Oklahoma 2024 Regular Session

Oklahoma Senate Bill SB1955 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
3		-	SENATE FLOOR VERSION - SB1955 SFLR Page 1
4		-	(Bold face denotes Committee Amendments) 1
	3	+	Req. No. 3481 Page 1 1
5	4		2
6	5		3
7	6		4
8	7		5
9	8		6
10	9		7
11	10		8
12	11		9
13	12		10
14	13		11
15	14		12
16	15		13
17	16		14
18	17		15
19	18		16
20	19		17
21	20		18
22	21		19
23	22		20
24	23		21
25	24		22
26	25		23
27	26		24
28	27
29		-	SENATE FLOOR VERSION
30		-	February 13, 2024
	28	+	STATE OF OKLAHOMA
31	29
	30	+	2nd Session of the 59th Legislature (2024)
32	31
33	32		COMMITTEE SUBSTITUTE
34	33		FOR
35		-	SENATE BILL ~~NO.~~ 1955 By: Standridge
	34	+	SENATE BILL 1955 By: Standridge
36	35
37	36
38	37
39	38
	39	+
	40	+	COMMITTEE SUBSTITUTE
40	41
41	42		An Act relating to the Patient’s Right to Pharmacy
42	43		Choice Act; defining terms; authorizing cause of
43	44		action for certain violations; authorizing award of
44	45		certain costs and fees; requiring award of certain
45	46		damages upon specified sho wing by plaintiff;
46	47		authorizing joinder of certain actions; providing for
47	48		division of certain damage award; requiring certain
48	49		evidence; authorizing discovery of specified
49	50		information; authorizing intervention of Attorney
50	51		General; providing for codification; and declaring an
51	52		emergency.
52	53
53	54
54	55
55	56
56	57
57	58		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
58	59		SECTION 1. NEW LAW A new section of law to be codified
59	60		in the Oklahoma Statutes as Section 6696.2 of Title 36, unless there
60	61		is created a duplication in numbering, reads as follows:
61	62		A. As used in this act:
62	63		1. “Closely aligned pharmacy provider” means a pharmacy
63	64		provider wholly or partially owned by :
64	65		a. the pharmacy benefits manager (PBM),
65	66		b. an entity that owns any portion of the PBM,
66		-	c. an entity owned wholly or partially by the PBM, or
67	67
68		-	SENATE FLOOR VERSION - SB1955 SFLR Page 2
69		-	(Bold face denotes Committee Amendments) 1
	68	+	Req. No. 3481 Page 2 1
70	69		2
71	70		3
72	71		4
73	72		5
74	73		6
75	74		7
76	75		8
77	76		9
78	77		10
79	78		11
80	79		12
81	80		13
82	81		14
83	82		15
84	83		16
85	84		17
86	85		18
87	86		19
88	87		20
89	88		21
90	89		22
91	90		23
92	91		24
93	92
	93	+	c. an entity owned wholly or partially by the PBM, or
94	94		d. an entity closely aligned with the PBM which would be
95	95		established by any other working relationship between
96	96		the PBM and the pharmacy provider which would be
97	97		construed as being beneficial to the PBM ;
98	98		2. “Damages” includes, but is not limited to, the difference in
99	99		reimbursement between the plaintiff or plaintif fs and the highest
100	100		total reimbursement, including drug pricing and any associated
101	101		reimbursed costs, of a closely aligned ph armacy provider or any
102	102		pharmacy provider that would be considered in competition with the
103	103		plaintiff or plaintiffs provid ing pharmacy services to the PB M;
104	104		3. “Drug pricing” includes but is not limited to drug costs,
105	105		rebates, incentives, discounts, kickbacks, profits, spread pricing,
106	106		fees, and other pricing information that would cause a disparit y
107	107		between reimbursement for the plaintiff or plaintiffs and other
108	108		contracted pharmacy providers of the PBM ;
109	109		4. “Payment history” includes but is not limited to direct
110	110		payments, rebates, discounts, kickbacks, credits , or any other form
111	111		of benefit to the payee; and
112	112		5. “Pharmacy contract” means any contract between a PBM and a
113	113		pharmacy provider.
114	114		B. 1. A licensed pharmacy or pharmacist located in this state
115	115		who is aggrieved by a violation of the Patient’s Right to Pharmacy
116	116		Choice Act, Section 6959 et seq. o f Title 36 of the Oklahoma
117		-	Statutes, related to pricing models or reimbursement r ates by a
118	117
119		-	SENATE FLOOR VERSION - SB1955 SFLR Page 3
120		-	(Bold face denotes Committee Amendments) 1
	118	+	Req. No. 3481 Page 3 1
121	119		2
122	120		3
123	121		4
124	122		5
125	123		6
126	124		7
127	125		8
128	126		9
129	127		10
130	128		11
131	129		12
132	130		13
133	131		14
134	132		15
135	133		16
136	134		17
137	135		18
138	136		19
139	137		20
140	138		21
141	139		22
142	140		23
143	141		24
144	142
	143	+	Statutes, related to pricing models or reimbursement r ates by a
145	144		pharmacy benefits manager (PBM) or the entity for which the PBM
146	145		performs pharmacy benefits management shall have a cause of action
147	146		against the PBM or entity to recover damages attributable to such
148	147		violation. In addition to actual damages, a court may award c ourt
149	148		costs and reasonable attorney fees.
