SB 789: Pharmacy benefit managers; permitting use of certain records without limitations of date or source for certain purposes; establishing certain reimbursement rates for certain drugs. Effective date. - Oklahoma

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

MODERATE

The bill was converted from the House version to the Senate version, which significantly reduced the list of sponsors and streamlined the text. The Senate version retains the core purpose of regulating pharmacy benefit manager audits but removes several specific procedural requirements found in the House version, such as the mandate to disclose recouped funds to plan sponsors and the prohibition on requiring pharmacists to break open single-patient-use packaging. It also consolidates audit timing rules and simplifies the language regarding wholesale purchase reviews.

Scope change

The scope of the bill's applicability remains focused on pharmacy benefit managers and pharmacy audits, but the specific operational requirements for how those audits must be conducted have been narrowed by removing certain procedural mandates present in the House draft.

REQUIREMENT

Removed the requirement for auditors to disclose any money recouped from a pharmacy to the plan sponsor whose claims were audited.

Removed the prohibition requiring pharmacists to break open packaging labeled 'for single-patient-use only' during audits.

Consolidated and simplified rules regarding when audits can be scheduled, merging the 'first seven days of the month' restriction with other timing constraints.

Streamlined the language regarding wholesale purchase audits, limiting them to verifying purchase inventory specific to the claims paid by the plan or manager.

FISCAL

Reduced the list of bill sponsors from over 30 legislators to just four, indicating a significant change in the legislative coalition supporting the bill.

House Committee Substitute for Senate Bill → Floor (House) · 3 edits

MINOR

The bill was converted from a Senate Committee Substitute to the House Floor version, resulting in significant changes to the list of sponsoring legislators and the document's header. Substantively, the text of the audit provisions for pharmacy benefit managers remains identical to the Senate version, with no changes to the specific rules regarding audit notice periods, recoupment limits, or pharmacist protections.

Scope change

The bill's scope and applicability remain unchanged; the substantive legal text regarding pharmacy audits is identical to the previous version.

TECHNICAL

The list of sponsoring legislators was updated to reflect the House Floor version, adding new names and reordering the existing list.

The document header was updated to indicate this is the 'House of Representatives - Floor Version' rather than the 'Committee Substitute'.

REQUIREMENT

The substantive policy text regarding pharmacy audit procedures, including notice periods, recoupment rules, and pharmacist protections, was not altered.

Proposed Committee Substitute (full committee) 1 → House Committee Substitute for Senate Bill · 5 edits

MODERATE

The bill text was reformatted to remove a 'Proposed Oversight' label and add a new House sponsor, Preston Stinson. Substantive policy changes include requiring refunds of recouped funds to patients first, prohibiting audits during the first week of the month, and restricting wholesale purchase reviews to specific claims rather than full dispensing reports.

Scope change

The bill's scope was expanded to include House sponsors and updated to reflect a 'Committee Substitute' rather than a 'Proposed Oversight' substitute.

ELIGIBILITY

Added House Representatives Stinson, Marti, Moore, and Stewart as sponsors to the bill.

REQUIREMENT

Added a requirement that any money recouped from a pharmacy must be refunded to the patient first before the plan keeps it.

Prohibited audits from being scheduled or initiated during the first seven days of any month unless consented to.

Limited wholesale purchase reviews during audits to only specific claims paid by the plan, removing the requirement for a full dispensing report.

Clarified that packaging labeled 'for single-patient-use only' must be treated as the smallest available package size.

Enrolled (final version) → Proposed Committee Substitute (full committee) 1 · 2 edits

MINOR

The bill was replaced entirely by a committee substitute that retains the original text but includes minor formatting adjustments and a change to the Senate sponsor list. No substantive policy changes, new requirements, or scope modifications were made to the legislation itself.

TECHNICAL

The Senate sponsor list was updated to reflect the current membership, changing 'Prieto' to 'Kern' and removing 'Mann'.

Minor formatting and spacing adjustments were applied throughout the text to conform to the committee substitute style.

Engrossed → Enrolled (final version) · 2 edits · May 28, 2025

MINOR

The bill transitioned from an 'Engrossed' draft to the final 'Enrolled' version, incorporating minor formatting corrections and updating the list of sponsoring legislators to reflect the final vote. The substantive policy language regarding pharmacy audit procedures, notice periods, and recoupment rules remains identical to the previous version.

TECHNICAL

Updated the list of Senate and House sponsors to include additional names (e.g., Mann, Stewart, Turner) that were likely added during the final legislative process.

Corrected minor formatting and spacing inconsistencies in the header and title sections to match the final enrolled format.

Amended And Engrossed → Engrossed · 7 edits · May 21, 2025

MODERATE

The bill was renumbered from an 'Engrossed House Amendment' to the primary 'Engrossed Senate Bill,' indicating it has passed both chambers and is ready for final action. Substantively, the audit requirements were expanded to include specific protections for pharmacies, such as mandatory written notice, limits on record-keeping requests, and a ban on recouping funds for clerical errors unless fraud is proven. The bill also clarifies that audits must apply identical standards to all pharmacies and prohibits scheduling audits during the first week of any month without consent.

Scope change

The bill now applies as the primary enacted legislation rather than an amendment, and the scope of audit protections was broadened to explicitly cover clerical errors, packaging integrity, and the use of external records for validation.

REQUIREMENT

Changed the document title from 'Engrossed House Amendment' to 'Engrossed Senate Bill,' reflecting its status as final legislation.

Added a requirement that audits must be conducted using identical standards and regularity for all similarly situated pharmacies.

Added a prohibition on scheduling or initiating audits during the first seven calendar days of any month unless the pharmacy consents.

Added protection against recouping funds for clerical or record-keeping errors (e.g., typos) unless there is proof of intent to commit fraud.

Added a rule that recouped funds must be refunded to the patient first before the pharmacy is charged.

Added a restriction preventing auditors from requiring a full dispensing report during wholesale purchase reviews.

Added a prohibition on labeling a claim as an audit discrepancy if the drug quantity is a subunit or multiple of the National Drug Code.

Introduced → Amended And Engrossed · 3 edits · May 21, 2025

MINOR

The bill was amended to change its subject matter from pharmacy benefit manager audits to general professions and occupations, including new provisions on leases and plan restrictions. Additionally, the list of House and Senate co-authors was updated to reflect changes in legislative sponsorship.

Scope change

The bill's scope was significantly altered; it no longer focuses exclusively on pharmacy benefit manager audit requirements but now covers broader professions, occupations, leases, and plan restrictions.

SCOPE

The bill's title and summary were changed from focusing on pharmacy benefit managers to covering professions and occupations, leases, and plan restrictions.

REQUIREMENT

The specific audit procedures and notice requirements for pharmacies were removed from the bill text.

TECHNICAL

The list of House and Senate co-authors was updated to add and remove specific legislators.

Pharmacy benefit managers; permitting use of certain records without limitations of date or source for certain purposes; establishing certain reimbursement rates for certain drugs. Effective date.

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