This bill amends existing Oklahoma law regarding pharmacy benefits managers (PBMs) by updating definitions, prohibiting certain payment conditions, and establishing requirements for timely payments and accounting from payors to providers. Key definitions are introduced, including "clean claim," "payor," and "provider," while the term "maximum allowable cost" is clarified. The bill also specifies that payments to providers cannot be contingent on post-transaction reconciliations or internal settlements, and mandates that payors remit full payment for clean claims within 30 days of receipt or adjudication. Additionally, it requires payors to provide detailed accounting of payments made to providers.

Furthermore, the bill prohibits payors from engaging in practices that obscure claim-level payment information, such as bundling claims or providing only aggregate data. It establishes that any late payments will accrue interest at a rate of 10% per month and allows the Attorney General to impose fines for violations. Contracts that attempt to waive or limit the rights established by this act will be deemed void. The provisions of this act will apply to all claims paid on or after its effective date of November 1, 2026.

Statutes affected:
Introduced: 59-357