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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
COMMITTEE SUBSTITUTE
FOR
SENATE BILL 1955 By: Standridge
COMMITTEE SUBSTITUTE
An Act relating to the Patient’s Right to Pharmacy
Choice Act; defining terms; authorizing cause of
action for certain violations; authorizing award of
certain costs and fees; requiring award of certain
damages upon specified sho wing by plaintiff;
authorizing joinder of certain actions; providing for
division of certain damage award; requiring certain
evidence; authorizing discovery of specified
information; authorizing intervention of Attorney
General; providing for codification; and declaring an
emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6696.2 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. As used in this act:
1. “Closely aligned pharmacy provider” means a pharmacy
provider wholly or partially owned by :
a. the pharmacy benefits manager (PBM),
b. an entity that owns any portion of the PBM,
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c. an entity owned wholly or partially by the PBM, or
d. an entity closely aligned with the PBM which would be
established by any other working relationship between
the PBM and the pharmacy provider which would be
construed as being beneficial to the PBM ;
2. “Damages” includes, but is not limited to, the difference in
reimbursement between the plaintiff or plaintif fs and the highest
total reimbursement, including drug pricing and any associated
reimbursed costs, of a closely aligned ph armacy provider or any
pharmacy provider that would be considered in competition with the
plaintiff or plaintiffs provid ing pharmacy services to the PB M;
3. “Drug pricing” includes but is not limited to drug costs,
rebates, incentives, discounts, kickbacks, profits, spread pricing,
fees, and other pricing information that would cause a disparit y
between reimbursement for the plaintiff or plaintiffs and other
contracted pharmacy providers of the PBM ;
4. “Payment history” includes but is not limited to direct
payments, rebates, discounts, kickbacks, credits , or any other form
of benefit to the payee; and
5. “Pharmacy contract” means any contract between a PBM and a
pharmacy provider.
B. 1. A licensed pharmacy or pharmacist located in this state
who is aggrieved by a violation of the Patient’s Right to Pharmacy
Choice Act, Section 6959 et seq. o f Title 36 of the Oklahoma
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Statutes, related to pricing models or reimbursement r ates by a
pharmacy benefits manager (PBM) or the entity for which the PBM
performs pharmacy benefits management shall have a cause of action
against the PBM or entity to recover damages attributable to such
violation. In addition to actual damages, a court may award c ourt
costs and reasonable attorney fees.
2. If a plaintiff shows that the disparity in reimbursement
between the amount the PBM reimburses the plaintiff and the amount
the PBM reimburses either a closely aligned pharmacy provider or any
pharmacy provider that would be considered in competition with the
plaintiff is financially harmful to the plaintiff while beneficial
to the other provider, then such damage will be considered
unnecessarily harmful to the plaintiff and the court shall award
damages to the plaintiff in an amount needed to cover the financial,
personal, and business harm that resulted from such unn ecessary
financial harm and an amount needed to bring the plaintiff to the
financial position tha t would have occurred if such unnecessary
financial harm was not inflicted.
3. If more than one licensed pharmacy or phar macist has similar
damages from the same PBM , such pharmacies or pharmacists may join
their cause of action and any damage award shall be divided among
the aggrieved parties according to the proportion of damages each
party sustained.
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C. A licensed pharmacy or pharmacis t, or more than one of
either or both, filing an action pursuant to subsection B of this
section shall be required to :
1. Present evidence of a consistent reimbursement rate that is
less than the combined total of the cost of medication and the
average cost of dispensing the medication as recognized in t he
industry. Each plaintiff must show a minimum of twelve (12) such
instances in a ninety-day period to sustain a claim for damages
under this section; or
2. Present evidence that a PBM initiated an audit against th e
pharmacy or pharmacies in violation of the Pharmacy Audit Integr ity
Act.
D. In an action filed pursuant to this section, the plaintiff
or plaintiffs shall have rights of discovery in all relevant areas
to determine the existenc e of unfair, anti-competitive, or
monopolistic actions on behalf of the PBM. Such discovery may
include but not be limited to :
1. Payment history and pharmacy contracts for similar pharmacy
services to any closely aligned pharmacy provider or any pharmacy
provider that would be considered in compe tition with the plaintiff
or plaintiffs;
2. Communications related to the contract of the plaintiff or
plaintiffs;
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3. Drug pricing or communications about drug pricing related to
the plaintiff or plaintiffs, any closely aligned pharmacy provider,
or contracted pharmacy providers of the PBM that would be considered
competitors of the plaintiff or plaintiffs; or
4. Any information or communication related to the disparity i n
reimbursement between the plaintiff or plaintiffs and any contracted
pharmacy provider of the PBM when such information or communication
would show anti-competitive or unfair business pract ices on the part
of the PBM.
E. In addition to the oversight and investigative authority
granted under the Patient’s Right to Pharmacy Choice Act, the
Attorney General may intervene in any action filed pursuant to
subsection B of this section.
SECTION 2. It being immediately necessary for the preservat ion
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 passage and approval.
59-2-3481 RD 2/13/2024 3:09:14 PM