This bill establishes new regulations for out-of-state pharmacies that ship drugs into Oklahoma, requiring them to obtain a license from the State Board of Pharmacy. It mandates that these pharmacies comply with the Oklahoma Pharmacy Act and relevant rules set by the Board. The bill outlines specific violations that could lead to disciplinary actions, including breaches of the pharmacy technician-to-pharmacist ratio, failure to adhere to manufacturer storage and delivery guidelines, and other violations as determined by the Board.

Additionally, the bill requires the Board to conduct initial and annual on-site inspections of these out-of-state pharmacies. If violations are found, the Board will notify the pharmacist in charge and impose fines, with a maximum penalty of $50,000 per violation. The Board will follow up with additional inspections to ensure compliance, and failure to correct violations may result in the revocation of the pharmacy's license. The inspections must be conducted by Board-employed inspectors, and the costs will be borne by the pharmacies. The act is set to take effect on November 1, 2026.