150	149		2. If a plaintiff shows that the disparity in reimbursement
151	150		between the amount the PBM reimburses the plaintiff and the amount
152	151		the PBM reimburses either a closely aligned pharmacy provider or any
153	152		pharmacy provider that would be considered in competition with the
154	153		plaintiff is financially harmful to the plaintiff while beneficial
155	154		to the other provider, then such damage will be considered
156	155		unnecessarily harmful to the plaintiff and the court shall award
157	156		damages to the plaintiff in an amount needed to cover the financial,
158	157		personal, and business harm that resulted from such unn ecessary
159	158		financial harm and an amount needed to bring the plaintiff to the
160	159		financial position tha t would have occurred if such unnecessary
161	160		financial harm was not inflicted.
162	161		3. If more than one licensed pharmacy or phar macist has similar
163	162		damages from the same PBM , such pharmacies or pharmacists may join
164	163		their cause of action and any damage award shall be divided among
165	164		the aggrieved parties according to the proportion of damages each
166	165		party sustained.
167	166
168		-	SENATE FLOOR VERSION - SB1955 SFLR Page 4
169		-	(Bold face denotes Committee Amendments) 1
	167	+	Req. No. 3481 Page 4 1
170	168		2
171	169		3
172	170		4
173	171		5
174	172		6
175	173		7
176	174		8
177	175		9
178	176		10
179	177		11
180	178		12
181	179		13
182	180		14
183	181		15
184	182		16
185	183		17
186	184		18
187	185		19
188	186		20
189	187		21
190	188		22
191	189		23
192	190		24
193	191
194	192		C. A licensed pharmacy or pharmacis t, or more than one of
195	193		either or both, filing an action pursuant to subsection B of this
196	194		section shall be required to :
197	195		1. Present evidence of a consistent reimbursement rate that is
198	196		less than the combined total of the cost of medication and the
199	197		average cost of dispensing the medication as recognized in t he
200	198		industry. Each plaintiff must show a minimum of twelve (12) such
201	199		instances in a ninety-day period to sustain a claim for damages
202	200		under this section; or
203	201		2. Present evidence that a PBM initiated an audit against th e
204	202		pharmacy or pharmacies in violation of the Pharmacy Audit Integr ity
205	203		Act.
206	204		D. In an action filed pursuant to this section, the plaintiff
207	205		or plaintiffs shall have rights of discovery in all relevant areas
208	206		to determine the existenc e of unfair, anti-competitive, or
209	207		monopolistic actions on behalf of the PBM. Such discovery may
210	208		include but not be limited to :
211	209		1. Payment history and pharmacy contracts for similar pharmacy
212	210		services to any closely aligned pharmacy provider or any pharmacy
213	211		provider that would be considered in compe tition with the plaintiff
214	212		or plaintiffs;
215	213		2. Communications related to the contract of the plaintiff or
216	214		plaintiffs;
217	215
218		-	SENATE FLOOR VERSION - SB1955 SFLR Page 5
219		-	(Bold face denotes Committee Amendments) 1
	216	+	Req. No. 3481 Page 5 1
220	217		2
221	218		3
222	219		4
223	220		5
224	221		6
225	222		7
226	223		8
227	224		9
228	225		10
229	226		11
230	227		12
231	228		13
232	229		14
233	230		15
234	231		16
235	232		17
236	233		18
237	234		19
238	235		20
239	236		21
240	237		22
241	238		23
242	239		24
243	240
244	241		3. Drug pricing or communications about drug pricing related to
245	242		the plaintiff or plaintiffs, any closely aligned pharmacy provider,
246	243		or contracted pharmacy providers of the PBM that would be considered
247	244		competitors of the plaintiff or plaintiffs; or
248	245		4. Any information or communication related to the disparity i n
249	246		reimbursement between the plaintiff or plaintiffs and any contracted
250	247		pharmacy provider of the PBM when such information or communication
251	248		would show anti-competitive or unfair business pract ices on the part
252	249		of the PBM.
253	250		E. In addition to the oversight and investigative authority
254	251		granted under the Patient’s Right to Pharmacy Choice Act, the
255	252		Attorney General may intervene in any action filed pursuant to
256	253		subsection B of this section.
257	254		SECTION 2. It being immediately necessary for the preservat ion
258	255		of the public peace, health or safety, an emergency is hereby
259	256		declared to exist, by reason whereof this act shall take effect and
260	257		be in full force from and after its passage and approval.
261		-	~~COMMITTEE REPORT BY: COMMITTEE ON RETIREMENT AND INSURAN CE~~
262		-	~~February~~ 13, 2024 ~~- DO PASS AS AMENDED BY CS~~
	258	+
	259	+	59-2-3481 RD 2/13/2024 3:09:14 PM