		-
471	777		D. Each day that a PBM conducts business in this state without
472	778		a license from the Insurance Department shall be deemed a violation
473	779		of the Patient’s Right to Pharmacy Choice Act.
474		-
475	780		E. 1. All hearings conducted by the Office of the Attorney
476	781		General pursuant to this section shall be public and held in
477	782		accordance with the Administrative Procedures Act.
478	783
	784	+	SB1390 HFLR Page 16
	785	+	BOLD FACE denotes Committee Amendments. 1
	786	+	2
	787	+	3
	788	+	4
	789	+	5
	790	+	6
	791	+	7
	792	+	8
	793	+	9
	794	+	10
	795	+	11
	796	+	12
	797	+	13
	798	+	14
	799	+	15
	800	+	16
	801	+	17
	802	+	18
	803	+	19
	804	+	20
	805	+	21
	806	+	22
	807	+	23
	808	+	24
	809	+
479	810		2. Hearings shall be held at the office Office of the Attorney
480	811		General or any other place the Attorney General may deem convenien t.
481		-
482		-
483		-	ENR. S. B. NO. 1390 Page 12
484	812		3. The Attorney General, upon written request from a PBM
485	813		affected by the hearing, shall cause a full stenographic record of
486	814		the proceedings to be made by a competent court reporter. This
487	815		record shall be at the expense of the PBM.
488		-
489	816		4. The ordinary fees and costs of the hearing examiner
490	817		appointed pursuant to Section 319 of this title may be assessed by
491	818		the hearing examiner against the respo ndent unless the respondent is
492	819		the prevailing party.
493		-
494	820		F. Any PBM whose license has been censured, suspended, revoked
495	821		or denied renewal or who has had a fine levied against him or her
496	822		shall have the right of appeal from the final order of the Attorney
497	823		General, pursuant to Section 318 et seq. of Title 75 of the Oklahoma
498	824		Statutes.
499		-
500	825		G. If the Attorney General determines, ba sed upon an
501	826		investigation of complaints, that a PBM has engaged in violations of
502	827		the provisions of the Patient ’s Right to Pharmacy Choice Ac t,
503	828		Pharmacy Audit Integrity Act, and Section 357 through 360 of Title
504	829		59 of the Oklahoma Statutes with such frequency as to indicate a
505	830		general business practice, and that the PBM should be subjected to
506	831		closer supervision with respect to those practices, th e Attorney
507	832		General may require the PBM to file a report at any periodic
508	833		interval the Attorney General deems necessar y.
	834	+
	835	+	SB1390 HFLR Page 17
	836	+	BOLD FACE denotes Committee Amendments. 1
	837	+	2
	838	+	3
	839	+	4
	840	+	5
	841	+	6
	842	+	7
	843	+	8
	844	+	9
	845	+	10
	846	+	11
	847	+	12
	848	+	13
	849	+	14
	850	+	15
	851	+	16
	852	+	17
	853	+	18
	854	+	19
	855	+	20
	856	+	21
	857	+	22
	858	+	23
	859	+	24
509	860
510	861		H. 1. The Attorney General shall have the authority to collect
511	862		all fines, penalties, restitution, and interest thereon pursuant to
512	863		the provisions of the Patient ’s Right to Pharmacy Choice Act,
513	864		Pharmacy Audit Integrity Act, and the provisions of Sectio ns 357
514	865		through 360 of Title 59 of the Oklahoma Statutes, or any other
515	866		charge, cause of action, judgment, prelitigation settlement, or
516	867		other settlement that requires the recovery of money as a result of
517	868		violations of the Patient ’s Right to Pharmacy Choice A ct. Funds
518	869		collected by the Attorney General pursuant to the Patient ’s Right to
519	870		Pharmacy Choice Act, Pharmacy Audit Integrity Act, and Secti ons 357
520	871		through 360 of Title 59 of the Oklahoma Statutes shall be deposited
521	872		into the Attorney General ’s Pharmacy Benefits Manager Enforcement
522	873		Revolving Fund.
