This bill amends Section 7310 of Title 63 of the Oklahoma Statutes, which pertains to step therapy protocols in health insurance plans. It establishes guidelines that require health carriers and utilization review organizations to utilize recognized, evidence-based, and peer-reviewed clinical practice guidelines when implementing step therapy protocols, with a fallback to the FDA label when such guidelines are unavailable. Additionally, the bill mandates that health insurance providers must offer a clear process for patients and healthcare providers to request exceptions to step therapy protocols, ensuring that exceptions are granted under specific conditions, such as contraindications or previous adverse reactions to required drugs.

Furthermore, the bill stipulates that health insurance providers must respond to requests for step therapy exceptions within 72 hours, or 24 hours in exigent circumstances, with a failure to respond resulting in automatic approval of the request. It also includes provisions that protect the prescribing authority of healthcare providers and outlines that if a drug subject to step therapy is FDA-approved for a rare disease, the restrictions cannot be more stringent than the FDA labeling conditions. The Oklahoma Insurance Department and the Oklahoma Health Care Authority are tasked with adopting necessary rules for implementation before January 1, 2020, and the act is set to take effect on November 1, 2025.