Bill > SB2074

This bill, effective November 1, 2026, aims to regulate Pharmacy Benefit Managers (PBMs), which are entities that manage prescription drug benefits for health plans. Key provisions include defining "acquisition cost" as the total amount a provider pays for a drug or medical product, including purchase price and associated charges, but excluding post-purchase rebates. The bill prohibits PBMs from refusing to accept additional documentation from providers after an appeal has been submitted and requires PBMs to provide detailed claim-level information when making adjustments to provider reimbursements. If a PBM approves an appeal that results in an adjusted reimbursement amount, they must ensure the provider is paid the correct amount, including any retroactive adjustments, and cannot require the provider to return any portion of the reimbursement for that claim. Furthermore, the bill mandates that PBMs reimburse providers for prescription drugs or pharmacy services at no less than the national average drug acquisition cost plus a minimum professional dispensing fee, or wholesale acquisition cost if the national average is unavailable, and prohibits reimbursement below these amounts.

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http://www.oklegislature.gov/BillInfo.aspx?Bill=sb2074&Session=2600