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

The document header was updated to indicate this is the 'Floor Version' and added the names of the House and Senate sponsors (Newton, Deck, and Rader).

Page numbers and internal tracking numbers were updated to reflect the new floor version layout.

Replaced the original definitions with a new list including 'adverse determination', 'chronic condition', 'clinical criteria', 'emergency health care services', and 'medically necessary'.

Added specific requirements for how health plans and pharmacy benefit managers must review and decide on prior authorization requests for prescription drugs.

Removed the original provisions regarding step-therapy protocols and 'fail first' policies.

Changed the statutory citation for where the law is codified in the Oklahoma Statutes from Section 6110 to Section 6570.50 of Title 36.

The bill title and subtitle were changed from 'Ensuring Transparency in Prescription Drugs Prior Authorization Act' to a generic description of health insurance rules, and the section header changed from 'Oversight' to 'Policy'.

The definition of 'Emergency health care services' was expanded to include stabilization efforts in independent emergency departments.

A new requirement was added for health plans to approve urgent prior authorization requests within 24 hours of receiving complete information.

New criteria were established for when insurers must grant exceptions to step-therapy protocols, including if the drug is contraindicated, ineffective, or if the patient has already tried the drug.

A specific prohibition was added against using 'fail-first' protocols or requiring documented adverse events (like FDA Form 3500) before approving prescriptions for substance use disorders.

The original text defining 'Adverse determination' and 'Clinical criteria' was removed, replaced by the new step-therapy and prior authorization rules.

The document title and header were updated to change from 'Enrolled' to 'Proposed Committee Substitute' and added committee amendment metadata.

Added two new names, Menz and Alonso-Sandoval, to the list of House sponsors and added Stanley to the Senate sponsors.

Added a requirement that prior authorization determinations must be based on medical necessity and good practice, rather than the convenience of the patient or provider.

Added new definitions for 'Notice', 'Pharmacist', 'PBM', 'Physician', 'Prior authorization', and 'Urgent prescription drug' to ensure consistent understanding of these terms.

Detailed operational requirements for health plans, including rules on cost-sharing collection, payment obligations, and restrictions on withholding payments, were removed.

Specific regulations regarding step-therapy protocols, including exceptions for adverse reactions, ineffectiveness, and continuity of care, were removed.

Detailed definitions for key terms like 'adverse determination,' 'chronic condition,' and 'emergency health care services' were removed.

The bill's title was updated to reflect its new purpose, and the codification instruction was changed from creating a new section to amending an existing one in Title 36.