ENGR. H. B. NO. 2048 Page 1 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
ENGROSSED HOUSE
BILL NO. 2048 By: Stinson, Deck, Moore,
Archer and Hefner of the
House
and
Howard of the Senate
An Act relating to prescriptions; creating the 340B
Nondiscrimination Act; defining terms; prohibiting
certain discriminatory action s related to
reimbursement of certain entities; making certain
provisions inapplicable when Medicaid provides
reimbursement for covered drugs; prohibiting certain
discriminatory actions by a manufacturer or
distributor related to certain entities; establishing
contract requirement; providing construing provision;
authorizing the Insurance Department to establish
rules and regulations; providing for enforcement by
the Attorney General and Insurance Commissioner;
providing for violations and the levying of ci vil
fines; allowing for the sharing of certain
information; requiring entities to keep information
confidential; providing an exception ; providing for
federal preemption; providing for severability;
amending 36 O.S. 2021, Sections 6960 and 6962, as
last amended by Sections 1 and 2, Chapter 306, O.S.L.
2024, and Section 3, Chapter 38 , O.S.L. 2022, as last
amended by Section 4, C hapter 306, O.S.L. 2024 (36
O.S. Supp. 2024, Sections 6960, 6962 , and 6966.1),
which relate to the Patient's Right to Pharmacy
Choice Act; defining terms; prohibiting certain
actions by pharmacy benefits managers (PBMs) or
agents of a PBM; providing additional requirements
for PBM contracts; requiring PBMs to make certain
drug formulary and coverage decisions; deeming all
processed claims final at point of adjudication;
providing for codification; and providing an
effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
ENGR. H. B. NO. 2048 Page 2 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statute s as Section 5400 of Title 36, unless there
is created a duplication in numbering, reads as follows:
This act shall be known and may be cited as the "340B
Nondiscrimination Act".
SECTION 2. NEW LAW A new section of law to be codifie d
in the Oklahoma Statutes as Section 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 pursuant 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 benefits manager" means a person that performs
pharmacy benefits manageme nt and any other person acting for such
ENGR. H. B. NO. 2048 Page 3 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
person under 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.
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, rea ds as follows:
A. With respect to reimbursement to a 340B entity for 340B
drugs, a health insur ance issuer, pharmacy benefit s manager, other
third-party payor, or its agent shall not:
1. Reimburse a 340B entity for 340B drugs at a rate lower than
that paid for the same drug to entities that are not 340B entities
or lower reimbursement for a claim on the basis that the claim is
for a 340B drug;
2. 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 non -340B entities on the basis that the entity
participates in the federal 340B drug discount program set forth in
Section 256b of Title 42 of the United States Code or that a drug is
a 340B drug including, without limitation , any of the following:
a. fees, charges, clawbacks, or other adjustments or
assessments. For purposes of this subsection, the
term "other adjustments" includes placing any
ENGR. H. B. NO. 2048 Page 4 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
additional requirements, restrictions, or unnecessary
burdens upon the 340B entity that result in
administrative costs or fees to the 340B entity that
are not placed upon other e ntities that do not
participate in the 340B drug discount program,
including affiliate pharmacies of the health insurance
issuer, pharmacy benefit s manager, or other third-
party payor,
b. dispensing fees that are less than the dispensing fees
for non-340B entities,
c. restrictions or requirements regarding participation
in standard or preferred pharmacy networks,
d. requirements relating to the frequency or scope of
audits of inventory management systems,
e. 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
f. any other restrictions, conditions, practices, or
policies that are not imposed on non -340B entities;
ENGR. H. B. NO. 2048 Page 5 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
3. Require a 340B entity to reverse, resubmit, or clarify a
claim after the initial adjudication unles s these actions are in the
normal course of pharmacy business and not related to 340B drug
pricing;
4. Discriminate against a 340B entity in a manner that prev ents
or interferes with any patient '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
practice that prevents or interferes with a patient 's choice to
receive drugs at a 340B entity if a health insurance issuer,
pharmacy benefits manager, or other third-party payor places any
additional requirements, restrictions, or unnecessary burdens upon
the 340B entity that results in administrative costs o r fees to the
340B entity, including 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 and Medicaid Services or the Oklahoma Health Care Authority
in administration of the Oklahoma Medicaid program ;
5. Include any other provision in a contract between a health
insurance issuer, pharmacy benefit s manager, or other third-party
payor and a 340B entity 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
ENGR. H. B. NO. 2048 Page 6 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
of the drug, in person or via direct deli very, mail, or other form
of shipment, or creation of a restriction or additional charge on a
patient who chooses to receive drugs from a 340B entity ;
6. Require or compel the submission of ingredient costs or
pricing data pertaining to 340B drugs to any health insurance
issuer, pharmacy benefit s manager, or other third -party payor; or
7. Exclude any 340B entity from the health insurance issuer,
pharmacy benefits 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 s Code, or
refusing to contract with a 340B entity for reasons other than those
that apply equally to non -340B entities.
