Oklahoma 2025 2025 Regular Session

Oklahoma Senate Bill SB993 Introduced / Bill

Filed 01/16/2025

                     
 
 
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STATE OF OKLAHOMA 
 
1st Session of the 60th Legislature (2025) 
 
SENATE BILL 993 	By: Gollihare 
 
 
 
 
 
AS INTRODUCED 
 
An Act relating to pharmacy benefit managers; 
amending 59 O.S. 2021, Sections 356.1, 356.2, 356.3, 
as amended by Sections 1, 2, and 3, Chapter 332, 
O.S.L. 2024, and 356.4 (59 O.S. Supp. 2024, Sections 
356.1, 356.2, and 356.3), which relate to 
definitions, pharmacy audit requirements, appeals 
process, and prohibited extrapolation audit; 
modifying notice contents ; prohibiting assessment of 
certain fines under certain circumstances; expanding 
certain claim limits; es tablishing requirements for 
preliminary audit findings reports; requiring 
provision of certain final audit results within a 
certain time period; updating statutory reference; 
requiring certain notification to Attorney General in 
certain circumstances; expanding requirement for 
initiation of certain audit; lengthening time period 
for certain preliminary report; allowing certain 
extension request; shortening certain time period for 
certain final report; establishing requirements for 
audit findings report; mod ifying definition; defining 
terms; requiring certain tolling in certain declared 
disaster; providing certain exceptions; amending 59 
O.S. 2021, Sections 357 and 358, as amended b y 
Sections 4 and 5, Chapter 332, O.S.L. 2024 (59 O.S. 
Supp. 2024, Sections 357 and 358), which relate to 
definitions and pharmacy benefits management 
licensure; defining terms; updating statutory 
references; requiring certain time period of tolling 
in certain declared disaster; establishing certain 
filing period after lifting of dis aster declaration; 
prohibiting certain denials; and declaring an 
emergency. 
 
 
   
 
 
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BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: 
SECTION 1.     AMENDATORY     59 O.S. 2021, Section 356.1, as 
amended by Section 1, Chapter 332, O.S.L. 2024 (59 O.S. Supp. 2024, 
Section 356.1), is amended to read as follows: 
Section 356.1.  A.  For purposes of the Pharmacy Audit Integrity 
Act, “pharmacy benefits manager ”: 
1. “Pharmacy benefits manager” or “PBM” shall have the same 
meaning as in Section 6960 of Title 36 of the Oklahoma Statutes ; 
2.  “Audit” means any review, inspection, or analysis conducted 
by a PBM or its representative of a pharmacy ’s records, practices, 
or compliance with contractual obligations; and 
3.  “Disaster declaration” and “declared disaster” means a 
declaration issued by the Governor of this state or the President of 
the United States for an event that qualifies as a disaster 
including, but not limited to, floods, tornadoes, earthquakes, 
wildfires, terrorist attacks, o r other catastrophic events . 
B.  The purpose of the Pharmacy Audit Integrity Act is to 
establish minimum and uniform standards and criteria for the audit 
of pharmacy records by o r on behalf of certain entities. 
C.  The Pharmacy Audit Integrity Act shall apply to any audit of 
the records of a pharmacy conducted by a managed care company, 
nonprofit hospital, medical service organization, insurance company, 
third-party payor, pharmac y benefits manager, a health program   
 
