HB 4457: Pharmacy benefits managers; terms; prohibiting pharmacy benefits managers from doing certain act; enforcement by Attorney General; effective date. - Oklahoma

Floor (House) → Floor (Senate) · 5 edits

MODERATE

The bill was amended to transition from a House version to a Senate version, updating the legislative session details and adding specific sponsors. The core policy language regarding Pharmacy Benefit Managers (PBMs) and medically integrated pharmacies was completely rewritten to clarify definitions, strengthen protections against patient steering, and ensure equal treatment for specialty pharmacies. These changes aim to improve transparency and prevent PBMs from unfairly directing patients away from pharmacies owned or operated by doctors.

Scope change

The bill's scope regarding PBM restrictions was expanded and clarified to explicitly prohibit steering patients away from medically integrated pharmacies and to require equal reimbursement terms for all network pharmacies.

TECHNICAL

Updated the header to reflect the Senate Floor Version and added specific Senate sponsors (Coleman, Murdock, Dossett, Haste, and Stanley).

DEFINITION

Rewrote the definitions of 'Health insurer', 'Medically integrated pharmacy', 'Specialty medication', 'Specialty provider', and 'Pharmacy benefits manager' to align with the Senate's preferred language.

REQUIREMENT

Significantly revised the prohibitions on PBMs to explicitly ban restricting access to specialty medications at medically integrated pharmacies, prohibiting patient steering, and requiring equal reimbursement rates and terms for all network pharmacies.

Added specific language clarifying that PBMs cannot deny coverage based on whether a drug is dispensed by a medically integrated pharmacy.

Expanded the definition of 'patient steering' to include a broader range of administrative acts designed to induce patients to use PBM-preferred pharmacies.

Senate Committee Substitute for House Bill → Floor (House) · 4 edits

MODERATE

The bill was revised to streamline the legislative text and correct the authorship list, removing the Senate co-sponsors from the 'By' line while retaining the bill's core purpose of regulating Pharmacy Benefit Managers (PBMs). The substantive policy content, including definitions of specialty medications and prohibitions on patient steering, remains unchanged from the committee version.

Scope change

The bill's scope and applicability remain the same; no new entities are included or excluded from the regulations.

TECHNICAL

The authorship section was updated to list only House sponsors (Newton) and one Senate sponsor (Jech), removing the other Senate sponsors listed in the committee version.

The title and summary of the act were condensed to remove detailed lists of specific prohibitions and requirements, replacing them with a high-level overview of the bill's intent.

Page headers and footer text were updated to reflect the 'Floor Version' status and removed the original committee report requirements.

Minor formatting adjustments were made to the definition section, such as changing 'licensed practitioner' to 'licensed physician' in the definition of a specialty provider.

House Committee Substitute → Senate Committee Substitute for House Bill · 4 edits

MODERATE

The bill was amended to transition from a 'Committee Substitute' to an 'Engrossed' version, incorporating additional sponsors and refining the legislative text. The substantive policy changes include clarifying definitions for 'specialty provider' to include other licensed practitioners, updating the definition of 'pharmacy benefits manager' to align with existing statutes, and streamlining the prohibited actions list to better address patient steering and reimbursement discrimination.

Scope change

The bill's scope remains focused on regulating pharmacy benefits managers (PBMs), but the definition of who qualifies as a 'specialty provider' was expanded to include licensed practitioners beyond just physicians, broadening the protections for those treating patients with complex conditions.

DEFINITION

The definition of 'specialty provider' was expanded to include 'other licensed practitioners' acting within their scope of licensure, not just physicians.

The definition of 'pharmacy benefits manager' was updated to reference the same definition found in Section 6960 of Title 36 of the Oklahoma Statutes for consistency.

REQUIREMENT

The list of prohibited PBM actions was reorganized and slightly condensed to more clearly address issues like patient steering, differential cost-sharing, and reimbursement delays.

TECHNICAL

The bill header was updated to reflect it is an 'Engrossed' version with additional Senate sponsors (Newton and Deck of the House, Jech, Coleman, Murdock, Dossett, Haste, and Stanley of the Senate) and updated page reference numbers.

Proposed Policy Committee Substitute 1 → House Committee Substitute · 4 edits

MODERATE

The House Committee Substitute replaced the original Proposed Policy Committee Substitute entirely, updating the bill title and page numbering to reflect the committee's final version. The substantive policy language regarding pharmacy benefits managers and specialty medications remains unchanged, but the document now includes a new section establishing the effective date as November 1, 2026, and assigning a specific statute number (60-2-17051).

Scope change

The bill's scope and applicability remain unchanged as the core text was not altered, but the inclusion of a specific effective date and statute number formalizes the timeline for implementation.

TECHNICAL

Updated the document title from 'Proposed Policy Committee Substitute' to 'Committee Substitute' to indicate the bill has been amended by the House Committee.

Changed the tracking number on the first page from 'Req. No. 16294' to 'Req. No. 17051' to match the new statute number.

Removed the header indicating this was a 'Proposed Policy Committee Substitute' and the associated date of February 16, 2026.

TIMELINE

Added a specific effective date of November 1, 2026, and assigned the bill the statute number 60-2-17051, which were missing in the previous version.

Engrossed → Proposed Policy Committee Substitute 1 · 3 edits

MINOR

The bill was completely rewritten by the Policy Committee Substitute, replacing the original text entirely. The substantive policy language regarding pharmacy benefits managers, specialty medications, and medically integrated pharmacies remains identical to the original version, indicating the committee made no changes to the bill's core provisions.

Scope change

The bill's scope and applicability remain unchanged as the substantive text is identical to the original Engrossed version.

TECHNICAL

Removed the original 'Engrossed' header, House/Senate passage dates, and presiding officer signatures.

Added new headers identifying the document as a 'Proposed Policy Committee Substitute' with updated metadata.

Replaced the entire body of the bill text with an identical copy of the original content, resulting in no substantive policy changes.

Introduced → Engrossed · 6 edits · Mar 23, 2026

MODERATE

The bill was amended to strengthen protections against conflicts of interest for Pharmacy Benefits Managers (PBMs). The changes redefine PBMs to include any entity managing their operations, explicitly prohibit PBMs from owning or having an interest in retail pharmacies, and ban PBMs from steering patients to affiliated pharmacies or imposing higher costs on them. The bill also introduces new definitions for 'medically integrated pharmacies' and 'specialty providers' to clarify which pharmacies are protected from these restrictions.

Scope change

The bill's scope expanded to explicitly include entities acting on behalf of a PBM under the conflict-of-interest prohibitions and added specific protections for specialty medications and medically integrated pharmacies.

DEFINITION

Redefined 'Pharmacy benefits manager' to explicitly include any person or entity acting on behalf of a PBM in a contractual or employment relationship.

Created new definitions for 'Medically integrated pharmacy' and 'Specialty provider' to establish specific protections for these entities.

REQUIREMENT

Added a prohibition against PBMs acquiring any direct or indirect interest in a pharmacy license.

Added prohibitions against PBMs restricting access to specialty medications from affiliated pharmacies, steering patients to PBM-owned pharmacies, or imposing differential costs based on pharmacy choice.

ENFORCEMENT

Changed the enforcement mechanism from the State Board of Pharmacy to the Attorney General for violations of the new conflict-of-interest rules.

TECHNICAL

Updated the codification section to change the statute number from Title 59, Section 356.10 to Title 36, Section 6958.1.

Pharmacy benefits managers; terms; prohibiting pharmacy benefits managers from doing certain act; enforcement by Attorney General; effective date.

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