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 of law to be codified
in the Oklahoma Statu tes as Section 5403 of Title 36, unless there
is created a duplication in numbering, reads as fo llows:
A. A manufacturer shall not deny, restrict, prohibit, or
otherwise interfere with, either directly or indirectly, the
acquisition of a 340B drug by, or delivery of a 340B drug to a 340B
entity, unless such receipt is prohibited by the United States
Department of Health and Human Services.
ENGR. H. B. NO. 2048 Page 7 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
B. A manufacturer shall not interfere with a pharmacy
contracted with a 340B entity.
C. A 340B entity shall contract with any willing pharmacy upon
mutually agreeable terms within a fifteen -mile radius of the 340 B
entity's location.
D. Nothing in this section shall be construed to limit the
number of pharmacies that a 340B entity shall be allowed to contract
with.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 5404 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. The Insurance Department is authorized to establish r ules
and regulations interpreting the provisions of this act concerning
health insurers. The De partment is responsible for enforcing this
act specifically with respect to health insurers. It may levy civil
fines ranging from One Hundred Dollars ($100.00) to Ten Thousand
Dollars ($10,000.00) per violation of this act. This section does
not prevent the Insurance Department from seeking assistance from
the Attorney General in enforcing this act or limit the Insurance
Departments ability to regulate the lice nsing of pharmacy benefit
managers. Each instance of a prohibited act constitutes a separate
violation.
B. The Attorney General is authorized to establish rules and
regulations interpreting the provisions of this act and concerning
ENGR. H. B. NO. 2048 Page 8 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
any person or entity w ho is not a health insurer subject to
enforcement by the Insurance Department. The Attorney General may
impose civil fines of not less than One Hundred Dollars ($100.00)
and not greater than Ten Thousand Dollars ($10,000.00) for each
violation of the prov isions of this act.
C. Nothing shall prohibit the Attorney General’s Office or the
Insurance Department from sharing any information with each other as
a part of an investigation regarding conduct that is prohibited by
this act. Any information shared be tween the Attorney General’s
Office and the Insurance Department shall be kept confidential
unless it is used during an enforcement action authorized by this
act, the disclosing agency has authorized such disclosure, or the
information is publicly availabl e.
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
ENGR. H. B. NO. 2048 Page 9 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
2. Other laws of this state if the state la w is compatible with
applicable federal law.
C. Limited distribution of a drug required under Section 355-1
of Title 21 of the United States Code is not to be construed as a
violation of this section.
D. If any provision of this act, an amendment made by this act,
or the application of such provision or amendment to any person or
circumstance is held to be unconstitutional, the remainder of this
act, the amendments made by this act, and the application of the
provisions of such to any person or circumstan ce shall not be
affected thereby.
SECTION 7. AMENDATORY 36 O.S. 2021, Section 6960, as
last amended by Section 1, Chapter 306, O.S.L. 2024 (36 O.S. Supp.
2024, Section 6960), is amended to read as follows:
Section 6960. A. For purposes of the Patient’s Right to
Pharmacy Choice Act:
1. “340B drug pricing” means the pricing agreement established
under Section 602 of the Veterans Health Care Act of 1992, Pub. L.