523		-
524	874		2. Costs of investigation, litigation, attorney fees, and other
525	875		expenses incurred shall be retain ed by the Office of the Attorney
526		-
527		-	ENR. S. B. NO. 1390 Page 13
528	876		General. Remaining funds shall be distributed to pharmacists,
529	877		patients, or other i njured parties as determined by the Attorney
530	878		General.
531		-
532	879		3. The Attorney General shall promulgate rules for the
533	880		distribution of funds pursuant to this subsection.
534		-
535	881		SECTION 5. NEW LAW A new section of law to be codified
536	882		in the Oklahoma Statutes as Section 6966.2 of Title 36, unless there
537	883		is created a duplication in numbering, reads as follows:
	884	+
	885	+	SB1390 HFLR Page 18
	886	+	BOLD FACE denotes Committee Amendments. 1
	887	+	2
	888	+	3
	889	+	4
	890	+	5
	891	+	6
	892	+	7
	893	+	8
	894	+	9
	895	+	10
	896	+	11
	897	+	12
	898	+	13
	899	+	14
	900	+	15
	901	+	16
	902	+	17
	903	+	18
	904	+	19
	905	+	20
	906	+	21
	907	+	22
	908	+	23
	909	+	24
538	910
539	911		There is hereby created in the State Treasury a revolving fund
540	912		for the Office of the Attorney General, to be designated the
541	913		“Attorney General’s Pharmacy Benefits Manager Enforcement Revolving
542	914		Fund”. The fund shall be a continuing fund, not subject to fiscal
543	915		year limitations, and shall consist of any monies collected by the
544	916		Attorney General and designated to the fund by law, including those
545	917		levied for activities related to enforcement of the Patient ’s Right
546	918		to Pharmacy Choice Act, the Pharmacy Audit Integrity Act, and the
547	919		provisions of Sections 357 through 360 of Title 59 of the Oklahoma
548	920		Statutes. All monies accruing to the credit of the fund are he reby
549	921		appropriated and may be budgeted and expended by the Attorney
550	922		General for the purposes provided in this section. Expenditures
551	923		from the fund shall be made upon warrants issued by the State
552	924		Treasurer against claims filed as prescribed by law with the
553	925		Director of the Office of Management and Enterprise Services for
554	926		approval and payment.
555		-
556	927		SECTION 6. AMENDATORY 36 O.S . 2021, Section 6967, is
557	928		amended to read as follows:
558		-
559	929		Section 6967. A. Documents, evidence, materials, records,
560	930		reports, complaints or other information in the possession or
561	931		control of the Office of the Attorney General or Insurance
562	932		Department or the Right to Pharmacy Choice Commission that are is
563	933		obtained by, created by or disclosed to the Office of the Attorney
564	934		General or Insurance Commissioner , Pharmacy Choice Commission or any
	935	+
	936	+	SB1390 HFLR Page 19
	937	+	BOLD FACE denotes Committee Amendments. 1
	938	+	2
	939	+	3
	940	+	4
	941	+	5
	942	+	6
	943	+	7
	944	+	8
	945	+	9
	946	+	10
	947	+	11
	948	+	12
	949	+	13
	950	+	14
	951	+	15
	952	+	16
	953	+	17
	954	+	18
	955	+	19
	956	+	20
	957	+	21
	958	+	22
	959	+	23
	960	+	24
	961	+
565	962		other person in the course of an evaluation, examination,
566	963		investigation or review made pursuant to the provisions of the
567	964		Patient’s Right to Pharmacy Choice Act, the Pharmacy Integrity Audit
568	965		Integrity Act or Sections 357 through 360 of Title 59 of the
569	966		Oklahoma Statutes, except as provided in subsection C of this
570		-
571		-	ENR. S. B. NO. 1390 Page 14
572	967		section, shall be confidential by law and privileged, shall not be
573	968		subject to open records request, shall not be subject to subpoena
574	969		and shall not be subject to discovery or admissible in evidence in
575	970		any private civil action if obtained from the Attorney General,
576	971		Insurance Commissioner, the Pharmacy Choice Commission or any
577	972		employees or representatives of the Attorney General or Insurance
578	973		Commissioner.
