Health insurance; creating the Ensuring Transparency in Prescription Drugs Prior Authorization Act; determination; consultation; prior authorization; effective date.

Page headers and document titles were updated to reflect the bill's status as the Floor (House) version rather than the Committee Substitute version, indicating procedural progress through the legislative process.

Replaced step-therapy protocol requirements with new prior authorization review processes that require health plans to evaluate medical necessity before denying prescription drug coverage.

Removed step-therapy exception provisions that previously allowed insurers to require trying lower-cost drugs first before approving more expensive medications.

Added requirements for consultation before adverse determinations and established criteria for reviewing physicians involved in prior authorization decisions.

Added new statutory definitions including 'adverse determination,' 'chronic condition,' 'clinical criteria,' and 'emergency health care services' to standardize how drug coverage decisions are made.

Changed timing requirements for prior authorization decisions from step-therapy specific timelines to new standards for urgent and nonurgent requests.

Changed from 'Proposed Oversight Committee Substitute' to 'Proposed Policy Committee Substitute', indicating a shift from monitoring to establishing policy standards.

Removed detailed definitions related to adverse determinations, chronic conditions, and clinical criteria; replaced with broader definitions focused on health benefit plans and health care services.

Added requirements for step-therapy protocols, including exceptions for contraindications, ineffectiveness, prior trials, stable conditions, and patient best interests.

Removed provisions related to retrospective denial prohibitions, continuity of care standards, and adverse determination consultation requirements.

Established specific timelines for prior authorization requests: 24 hours for urgent requests and 24 hours for nonurgent requests after receiving necessary information.

Added enforcement provisions assigning authority to the Attorney General and rule promulgation authority.

Changed codification section from 'not to be codified' to 'to be codified' in Oklahoma Statutes as Section 6110 of Title 36.

The document format changed from 'Enrolled House Bill' to 'Committee Amendment' with updated header information, including a new amendment date and sponsor signature line.

Page numbering and formatting were updated to reflect the committee substitute version, with line numbers added for tracking amendments.

The bill title and purpose language remained identical, indicating no changes to the substantive provisions regarding prescription drug prior authorization requirements.

Sponsor list was updated to include additional legislators (Menz, Alonso-Sandoval, Stanley) in the Enrolled version.

A subject line 'Health insurance' was added to the Enrolled version for clarity.

Page headers and line numbers were adjusted to reflect the Enrolled version's formatting.

All substantive definitions, requirements, and provisions remain identical between versions.

Added requirement that prior authorization reviews must not be primarily for the convenience of the enrollee or their healthcare provider

Added new definitions for 'Notice', 'Pharmacist', 'PBM', 'Physician', 'Prior authorization', and 'Urgent prescription drug' to clarify how the law applies

Modified the list of terms included in the definition of 'Prior authorization' to include 'authorization', 'pre-certification', and other similar terms

Added Senate coauthor Stanley to the bill authorship list

Changed document type from 'Introduced' to 'Engrossed Senate Amendment'

Updated bill title to include full descriptive name about prescription drug prior authorization transparency

Revised section numbering and codification references to reflect Senate amendment status

Changed enacting clause language from 'BE IT ENACTED' to 'This act shall be known and may be cited as'