Bill No. 2007 amends existing legislation regarding the responsibilities of pharmacy benefits managers (PBMs) in Oklahoma. The bill mandates that PBMs must include specific details in their contracts with providers, such as the sources for maximum allowable cost (MAC) pricing and the requirement to update MAC pricing every seven days. It also establishes a process for providers to appeal reimbursement amounts, ensuring that PBMs respond to these appeals in a timely manner and do not require unnecessary administrative burdens on pharmacies. Additionally, the bill introduces new provisions that require PBMs to remit administrative fees to providers if they adjust reimbursement amounts following an appeal.

The legislation further stipulates that PBMs cannot place a drug on the MAC list unless there are at least two therapeutically equivalent drugs available for purchase. It also ensures that pharmacies are reimbursed at no less than the wholesale acquisition cost for drugs listed in the FDA Drug Shortages Database. Other provisions include prohibiting PBMs from requiring unnecessary accreditation for providers and ensuring that pharmacies can decline services if the payment is below their cost. The bill is set to take effect on November 1, 2026.

Statutes affected:
Introduced: 59-360
Floor (Senate): 59-360
Engrossed: 59-360