579		-
580	974		B. Nothing in this section shall prevent the disclosure of a
581	975		final order issued against a pharmacy benefits manager by the
582	976		Attorney General or Insurance Commissioner or Pharmacy Choice
583	977		Commission. Such orders shall be open records.
584		-
585	978		C. Nothing in this section shall prevent the Attorney General
586	979		from making public, in the form of an examination report, any
587	980		findings from an exami nation pursuant to Section 6965 of this title.
588	981		It shall be the Attorney General ’s sole discretion to determine
589	982		whether it is in the public ’s interest to publish these findings.
590	983		Only the final examination report shall be made public. Any
591	984		documents, evidence, materials, records, reports, complaints, or
592	985		other information in possession or control of the Attorney General
	986	+
	987	+	SB1390 HFLR Page 20
	988	+	BOLD FACE denotes Committee Amendments. 1
	989	+	2
	990	+	3
	991	+	4
	992	+	5
	993	+	6
	994	+	7
	995	+	8
	996	+	9
	997	+	10
	998	+	11
	999	+	12
	1000	+	13
	1001	+	14
	1002	+	15
	1003	+	16
	1004	+	17
	1005	+	18
	1006	+	19
	1007	+	20
	1008	+	21
	1009	+	22
	1010	+	23
	1011	+	24
	1012	+
593	1013		obtained through the examination shall be confidential by law and
594	1014		privileged, shall not be subject to the Oklahoma Open Records Act,
595	1015		shall not be subject to subpoena, and shall not be subject to
596	1016		discovery or admissible evidence in any private civil action if
597	1017		obtained from the Attorney General.
598		-
599	1018		D. In the course of any hearing made pursuant to the provisions
600	1019		of the Patient’s Right to Pharmacy C hoice Act, the Pharmacy
601	1020		Integrity Audit Integrity Act or Sections 357 through 360 of Title
602	1021		59 of the Oklahoma Statut es, nothing in this section shall be
603	1022		construed to prevent the Insurance Commissioner or any employees or
604	1023		representatives of the Insurance Co mmissioner from presenting
605	1024		admissible documents, evidence, materials, records, reports or
606	1025		complaints to the adjudica ting authority.
607		-
608	1026		SECTION 7. REPEALER 36 O.S. 2021, Section 6966, is
609	1027		hereby repealed.
610		-
611	1028		SECTION 8. It being immediately necessary for the preservation
612	1029		of the public peace, health or safety, an emergency is hereby
613		-
614		-	ENR. S. B. NO. 1390 Page 15
615	1030		declared to exist, by reason whereof this act shall take effect and
616	1031		be in full force from and after its passage and approval.
617	1032
618		-
619		-	ENR. S. B. NO. 1390 Page 16
620		-	Passed the Senate the 29th day of February, 2024.
621		-
622		-
623		-
624		-	Presiding Officer of the Senate
625		-
626		-
627		-	Passed the House of Representatives the 1st day of April, 2024.
628		-
629		-
630		-
631		-	Presiding Officer of the House
632		-	of Representatives
633		-
634		-	OFFICE OF THE GOVERNOR
635		-	Received by the Office of the Governor this _______ _____________
636		-	day of _________________ __, 20_______, at _______ o'clock _______ M.
637		-	By: _________________________________
638		-	Approved by the Governor of the State of Oklahoma this _______ __
639		-	day of _____________ ______, 20_______, at _______ o'clock _______ M.
640		-
641		-	_________________________________
642		-	Governor of the State of Oklahoma
643		-
644		-
645		-	OFFICE OF THE SECRETARY OF STATE
646		-	Received by the Office of the Secretary of State this _______ ___
647		-	day of _________________ _, 20 _______, at _______ o'clock _______ M.
648		-	By: _________________________________
	1033	+	COMMITTEE REPORT BY: COMMITTEE ON RULES, dated 03/26/2024 - DO PASS,
	1034	+	As Coauthored.