provides that no pharmacy wholesaler may prevent a pharmacist contracted with the wholesaler from purchasing drugs that the wholesale distributor sells or limiting the amount of a particular drug sold to a licensed pharmacy. The provisions of this measure shall not apply to a pharmacy in violation of federal or state laws or in breach of contract.
prohibits any pharmaceutical drug plan or pharmacy benefits manager from refusing to approve, pay, or authorize the dispensation of a white bagged drug to a patient solely because the drug is a white bagged drug. Additionally, the measure prohibits any health benefit plan from refusing to authorize, approve, or pay a participating provider for providing covered physicianadministered drugs to covered persons. Providers and health care facilities shall be permitted to dispense and administer a covered physician-administered drug based on a patient’s best interest if the health care facility or provider that administers the drug [...]
prohibits pharmaceutical drug plans and pharmacy benefit managers from refusing to authorize, approve, or pay a participating provider for supplying covered physician-administered drugs to patients and requires all white-bagged drugs to meet supply chain security controls. Plan providers are prohibited from requiring a patient to self-administer an injectable drug against a provider's recommendation and may not require patients to pay additional fees beyond cost-sharing obligations outlined in the individual's plan. The measure also requires that providers establish a billing method based on the patient's best interest. Any payer in violation is to be fined [...]
creates the Oklahoma Rebate Pass-Through and PBM Meaningful Transparency Act of 2023 by expanding on the definitions for pharmacy benefits management and pharmacy benefits manager as it relates to Pharmacy Audit Integrity Act. The measure expands on the required items for a licensure application by adding information on the business structure of the PBM, and a signed statement indicating that the PBM has not been convicted of a felony and has not violated any of the requirements of the Oklahoma Pharmacy Act and the Patient's Right to Pharmacy Choice Act. The measure amends the [...]
directs the Department of Health to create a program for participants to purchase insulin at a discounted, post-rebate rate.
requires licensed practitioners to offer to administer a pharmacogenomic test to a patient prior to the prescription of any psychotropic drug in order to determine how the patient’s genes may react to certain medications. The practitioner shall be required to inform the patient of the efficacy of pharmacogenomic testing and whether the whether the pharmacogenomic test to be administered is approved by the Food and Drug Administration.
prohibits step therapy requirements for certain prescription drugs to treat advanced metastatic cancer and associated conditions. The measure outlines prerequisites a health benefit plan may not require prior to covering such drugs.
requires health benefit plans to implement a clear and transparent process for a participant or beneficiary with CRF-COPD to request an exception to step therapy protocol and cover the requested treatment. An exemption may be required when: • Other treatments required under protocol are ineffective; • Delaying effective treatment would cause severe consequences; • Other treatments are likely to cause harm; • Other treatments will prevent a participant from maintaining necessary functional abilities; or • The patient’s disease is life threatening. The health benefit plan will publish requirements and information for requesting an exception [...]
prohibits the Oklahoma Health Care Authority from authorizing payments through the state Medicaid program to an out-of-state medical provider unless that state also allows their residents to contract with providers under their state Medicaid program in Oklahoma.
requires the Health Care Authority to establish a provider enrollment and credentialing process for any Medicaid fee-for-service or capitated contracts with contracted entities.