 
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administered by a department of this stat e, or any entity that 
represents these companies, groups, or departments. 
D.  The Attorney General may promulgate rules to implement the 
provisions of the Pharmacy Audit Integrit y Act. 
SECTION 2.     AMENDATORY     59 O.S. 2021, Section 356.2, as 
amended by Section 2, Chapter 332, O.S.L. 2024 (59 O.S. Supp. 2024, 
Section 356.2), is amended to read as follows: 
Section 356.2. A.  The entity conducting an audit of a pharmacy 
shall: 
1.  Identify and specifically describe the audit and appeal 
procedures in the pharmacy contract.  Prescription claim 
documentation and record -keeping requirements shall not exceed the 
requirements set forth by the Oklahoma Pharmacy Act or other 
applicable state or federal laws or regulations; 
2.  Give the pharmacy written notice by certified letter to the 
pharmacy and the pharmacy ’s contracting agent, including 
identification of specific prescription numbers and, fill dates, 
drug name, and National Drug Code (NDC) number to be audited, at 
least fourteen (14) calenda r days prior to conducting the audit, 
including, but not limited to, an on -site audit, a desk audit, or a 
wholesale purchase audit, request for documentation related to the 
dispensing of a prescription drug or any reimbursed activity by a 
pharmacy provider; provided, however, that wholesale purchase audits 
shall require a minimum of thirty (30) calendar days ’ written   
 
 
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notice.  For an on-site audit, the audit date shall be the date the 
on-site audit occurs.  For all other audit types, the audit date 
shall be the date the pharmacy provides the documentation requested 
in the audit notice.  The pharmacy shall have the opportunity to 
reschedule the audit no more than seven (7) calendar d ays from the 
date designated on the original audit notification; 
3.  Not interfere with the delivery of pharmacist services to a 
patient and shall utilize every reasonable effort to minimize 
inconvenience and disruption to pharmacy operations during the au dit 
process; 
4.  Conduct any audit involving clinical or professional 
judgment by means of or in consultation with a licensed pharmacist; 
5.  Not consider as fraud any clerical or record -keeping error, 
such as a typographical error, scrivener ’s error or computer error, 
including, but not limited to, a miscalculated day supply, 
incorrectly billed prescription written date or prescription origin 
code, and such errors shall not be subject to recoupment.  The 
pharmacy shall have the right to submit amended clai ms 
electronically to correct clerical or record -keeping errors in lieu 
of recoupment.  To the extent that an audit results in the 
identification of any clerical or record -keeping errors such as 
typographical errors, scrivener ’s errors or computer errors in a 
required document or record, the pharmacy shall not be subject to 
recoupment of funds by the pharmacy benefits manager unless the   
 
 
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pharmacy benefits manager can provide proof of intent to commit 
fraud.  A person shall not be subject to criminal penalties for 
errors provided for in this paragraph without proof of intent to 
commit fraud; 
6.  Permit a pharmacy to use the records of a hospital, 
physician, or other authorized practitioner of the healing arts for 
drugs or medicinal supplies written or transmitt ed by any means of 
communication for purposes of validating the pharmacy record with 
respect to orders or refills of a legend or narcotic drug; 
7.  Not include the dispensing fee amount or the actual invoice 
cost of the prescription dispensed in a finding of an audit 
recoupment unless a prescription was not actually dispensed or a 
physician denied authorization of a dispensing order; 
8.  Audit each pharmacy under identical standards, regularity 
and parameters as other similarly situated pharmacies and all 
pharmacies owned or managed by the pharmacy benefits manager 
conducting or having conducted the audit; 
9.  Not exceed one (1) year from the date the claim was 
submitted to or adjudicated by a managed care company, nonprofit 
hospital or medical service organ ization, insurance company, third -
party payor, pharmacy benefits manager, a he alth program 
administered by a department of this state, or any entity that 
represents the companies, groups, or departments for the period 
covered by an audit;   
 
 
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10.  Not schedule or initiate an audit during the first seven 
(7) calendar days of any month unless otherwise consented to by the 
pharmacy; 
11.  Disclose to any plan sponsor whose claims were included in 
the audit any money recouped in the audit; 
12.  Not require pharmacis ts to break open packaging labeled 
“for single-patient-use only”.  Packaging labeled “for single-
patient-use only” shall be deemed to be the smallest package size 
available; and 
13.  Upon recoupment of funds from a pharmacy, refund first to 
the patient the portion of the recovered funds that were originally 
paid by the patient, provided such funds were part of the 
recoupment; and 
14.  Not assess a fine, penalty, or any other financial 
requirement on the pharmacy or pharmacist for any prescription 
audited unless there is a valid recoupment under the Pharmacy Audit 
Integrity Act. 
B.  1.  Any entity that conducts wholesale purchase review 
during an audit of a pharmacist or pharmacy shall not require the 
pharmacist or pharmacy to provide a full dispensing report .  
Wholesaler invoice reviews shall be limited to verification of 
purchase inventory specific to the pharmacy claims paid by the 
health benefits plan or pharmacy benefits manager conducting the 
audit.   
 
