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53	53	STATE OF OKLAHOMA
54	54
55	55	1st Session of the 60th Legislature (2025)
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57	57	SENATE BILL 1063 By: Rosino
58	58
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63	63	AS INTRODUCED
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65	65	An Act relating to prescriptions; creating the
66	66	Oklahoma Health Care Safety Net and Affordable
67	67	Prescriptions Accessibility Act; providing short
68	68	title; defining terms; prohibiting certain
69	69	discriminatory actions related to reimbursement of
70	70	certain entities; prohibiting certain discriminatory
71	71	actions by a manufacturer or distributor related to
72	72	certain entities; providing for enforcement by the
73	73	Attorney General and Insurance Commissioner;
74	74	providing for violations; providi ng for federal
75	75	preemption; providing for noncodification; providing
76	76	for codification; and providing an effective date .
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81	81	BE IT ENACTED BY THE PEOPLE OF THE STATE OF OK LAHOMA:
82	82	SECTION 1. NEW LAW A new section of law not to be
83	83	codified in the Oklahoma Statutes reads as follows:
84	84	This act shall be known and may be cited as the “Oklahoma Health
85	85	Care Safety Net and Affordable Prescriptions Accessibilit y Act”.
86	86	SECTION 2. NEW LAW A new section of law to be c odified
87	87	in the Oklahoma Statutes as Section 5400 of Title 36, unless there
88	88	is created a duplication in numbering, reads as follows:
89	89	As used in this act:
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141	141	1. “340B drug” means a drug that has been subject to any offer
142	142	for reduced prices by a manufacturer pursuant to 42 U.S.C., Section
143	143	256b, and is purchased by a covered entity as defined in 42 U.S.C.,
144	144	Section 256b(a)(4);
145	145	2. “340B entity” means an entity participating or authorize d to
146	146	participate in the federal 340B drug discount program, as described
147	147	in 42 U.S.C., Section 256b, including its pharmacy, or any pharmacy
148	148	contracted with the participating entity to dispense drugs purchased
149	149	through the 340B drug discount program;
150	150	3. “Pharmacy” means a pharmacy licensed by the State Board of
151	151	Pharmacy, except that patients who are provided pharmacy care shall
152	152	be physically located in the state; and
153	153	4. “Pharmacy benefits manager” means a person that performs
154	154	pharmacy benefits management a nd any other person acting for such
155	155	person under a contractual or employment re lationship in the
156	156	performance of pharmacy benefits management for a managed care
157	157	company, nonprofit hospital, medical service organization, insurance
158	158	company, third-party payor, or a health program administered by a
159	159	department of this state.
160	160	SECTION 3. NEW LAW A new section of law to be codified
161	161	in the Oklahoma Statutes as Section 5401 of Title 36, unless there
162	162	is created a duplication in numbering, reads as follows:
163	163
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214	214	A. 1. With respect to reimbursement to a 340B entity for 340B
215	215	drugs, a health insurance issuer, pharmacy benefit s manager, other
216	216	third-party payor, or its agent shall not:
217	217	a. reimburse a 340B entity for 340B drugs at a rate lower
218	218	than that paid for the same drug to entities that are
219	219	not 340B entities or lower reimbursement for a claim
220	220	on the basis that the claim is for a 340B drug,
221	221	b. impose any terms or conditions on any 340B entity with
222	222	respect to any of the following that differ from such
223	223	terms or conditions applied to non -340B entities on
224	224	the basis that the entity pa rticipates in the federal
225	225	340B drug discount program set forth in 42 U.S.C.,
226	226	Section 256b, or that a drug is a 340B drug . Such
227	227	terms and conditions shall include, but not be limited
228	228	to, any of the following:
229	229	(1) fees, charges, clawbacks, or other adjustments or
230	230	assessments. For purposes of this subsection,
231	231	the term “other adjustments” includes placing any
232	232	additional requirements, restrictions, or
233	233	unnecessary burdens upon the 34 0B entity that
234	234	result in administrative costs or fees to the
235	235	340B entity that are not placed upon other
236	236	entities that do not participate in the 340B drug
237	237	discount program, including affiliate pharmacies
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289	289	of the health insurance issuer, pharmacy benefit s
290	290	manager, or other third -party payor,
291	291	(2) dispensing fees that are less than the dispensing
292	292	fees for non-340B entities,
293	293	(3) restrictions or requirements regarding
294	294	participation in standard or preferred pharmacy
295	295	networks,
296	296	(4) requirements relating to the freque ncy or scope
297	297	of audits of inventory management systems,
298	298	(5) requirements that a claim for a drug include any
299	299	identification, billing modifier, attestation, or
300	300	other indication that a drug is a 340B drug in
301	301	order to be processed or resubmitted unless it is
302	302	required by the Centers for Medicare and Medicaid
303	303	Services or the Oklahoma Health Care Authority
304	304	for the administration of the Oklahoma Medicaid
305	305	program, or
306	306	(6) any other restrictions, conditions, practices, or
307	307	policies that are not imposed on non -340B
308	308	entities,
309	309	c. require a 340B entity to reverse, resubmit, or clarify
310	310	a claim after the initial adjudication unless these
311	311	actions are in the normal course of pharmacy business
312	312	and not related to 340B drug pricing,
