The Oklahoma Rebate Pass-Through and Pharmacy Benefits Manager Meaningful Transparency Act of 2025 aims to improve transparency and accountability within the pharmacy benefits management (PBM) sector. The bill mandates that enrollees' defined cost-sharing amounts be reduced by at least 85% of all rebates received by PBMs and introduces penalties for non-compliance, allowing the Insurance Commissioner to impose fines ranging from $100 to $10,000. It also classifies specific rebate information as trade secrets, thus prohibiting PBMs from disclosing this data. The legislation amends existing definitions and compliance requirements, introducing new terms such as "defined cost sharing" and "aggregate retained rebate percentage," while clarifying PBMs' roles and responsibilities.

Additionally, the bill enhances the rights of pharmacies and pharmacists by prohibiting unfair practices by PBMs, such as reimbursing independent pharmacies at lower rates than PBM-owned pharmacies and retroactively denying reimbursements without specific conditions. It requires PBMs to establish transparent formulary development processes and ensures that pharmacy and therapeutics committees consist of a majority of practicing healthcare professionals. The bill also expands the definition of services provided by PBMs and establishes new licensure requirements, mandating that PBMs obtain a license from the Insurance Department before offering services. The application process will require detailed disclosures, and the Department is empowered to enforce compliance, including the suspension or revocation of licenses for noncompliance. The bill is set to take effect on November 1, 2025.

Statutes affected:
Introduced: 36-6960, 36-6962, 59-357, 59-358