 
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2.  Any entity conducting an audit shall not identify o r label a 
prescription claim as an audit discrepancy when: 
a. the National Drug Code for the dispensed drug is in a 
quantity that is a subunit or multiple of the drug 
purchased by the pharmacist or pharmacy as supported 
by a wholesale invoice, 
b. the pharmacist or pharmacy dispensed the correct 
quantity of the drug according to the prescription, 
and 
c. the drug dispensed by the pharmacist or pharmacy 
shares all but the last two digits of the National 
Drug Code of the drug reflected on the supplier 
invoice. 
3.  An entity conducting an audit shall accept as evidence, 
subject to validation, to support the validity of a pharmacy claim 
related to a dispensed drug: 
a. redacted copies of supplier invoices in the 
pharmacist’s or pharmacy’s possession, or 
b. invoices and any supporting documents from any 
supplier as authorized by federal or state law to 
transfer ownership of the drug acquired by the 
pharmacist or pharmacy. 
4.  An entity conducting an audit shall provide, no later than 
five (5) calendar days after the date of a request by the pharmacist   
 
 
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or pharmacy, all supporting documents the pharmacist’s or pharmacy’s 
purchase suppliers provided to the health benefits plan issuer or 
pharmacy benefits manager. 
C.  A pharmacy shall be allowed to provide the pharmacy ’s 
computerized patterned medical records or the records of a hospital, 
physician, or other authorized practitioner of the healing arts for 
drugs or medicinal supplies written or transmitted by any means of 
communication for purposes of supporting the pharmac y record with 
respect to orders or refills of a legend or narcotic drug. 
D.  The entity conducting the audit shall not audit more than 
fifty prescriptions, with specific date of service, per calendar 
year.  The PBM or its agent shall not exceed an annual l imit of one 
hundred prescription claims with a specific prescription number and 
date of fill per calendar year.  The annual limit to the number of 
prescription claims audited shall be inclusive of all audits by a 
PBM or its agent, including any prescriptio n-related documentation 
requests from the health insurer, pharmacy benefits ma nager or any 
third-party company conducting audits on behalf of any health 
insurer or pharmacy benefits manager during a calendar year. 
E.  If paper copies of records are request ed by the entity 
conducting the audit, the entity shall pay twenty -five cents ($0.25) 
per page to cover the costs incurred by the pharmacy.  The entity 
conducting the audit shall provide the pharmacy with accurate   
 
 
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instructions, including any required form for obtaining 
reimbursement for the copied records. 
F.  The entity conducting the audit shall: 
1.  Deliver a preliminary audit findings report to the pharmacy 
and the pharmacy’s contracting agent within forty -five (45) calendar 
days of conducting the audit ; 
2.  Allow the pharmacy at least ninety (90) calendar days 
following receipt of the preliminary audit findings report in which 
to produce documentation to address any discrepancy found during the 
audit; provided, however, a pharmacy may request an extensi on, not 
to exceed an additional forty -five (45) calendar days; 
3.  Deliver a final audit findings report to the pharmacy and 
the pharmacy’s contracting agent signed by the auditor within ten 
(10) calendar days after receipt of additional documentation 
provided by the pharmacy, as provided for in Section 356.3 of this 
title; 
4.  Allow the pharmacy to reverse and resubmit claims 
electronically within thirty (30) calendar days of receipt of the 
final audit report in lieu of the auditing entity recouping 
discrepant claim amounts from the pharmacy; 
5.  Not recoup any disputed funds until after final disposition 
of the audit findings, including the appeals process as provided for 
in Section 356.3 of this title; and 
6.  Not accrue interest during the audit and appe al period;   
 