No. 102-585;
2. “340B entity” means a covered entity as that term is defined
in 42 U.S.C., Section 256b ;
3. “Covered entity” means a nonprofit hospital or medical
service organization, for -profit hospital or medical service
organization, insurer, health benefit plan, health maintenance
ENGR. H. B. NO. 2048 Page 10 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
organization, health program administered by the state in the
capacity of providing health coverage, or an employer, labor union,
or other group of persons that provides health coverage to persons
in this state. This term does not include a health plan that
provides coverage only for acciden tal injury, specified disease,
hospital indemnity, disability income, or other limited benefit
health insurance policies and contracts that do not include
prescription drug coverage;
2. 4. “Health insurer” means any corporation, association,
benefit society, exchange, partnership or individual licensed by the
Oklahoma Insurance Code;
3. 5. “Health insurer payor” means a health insurance company,
health maintenance organization, union, hospital and medical
services organization or any entity providing or a dministering a
self-funded health benefit plan;
4. 6. “Mail-order pharmacy” means a pharmacy licensed by this
state that primarily dispenses and delivers cover ed drugs via common
carrier;
5. 7. “Pharmacy benefits manager” or “PBM” means a person,
business, or other entity that performs pharmacy benefits
management. The term shall include a person or entity acting on
behalf of a PBM in a contractual or employme nt relationship in the
performance of pharmacy benefits management for a managed care
company, nonprofit hospital, medical service organization, insurance
ENGR. H. B. NO. 2048 Page 11 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
company, third-party payor or a health program administered by a
department of this state;
6. 8. “Pharmacy benefits management” means a service provided
to covered entities to facilitate the provisions of prescription
drug benefits to covered individuals within the state, including,
but not limited to, negotiating pricing and other terms with drug
manufacturers and providers. Pharmacy benefits management may
include any or all of the following ser vices:
a. claims processing, retail network management, and
payment of claims to pharmacies for prescription drugs
dispensed to covered individuals,
b. administration or management of pharmacy discount
cards or programs,
c. clinical formulary development and management
services, or
d. rebate contracting and administration;
7. 9. “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;
8. 10. “Retail pharmacy network” means r etail pharmacy
providers contracted with a PBM in which the pharmacy primarily
fills and sells prescriptions via a retail, storefront location;
ENGR. H. B. NO. 2048 Page 12 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
9. 11. “Rural service area” means a five -digit ZIP code in
which the population density is less than one thousand (1,000)
individuals per square mile;
10. 12. “Spread pricing” means a prescription drug pricing
model utilized by a pharmacy benefits manager in which the P BM
charges a health benefit plan a contracted price for prescription
drugs that differs from the amount the PBM directly or indirectly
pays the pharmacy or pharmacist for providing pharmacy services;
11. 13. “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) individuals per square mile; and
12. 14. “Urban service area” means a five -digit ZIP code in
which the population density is greater than three thousand (3,000 )
individuals per square mile.
B. Nothing in the definitions of pharmacy benefits manager or
pharmacy benefits management as such terms are defined in the
Patient’s Right to Pharmacy Choice Act, the Pharmacy Audit Integrity
Act, or Sections 357 through 36 0 of Title 59 of the Oklahoma
Statutes shall be construed to deem the following entities to be a
pharmacy benefits manager:
1. An employer of its own self -funded health benefit plan,
except, to the extent permitted by applicable law, where the
employer without the utilization of a third party and unrelated to
the employer’s own pharmacy:
ENGR. H. B. NO. 2048 Page 13 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
a. negotiates directly with drug manufacturers,
b. processes claims on behalf of its members, or
c. manages its own retail network of pharmacies; or
2. A pharmacy that pr ovides a patient with a discount card or
program that is for exclusive use at the pharmacy offering the
discount.
SECTION 8. AMENDATORY 36 O.S. 2021, Section 6962, as
last amended by Section 2, Chapter 306, O.S.L. 2024 (36 O.S. Su pp.
