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Code · Oklahoma · Title 36 — Insurance

§36-6963. Health insurer to monitor activities and ensure

256 words·~1 min read·/ok/title-36-insurance/36-6963·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

compliance.
A. A health insurer shall be responsible for monitoring all activities carried out by, or on behalf of, the health insurer under the Patient's Right to Pharmacy Choice Act, and for ensuring that all requirements of this act are met.
B. Whenever a health insurer contracts with another person to perform activities required under this act, the health insurer shall be responsible for monitoring the activities of that person with whom the health insurer contracts and for ensuring that the requirements of this act are met.
C. An individual may be notified at the point of sale when the cash price for the purchase of a prescription drug is less than the individual's copayment or coinsurance price for the purchase of the same prescription drug.
D. A health insurer or pharmacy benefits manager
(PBM)shall not restrict an individual's choice of in-network provider for prescription drugs.
E. An individual's choice of in-network provider may include a retail pharmacy or a mail-order pharmacy. A health insurer or PBM shall not restrict such choice. Such health insurer or PBM shall not require or incentivize using any discounts in cost-sharing or a reduction in copay or the number of copays to individuals to receive prescription drugs from an individual's choice of in-network pharmacy.
F. A health insurer, pharmacy or PBM shall adhere to all Oklahoma laws, statutes and rules when mailing, shipping and/or causing to be mailed or shipped prescription drugs into the State of Oklahoma. Added by Laws 2019, c. 426, § 6, eff. Nov. 1, 2019.
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