 
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7.  Ensure that each preliminary audit findings report required 
by this section includes: 
a. specific prescription numbers, fill dates, drug name s, 
and NDC numbers, and 
b. the date of receipt of documents from the pharmacy, 
the pharmacy’s contracting agent, or any other source 
associated with the audit . 
G.  Each entity conducting an audit shall provide a copy of the 
final audit results, and a final audit report upon request, after 
completion of any review process to the plan sponsor 
In addition to the requirements for a preliminary audit findings 
report in this paragraph, the final audit findings report shall 
include any additional documentation that was submitted to the 
auditing entity; 
8.  Provide the plan sponsor a copy of the final audit resul ts 
within thirty (30) calendar days of the final disposition of the 
audit; and 
9.  At the request of the plan sponsor , provide a copy of the 
final audit report within thirty (30) calendar days of the request . 
H. G. 1.  The full amount of any recoupment on an audit shall 
be refunded to the plan sponsor.  Except as provided for in 
paragraph 2 of this subsection, a charge or assessment for an audit 
shall not be based, directly or indirectly, on amounts recouped.   
 
 
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2.  This subsection does not prevent the entity conducting the 
audit from charging or assessing the responsible party, direct ly or 
indirectly, based on amounts recouped if both of the following 
conditions are met: 
a. the plan sponsor and the entity conducting the audit 
have a contract that explicitly s tates the percentage 
charge or assessment to the plan sponsor, and 
b. a commission to an agent or employee of the entity 
conducting the audit is not based, directly or 
indirectly, on amounts recouped. 
I. H.  Unless superseded by state or federal law, audit ors shall 
only have access to previous audit reports on a particular pharmacy 
conducted by the auditing entity for the same pharmacy benefits 
manager, health plan or insurer.  An auditing vendor contracting 
with multiple pharmacy benefits managers or healt h insurance plans 
shall not use audit reports or other information gained from an 
audit on a pharmacy to conduct another audit for a different 
pharmacy benefits manager or health insurance plan. 
J. Sections A through I  
I.  Paragraph 2 of subsection A of this section through 
subsection D of this section, and paragraph 1 through par agraph 7 of 
subsection F of this section shall not apply to any audit initiated 
based on or that involves suspicion of fraud, willful 
misrepresentation, or abuse.   
 
 
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K. J. If the Attorney General, after notice and opportunity for 
hearing, finds that the entity conducting the audit failed to follow 
any of the requirements pursuant to the Pharmacy Audit Integrity 
Act, the audit shall be considered null and void.  Any monies 
recouped from a null and void audit shall be returned to the 
affected pharmacy within fo urteen (14) calendar days.  Any violation 
of this section by a pharmacy benefits manager or auditing entity 
shall be deemed a violation of the Pharmacy Audit Integrity Act. 
SECTION 3.     AMENDATORY     59 O.S. 2021, Section 356.3, as 
amended by Section 3, Chapter 332, O.S.L. 2024 (59 O.S. Supp. 2024, 
Section 356.3), is amended to read as follows: 
Section 356.3. A.  Each entity conducting an audit shall 
establish a written appeals process under which a pharmacy may 
appeal an unfavorable p reliminary audit report and/or final audit 
report to the entity. 
B.  Following an appeal, if the entity finds that an unfavorable 
audit report or any portion thereof is unsubstan tiated, the entity 
shall dismiss the audit report or the unsubstantiated portion of the 
audit report without any further action. 
C.  Any final audit report, following the final audit appeal 
period, with a finding of fraud or willful misrepresentation shall 
be referred to the district attorney having proper jurisdiction or 
the Attorney General for prosecution upon completion of the appeals 
process.  If a finding of fraud, willful misrepresentation, or abuse   
 