2024, Section 6962), is amended to read as follows:
Section 6962. A. The Attorney General shall review and approve
retail pharmacy network access for all pharmacy benefits managers
(PBMs) to ensure compliance 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, proposal or offer that is
untrue, deceptive or misleading;
2. Charge a pharmacist or pharmacy 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;
ENGR. H. B. NO. 2048 Page 14 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
3. Reimburse a pharmacy or pharmacist in the state an amount
less than the amount that the PBM reimburses a pharmacy owned by or
under common ownership with a PBM for providing the same covered
services. The reimbu rsement amount paid to the pharmacy shall be
equal to the reimbursement amount calculated on a p er-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 opportu nity to participate in any
pharmacy network at preferred participation status if the provider
is willing to accept the terms and conditions that the PBM has
established for other providers as a condition of preferred network
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, with the State Board of
Pharmacy;
6. Retroactively deny or reduce 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 fraudulently, 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;
ENGR. H. B. NO. 2048 Page 15 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
7. Fail to make any payment due to a pharmacy or pharmacist for
covered services properly rendered in the event a PBM terminates a
provider from a pharmacy benefits manager network;
8. Conduct or practice spread pricing, as defined in Section
6960 of this title, in this state; or
9. Charge a pharmacist or pharmacy a fee related to
participation in a retail 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 ;
10. Discriminate, offer lower reimbursement, or impose any
separate terms upon a provider on the basis that a provider
participates in 340B drug pricing;
11. Require a provider to reverse, resubmit, or clarify a 340B
drug pricing claim after the initial adjudication unless these
actions are in the normal course of pharmacy business and not
related to 340B drug pricing;
12. Require a billing modifier to indicate that the drug or
claim is a 340B drug pricing claim, unless the drug or claim is
being billed to the Oklahoma Medicaid Program;
ENGR. H. B. NO. 2048 Page 16 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
13. Modify a patient copayment on the basis that the provider
of the patient participates in 340B drug pricing;
14. Exclude a provider from a network on the basis that the
provider participates in 340B drug pricing;
15. Establish or set network adequacy requirements ba sed on
340B drug pricing participation by a provider;
16. Prohibit a 340B entity or a pharmacy under contract with a
340B entity from participating in the network of the PBM on the
basis of participation in 340B drug pricing; or
17. Base the drug formulary or drug coverage decisions upon the
340B drug pricing status of a drug, including price or availability,
or whether a dispensing pharmacy participates in 340B drug pricing .
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 prescription drug from informing, or
penalize such pharmacy for informing, a n 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
ENGR. H. B. NO. 2048 Page 17 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
b. ensure that any entity that provides pharmacy bene fits
management services under a contract with any such
health plan or health insurance coverage does not,
with respect to such plan or coverage, restrict,
directly or indirectly, a pharmacy that dispenses a
prescription drug from informing, or penalize su ch
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 us ing
any health plan or health insurance coverage , and
c. eliminate discriminatory contracting a s it relates to:
(1) transferring the benefit of 340B drug pricing
savings from a 340B entity to another entity,
including without limitation pharmacy benefits
managers, private insurers, and managed care
organizations,
(2) offering a lower reimbursement rate for drugs
purchased under 340B drug pricing than for the
same drug not purchased under 340B drug pricing,
(3) refusal to cover drug purchases utilizing 3 40B
drug pricing,
ENGR. H. B. NO. 2048 Page 18 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
(4) refusal to allow providers who utilize 340B drug
pricing to participate i n networks, and
(5) charging more than fair market value or seeking
profit sharing in exchange for services involving
340B drug pricing.
2. A pharmacy benefit s manager’s contract with a provider shall
not prohibit, restrict, or limit disclosure of information or
documents to the Attorney General, law enforcement or state and
federal governmental officials investigating or examining a
complaint or conducting a r eview of a pharmacy benefits manager’s
compliance with the requirements under the Patient’s Righ t to
Pharmacy Choice Act, the Pharmacy Audit Integrity Act, and Sections
357 through 360 of Title 59 of the Oklahoma Statutes.
D. A pharmacy benefits manager s hall:
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;
2. Fully disclose to insurers, self-funded employers, unions or
other PBM clients the existence of the respective aggregate
prescription drug discounts, rebates received 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
ENGR. H. B. NO. 2048 Page 19 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 lim ited to
contract negotiations and any denials to providers to join networks.
This documentation shall be made available to the Attorney General
upon request; and
5. Report to the Attorney General, on a quarterly basis for
each health insurer payor, on the following information:
a. the aggregate amount of rebates received by the PBM,
b. the aggregate amount of rebates distributed to the
appropriate health insure r payor,
c. the aggregate amount of rebates passed on to the
enrollees of each health insurer pa yor at the point of
sale that reduced the applicable deductible,
copayment, coinsure or other cost sharing amount of
the enrollee,
d. the individual and aggrega te amount paid by the health
insurer payor to the PBM for pharmacy services
itemized by pharmacy, drug product and service
provided, and
ENGR. H. B. NO. 2048 Page 20 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
e. the individual and aggregate amount a PBM paid a
provider for pharmacy services itemized by pharmacy,
drug product and service provided;
6. Make drug formulary and coverage decisions based on the
normal course of business of the PBM, not based upon the 340B drug
pricing status of a drug, including price or availability, or
whether a dispensing pharmacy participates in 340B drug pricing.
