1| SENATE FLOOR VERSION | | April 11, 2024 | 2| | | | 3|ENGROSSED HOUSE | |BILL NO. 1713 By: Marti of the House | 4| | | and | 5| | | Garvin and Hicks of the | 6| Senate | | | 7| | | | 8| | | | 9| An Act relating to pharmacies; defining terms; | | creating certain requirements; creating a penalty; | 10| providing for codification; and declaring an | | emergency. | 11| | | | 12| | | | 13|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 14| SECTION 1. NEW LAW A new section of law to be codified | | | 15|in the Oklahoma Statutes as Section 6969 of Title 36, unless there | | | 16|is created a duplication in numbering, reads as follows: | | | 17| A. As used in this section: | | | 18| 1. "Health benefit plan" means a health benefit plan as defined | | | 19|pursuant to Section 6060.4 in Title 36 of the Oklahoma Statutes; | | | 20| 2. "Pharmacy benefits manager" means a person that performs | | | 21|pharmacy benefits management and any other person acting for such | | | 22|person under a contractual or employment relationship in the | | | 23|performance of pharmacy benefits management for a managed-care | | | 24|company, not-for-profit hospital, medical services organization, | | | arsid11239104 SENATE FLOOR VERSION - HB1713 SFLR Page 1 ___________________________________________________________________________
1|insurance company, third-party payor, or a health program | | | 2|administered by a state agency; and | | | 3| 3. "White bagged drugs" means the distribution of physician | | | 4|administered medication from a pharmacy, typically a specialty | | | 5|pharmacy, to the physician's office, hospital, or clinic for | | | 6|administration. | | | 7| B. All health benefit plans and pharmacy benefits managers in | | | 8|this state shall not refuse to authorize, approve, or pay a | | | 9|participating provider for providing covered physician-administered | | | 10|drugs to covered persons. | | | 11| C. All white bagged drugs distributed in this state shall meet | | | 12|supply chain security controls set forth by the federal Drug Supply | | | 13|Chain Security Act as amended. | | | 14| D. A health benefit plan or a pharmacy benefits manager of a | | | 15|plan shall not require a covered patient to self-administer an | | | 16|injectable drug against a health care provider's recommendation in | | | 17|accordance with the manufacturer's approved guidelines. | | | 18| E. Health benefit plans shall not require a covered patient to | | | 19|pay additional fees for white bagged drugs beyond cost-sharing | | | 20|obligations as outlined in the individual's plan. | | | 21| F. Providers and health care facilities shall be permitted to | | | 22|dispense and administer a covered physician-administered drug based | | | 23|on a patient's best interest, provided that the health care facility | | | 24|or provider that administers the drug shall agree to the terms and | | | arsid11239104 SENATE FLOOR VERSION - HB1713 SFLR Page 2 ___________________________________________________________________________
1|conditions of network participation and accept, as payment in full, | | | 2|reimbursement for the drug at the health insurer's negotiated | | | 3|contracted rate. The health care facility or provider is prohibited | | | 4|from billing or collecting from the patient any amount in excess of | | | 5|or in addition to the patient's cost sharing obligations as outlined | | | 6|in the individual's plan. | | | 7| G. Any payor in violation of this act shall be fined a minimum | | | 8|of Five Thousand Dollars ($5,000.00) per violation, but not more | | | 9|than Ten Thousand Dollars ($10,000.00) per violation. Fines related | | | 10|to this section shall not be used when calculating payors, plans, or | | | 11|members loss ratios and losses incurred pursuant to this subsection | | | 12|shall not be passed on to the consumer in future rate increases. | | | 13| SECTION 2. It being immediately necessary for the preservation | | | 14|of the public peace, health or safety, an emergency is hereby | | | 15|declared to exist, by reason whereof this act shall take effect and | | | 16|be in full force from and after its passage and approval. | | | 17|COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES | |April 11, 2024 - DO PASS | 18| | | | 19| | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | arsid11239104 SENATE FLOOR VERSION - HB1713 SFLR Page 3