 
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is referred to a district attorney under this subse ction, the 
auditing entity shall notify the Attorney General to whom the 
referral was made and the date the referral was made. 
D.  For any audit initiated based on or that involves suspicion 
of fraud, willful misrepresentation, or abuse, the auditing entit y 
shall provide, in writing, at the time of the audit, a clear and 
conspicuous declaration to the pharmacy being audited that the audit 
is being conducted under suspicion of fraud, willful 
misrepresentation, or abuse and a statement of facts that supports 
the reasonable suspicion. 
E.  Any entity conducting an audit that is based on or involves 
suspicion of fraud, willful misrepresentation, or abuse shall 
provide to the Office of the Attorney General: 
1.  Notice at least two (2) calendar days prior to beginn ing 
performance of an audit pursuant to this section; 
2.  A preliminary report within thirty (30) ninety (90) calendar 
days of performing notification of the audit to the pharmacy and the 
pharmacy’s contracting agent pursuant to this section .  The auditing 
entity may request an extension from the Attorney General, not to 
exceed an additional thirty (30) calendar days ; and 
3.  A final report within thirty (30) ten (10) calendar days 
following the closure of the final appeal period for an audit 
performed pursuant to this section.  The auditing entity may request   
 
 
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an extension from the A ttorney General, not to exceed an additional 
ten (10) calendar days. 
F.  1.  The preliminary audit findings report required by 
subsection E of this section shall include: 
a. specific prescription numbers, fill dates, drug name s, 
and National Drug Code ( NDC) numbers which were part 
of the audit, and 
b. the dates when documents were received by the auditing 
entity from the pharmacy, the pharmacy ’s contracting 
agent, or any other sou rce associated with the audit. 
2.  In addition to the requirements for a preli minary audit 
findings report pursuant to this subsection, the final audit 
findings report shall include any additional documentation that was 
submitted to the auditing entity. 
G. The Attorney General, authorized employees, and examiners 
shall have access to any pharmacy benefits manager ’s files and 
records that may relate to an audit that is based on or involves 
suspicion of fraud, willful misrepresentation, or abuse. 
G. H.  The Attorney General may levy a civil or administrative 
fine of not less than One Hundred Dollars ($100.00) and not greater 
than Ten Thousand Dollars ($10,000.00) for each violation of this 
section and assess any other penalty or remedy authorized by law. 
SECTION 4.     AMENDATORY     59 O.S. 2021, Section 356.4, is 
amended to read as follows:   
 
 
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Section 356.4. A.  For the purposes of the Pharmacy Audit 
Integrity Act, “extrapolation audit” means an audit of a sample of 
prescription drug benefit claims submitted by a pharmacy to the 
entity conducting the audit that is then used to estimate audit 
results for a larger batch or group of claims not reviewed by the 
auditor, including refills not listed in the written notification in 
accordance with paragraph 2 of subsection A of Section 356 .2 of this 
title. 
B.  The entity conducting the audit shall not use the accounting 
practice of extrapolation in calculating recoupments or penalties 
for audits. 
SECTION 5.     NEW LAW     A new section of law to be codified 
in the Oklahoma Statutes as Section 356.6 of Title 59, unless there 
is created a duplication in numbering, reads as follows: 
A. Notwithstanding any other provision of law, the ability of a 
pharmacy benefits manager (PBM) to initiate, continue, or conclude 
an audit of a pharmacy shall be tolled for the duration of a 
declared disaster and for an additional period of thirty (30) 
calendar days following the termination of a declared disaster. 
This shall apply only to the pharmacies locat ed within the 
geographical boundaries of the county or counties affected by th e 
declared disaster.   
 
