1 STATE OF OKLAHOMA
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2 1st Session of the 59th Legislature (2023)
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3 SENATE BILL 145 By: Hicks
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6 AS INTRODUCED
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7 An Act relating to prescription drugs; defining
7 terms; prohibiting an insurer from modifying coverage
8 under certain conditions with certain exceptions;
8 providing for certain civil penalty; requiring
9 promulgation of rules; providing for codification;
9 and providing an effective date.
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12 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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13 SECTION 1. NEW LAW A new section of law to be codified
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14 in the Oklahoma Statutes as Section 6850.2 of Title 36, unless there
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15 is created a duplication in numbering, reads as follows:
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16 A. As used in this section:
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17 1. “Insurer” means an insurer as defined pursuant to Section
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18 6054 of Title 36 of the Oklahoma Statutes;
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19 2. “Practitioner” means a practitioner as defined pursuant to
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20 Section 6054 of Title 36 of the Oklahoma Statutes; and
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21 3. “Prescription drug” or “drug” means a prescription drug as
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22 defined pursuant to Section 367.2 of Title 59 of the Oklahoma
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23 Statutes.
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 1 B. An insurer shall not modify an insured’s coverage of a
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2 prescription drug if the following conditions are met:
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3 1. The drug had been previously preauthorized for coverage by
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4 the insurer or was listed on the formulary of the insurer at the
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5 time the insured was prescribed the drug by his or her practitioner;
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6 2. The insured has already received the drug; and
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7 3. A practitioner continues to prescribe the drug to the
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8 insured.
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9 C. Modification prohibited under this section shall include,
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10 but not be limited to:
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11 1. Increasing the premium, copayment, coinsurance, or
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12 deductible;
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13 2. Denying or otherwise failing to provide continued coverage
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14 of the prescription drug;
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15 3. Moving the drug to a more restrictive coverage category or
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16 tier; or
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17 4. Replacing the brand-name drug for a generic drug after the
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18 insured has qualified for the brand-name drug pursuant to this
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19 section.
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20 D. Nothing in this section shall be construed to prohibit an
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21 insurer from modifying coverage of a prescription drug if:
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22 1. The federal Food and Drug Administration has issued a
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23 statement calling into question the clinical safety of the drug; or
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 1 2. The manufacturer of the drug has notified the federal Food
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2 and Drug Administration of a manufacturing discontinuance or
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3 potential discontinuance of the drug, as required by 21 U.S.C. 356c.
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4 E. Any insurer that violates the provisions of this section
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5 shall be subject to a civil penalty in an amount to be determined by
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6 the Insurance Commissioner. The Insurance Commissioner shall
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7 promulgate rules to effectuate the provisions of this section.
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8 SECTION 2. This act shall become effective November 1, 2023.
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10 59-1-1218 RD 1/4/2023 3:37:21 PM
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