E. 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 requ ired by this section. The
Attorney General may alter the frequency of the reports required by
this section at his or her sole discretion.
F. The Attorney General may promulgate rules to implement the
provisions of the Patient’s Right to Pharmacy Choice A ct, the
Pharmacy Audit Integrity Act, and Sections 357 through 360 of Title
59 of the Oklahoma Statutes.
SECTION 9. AMENDATORY Section 3, Chapter 38, O.S.L.
2022, as last amended by Section 4, Chapter 306, O.S.L. 2024 (36
O.S. Supp. 2024, Section 6966.1), is amended to read as follows:
Section 6966.1. A. The Insurance Comm issioner 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
ENGR. H. B. NO. 2048 Page 21 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
of this state for any violation of the Patient’s Right to Pharmacy
Choice Act, Section 6958 et seq. of 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 pro visions of the Patient’s Right to Pharmacy
Choice Act, the Pharmacy Audit Integrity Act or the p rovisions of
Sections 357 through 360 of Title 59 of the Oklahoma Statutes, the
Attorney General may instruct the Insurance Commissioner that the
PBM be censured or his or her license be suspended or revoked. If
the Attorney General makes such instruction, the Commissioner shall
enforce such action within thirty (30) days.
2. In addition to or in lieu of any censure or suspension or
revocation of a license by t he Commissioner, the Attorney General
may levy a civil or administrative fine 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 the Patient’s
Right to Pharmacy Choice Act, the Pharmacy Audit Integrity Act or
the provisions of Sections 357 through 360 of Title 59 of the
Oklahoma Statutes.
3. The Attorney General may order restitution for economic loss
suffered by pharmacies or patients for violations of the Patient’s
Right to Pharmacy Choice Act, the Pharmacy Audit Integrity Act, or
the provisions of Sections 357 through 360 of Title 59 of the
Oklahoma Statutes.
ENGR. H. B. NO. 2048 Page 22 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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 Choice Act and impose
any penalty or remedy authorized under the act against a PBM under
investigation for or charged with a violation of the Patient’s Right
to Pharmacy Choice Act, the Pharmacy Audit Integrity Act, the
provisions of Sections 357 through 360 of Title 59 of the Oklahoma
Statutes or any provision of the insurance laws of this state.
D. Each day that a PBM conducts busines s in this state 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 hel d 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 full 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
ENGR. H. B. NO. 2048 Page 23 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
the hearing examiner against the respondent unless the respondent 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, the
Pharmacy Audit Integrity A ct, and Sections 357 through 360 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 those practices, the Attorney
General may require the PBM to file a report at any periodic
interval the Attorney General deems necessary.
H. 1. The Attorney General shall have the authority to collect
all fines, penalties, restitution, and interest thereon pursuant to
the provisions of the Patient’s Right to Pharmacy Choice Act, the
Pharmacy Audit Integrity Act, and the provisions of Sections 357
through 360 of Title 59 of the Oklahoma Statutes, or any othe r
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
ENGR. H. B. NO. 2048 Page 24 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
collected by the Attorney General pursuant to the Patient’s Right t o
Pharmacy Choice Act, the Pharmacy Audit Integrity Act, and Sections
357 through 360 of Title 5 9 of the Oklahoma Statutes shall be
deposited into the Attorney General’s Pharmacy Benefits Manager
Enforcement Revolving Fund created in Section 5 of this act.
2. Costs of investigation, litigation, attorney fees, and other
expenses incurred shall be retained by the Office of the Attorney
General. Remaining funds shall be distributed to pharmacists,
patients, or other injured parties as determined by the Attor ney
General.
3. The Attorney General shall promulgate rules for the
distribution of funds pursu ant to this subsection.
I. All claims processed by a PBM on behalf of a provider that
participates in 340B drug pricing or on behalf of a 340B entity
shall be deemed final at the point of adjudication.
SECTION 10. This act shall become effective November 1, 2025.
ENGR. H. B. NO. 2048 Page 25 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Passed the House of Representatives the 26th day of March, 2025.
Presiding Officer of the House
of Representatives
Passed the Senate the ___ day of ___________, 2025.
Presiding Officer of the Senate