 
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B.  The provisions of this section shall apply to all PBMs 
operating with within this state, and to all audits conducted 
pursuant to contracts between PBMs a nd pharmacies. 
C. This section shall not apply to: 
1.  Audits conducted for suspected fraudulent activity if 
documented evidence of such activity exists; or 
2.  Audits required to comply with federal or state law 
unrelated to the contractual relationship between a PBM and a 
pharmacy. 
D.  Nothing in this section shall be construed t o prohibit a 
pharmacy from voluntarily agreeing to continue or complete an audit 
during the tolling period, provided such agreement is documented in 
writing and signed by both pa rties. 
SECTION 6.     AMENDATORY     59 O.S. 2021, Section 357, as 
amended by Section 4, Chapter 332, O.S.L. 2024 (59 O.S. Supp. 2024, 
Section 357), is amended to read as follows: 
Section 357. A.  As used in Sections 357 through 360 of this 
title and Section 8 of this act: 
1.  “Covered entity” means a nonprofit ho spital or medical 
service organization, for -profit hospital or medical service 
organization, insurer, health benefit plan, health maintenance 
organization, health program adminis tered 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   
 
 
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in this state.  This term does not include a health benefit plan 
that provides coverage only fo r accidental injury, specified 
disease, hospital indemnity, disability income, or other limited 
benefit health insurance policies and contracts that do not include 
prescription drug coverage; 
2.  “Covered individual” means a member, participant, enrollee, 
contract holder or policy holder or beneficiary of a covered entity 
who is provided health coverage by the covered entity.  A covered 
individual includes any dependent or other person provided health 
coverage through a policy, contract or plan for a covere d 
individual; 
3.  “Department” means the Insurance Department; 
4.  “Maximum allowable cost”, “MAC”, or “MAC list” means the 
list of drug products delineating the maximum per -unit reimbursement 
for multiple-source prescription drugs, medical product, or dev ice; 
5.  “Multisource drug product reimbursement ” (reimbursement) 
means the total amount paid to a pharmacy inclusive of any reduction 
in payment to the pharmacy, excluding prescription dispense fees; 
6.  “Office” means the Office of the Attorney General; 
7.  “Pharmacy benefits management ” means a service provided to 
covered entities to facilitate the provision of prescription drug 
benefits to covered individuals within the state, including 
negotiating pricing and other terms with drug manufacturers and   
 
 
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providers.  Pharmacy benefits management may include any or all of 
the following services: 
a. claims processing, retail network management and 
payment of claims to pharmacies for prescription drugs 
dispensed to covered individuals, 
b. clinical formulary devel opment and management 
services, or 
c. rebate contracting and administration; 
8.  “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 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 administ ered by an 
agency or department of this state; 
9.  “Plan sponsor” means the employers, insurance companies, 
unions and health maintenance organizations or any other entity 
responsible for establishing, maintaining, or administering a health 
benefit plan on behalf of covered individuals; and 
10.  “Provider” means a pharmacy licensed by the State Board of 
Pharmacy, or an agent or representative of a pharmacy, including, 
but not limited to, the pharmacy ’s contracting agent, which 
dispenses prescription drugs o r devices to covered individuals.   
 
 
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B.  Nothing in the definition of pharmacy be nefits management or 
pharmacy benefits manager in the Patient ’s Right to Pharmacy Choice 
Act, Pharmacy Audit Integrity Act, or Sections 357 through 360 of 
this title and Section 8 of this act shall deem an employer a 
“pharmacy benefits manager ” 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: 
a. negotiates 
1. Negotiates directly with drug manufacturers ,; 
b. processes 
2.  Processes claims on behalf of its members ,; or 
c. manages 
3.  Manages its own retail network of pharmacies. 
SECTION 7.     AMENDATORY     59 O.S . 2021, Section 358, as 
amended by Section 5, Chapter 332, O.S.L. 2024 (59 O.S. Supp. 2024, 
Section 358), is amended to read as follows: 
Section 358. A.  In order to provide pharmacy benefits 
management or any of the services included under the definition of 
pharmacy benefits management in this state, a pharmacy benefits 
manager or any entity acting as one in a contractual or employment 
relationship for a covered entity shall first obtain a license from 
the Insurance Department, and the Department may char ge a fee for 
such licensure.   
 