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364	364	d. discriminate against a 340B entity in a mann er that
365	365	prevents or interferes with any patient ’s choice to
366	366	receive such drugs from the 340B entity, including the
367	367	administration of such drugs. For purposes of this
368	368	subsection, it is considered a discriminatory practice
369	369	that prevents or interferes with a patient’s choice to
370	370	receive drugs at a 340B entity if a health insurance
371	371	issuer, pharmacy benefits manager, or other third -
372	372	party payor places any additional requirements,
373	373	restrictions, or unnecessary burdens upon the 340B
374	374	entity that results in administra tive costs or fees to
375	375	the 340B entity, including , but not limited to,
376	376	requiring a claim for a drug to include any
377	377	identification, billing modifier, attestation, or
378	378	other indication that a drug is a 340B drug in order
379	379	to be processed or resubmitted unless i t is required
380	380	by the Centers for Medicare and Medicaid Services or
381	381	the Oklahoma Health Care Authority in administration
382	382	of the Oklahoma Medicaid program,
383	383	e. include any other provision in a contract between a
384	384	health insurance issuer, pharmacy benefit s manager, or
385	385	other third-party payor and a 340B entity that
386	386	discriminates against the 340B entity or prevents or
387	387	interferes with an individual ’s choice to receive a
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439	439	prescription drug from a 340B entity, including the
440	440	administration of the drug, in person or via direct
441	441	delivery, mail, or other form of shipment, or creation
442	442	of a restriction or additional charge on a patient who
443	443	chooses to receive drugs from a 340B entity,
444	444	f. require or compel the submission of ingredient costs
445	445	or pricing data pertaining to 340B dr ugs to any health
446	446	insurance issuer, pharmacy benefit s manager, or other
447	447	third-party payor, or
448	448	g. exclude any 340B entity from the health insurance
449	449	issuer, pharmacy benefit s manager, or other third -
450	450	party payor network on the basis that the 340B entity
451	451	dispenses drugs subject to an agreement under 42
452	452	U.S.C., Section 256b, or refuse to contract with a
453	453	340B entity for reasons other than those that apply
454	454	equally to non-340B entities.
455	455	B. Nothing in this section applies to the Oklahoma Medicaid
456	456	program as payor when Medicaid provides reimbursement for covered
457	457	outpatient drugs as defined in 42 U.S.C., Section 1396r-8(k).
458	458	SECTION 4. NEW LAW A new section of law to be codified
459	459	in the Oklahoma Statutes as Section 5402 of Title 36, unless there
460	460	is created a duplication in numbering, reads as follows:
461	461	A. A manufacturer or distributor shall not deny, restrict,
462	462	prohibit, or otherwise interfere with, either directly or
463	463
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514	514	indirectly, the acquisition of a 340B drug by, or delivery of a 340B
515	515	drug to, a pharmacy that is under contract with a 340B entity and is
516	516	authorized under such contract to receive and dispense 340B drugs on
517	517	behalf of the covered entity unless such receipt is prohibited by
518	518	the United States Department of Health and Human Services.
519	519	B. A manufacturer or distributor shall not interfere with a
520	520	pharmacy contracted wit h a 340B entity.
521	521	SECTION 5. NEW LAW A new section of law to be codified
522	522	in the Oklahoma Statutes as Section 5403 of Title 36, unless there
523	523	is created a duplication in numbering, reads as follows:
524	524	A. The Attorney General may make rules and regulations
525	525	interpreting the provisions of this act, and shall make
526	526	recommendations to the Insurance Commissioner for enforcement with
527	527	the jurisdiction of the Insurance Commissioner.
528	528	B. The Insurance Commissioner may censure, suspend, revoke, or
529	529	refuse to issue or renew a license of or levy a civil penalty
530	530	against any person licensed under the insurance laws of this state
531	531	for any violation of this act.
532	532	C. In addition to or in lieu of any applicable censure,
533	533	suspension, or revocation of a license, a manufacturer, distributor,
534	534	health insurance issuer, pharmacy benefit s manager, other third -
535	535	party payor, or its agent may be subject to a civil fine not less
536	536	than One Hundred Dollars ($100.00) and not greater than Ten Thousand
537	537
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588	588	Dollars ($10,000.00) for eac h violation of the provisions of this
589	589	act. A violation occurs each time a prohibited act is committed.
590	590	SECTION 6. NEW LAW A new section of law to be cod ified
591	591	in the Oklahoma Statutes as Section 5404 of Title 36, unless there
592	592	is created a duplication in numbering, reads as follows:
593	593	A. Nothing in this section is to be construed or applied to be
594	594	less restrictive than federal law for a person or entity regul ated
595	595	by this act.
596	596	B. Nothing in this act is to be construed or applied to be i n
597	597	conflict with any of the following:
598	598	1. Applicable federal law and related regulations; or
599	599	2. Other laws of this state if the state law is compatible with
600	600	applicable federal law.
601	601	C. Limited distribution of a drug required under 21 U.S.C.,
602	602	Section 355-1, is not to be construed as a violation of this
603	603	section.
604	604	SECTION 7. This act shall become effective November 1, 2025.
605	605
606	606	60-1-759 CAD 1/16/2025 3:01:37 PM

Oklahoma 2025 Regular Session

Oklahoma Senate Bill SB1063 Compare Versions