 
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B.  The Department shall establish, by regulation, licensure 
procedures, required disclosures for pharmacy benefits managers 
(PBMs) and other rules as may be necessary for carrying out and 
enforcing the provisions of this title .  The licensure procedures 
shall, at a minimum, include the completion of an application form 
that shall include the name and address of an agent for service of 
process, the payment of a requisite fee, and evidence of the 
procurement of a surety bond. 
C.  The Department or the Office of the Attorney General may 
subpoena witnesses and information.  Its compliance officers may 
take and copy records for investigative use and prosecutions.  
Nothing in this subsection shall limit the Office of the Attorney 
General from using its investigative demand authority to investigate 
and prosecute violations of the law. 
D.  The Department may suspend, revoke or refuse to issue or 
renew a license for noncompliance with any of the provisions hereby 
established or with the r ules promulgated by the Department; for 
conduct likely to mislead, deceive or defraud the public or the 
Department; for unfair or deceptive business practices or for 
nonpayment of an application or renewal fee or fine.  The Department 
may also levy adminis trative fines for each count of which a PBM has 
been convicted in a Department hearing. 
E.  1.  The Office of the Attorney General , after notice and 
opportunity for hearing, may instruct the Insurance Commissioner   
 
 
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that the PBM’s license be censured, suspended, or revoked for 
conduct likely to mislead, deceive, or defraud the public or the 
State of Oklahoma; or for unfair or deceptive business practices, or 
for any violation of the Patient’s Right to Pharmacy Choice Act, the 
Pharmacy Audit Integrity Act, or Sections 357 through 360 of this 
title.  The Office of the Attorney General ma y also levy 
administrative fines for each count of which a PBM has been 
convicted following a hearing before the Attorney General.  If the 
Attorney General makes such instruction , the Commissioner shall 
enforce the instructed action within thirty (30) calendar days. 
2.  In addition to or in lieu of any censure, suspension, or 
revocation of a license by the Commissioner, the Attorney General 
may levy a civil or administrative fine of not less than One Hundred 
Dollars ($100.00) and not greater than Ten Thousa nd Dollars 
($10,000.00) for each violation of this subsection and/or assess any 
other penalty or remedy authorized by this section.  For purposes of 
this section, each day a PBM fails to comply with an investigation 
or inquiry may be considered a separate violation. 
F.  The Attorney General may promulgate rules to implement the 
provisions of Sections 357 through 360 of this title and Section 8 
of this act. 
SECTION 8.     NEW LAW     A new section of law to be codified 
in the Oklahoma Statute s as Section 360.1 of Title 59, unless there 
is created a duplication in numbering, reads as follows:   
 
 
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A. If a disaster declaration is issued for a county in this 
state, the time period for a provider, a provider ’s representative, 
or a pharmacy service administrative organization to file a below -
cost reimbursement appeal pursuant to Section 360 of Title 59 of the 
Oklahoma Statutes shall be tolled for the duration of the disaster 
declaration. 
B.  Upon the expiration of the disaster declaration, the tolling 
of the filing period for below -cost reimbursement appeals shall 
continue for an additional thirty (30) calendar days.  Afterward, 
the time period for filing a below -cost reimbursement appeal, as 
otherwise provided under state law, shall resume. 
C. The tolling provisions of this section shall apply only to 
continuing counties included in the declared disaster area and to 
below-cost reimbursement appeals arising from claims impacted during 
the time period of the declared disaster. 
D.  A pharmacy benefits mana ger (PBM) shall not deny a below -
cost reimbursement appeal on timeliness if such appeal is filed 
during the tolled period provided in this section. 
SECTION 9.  It being immediately necessary for the preservation 
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. 
 
60-1-698 CAD 1/16/2025 2:13:26 PM