{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-3634.4","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-3634.4","heading":"Prescription drug or device coverage – Uniform","body":"prescription drug information on card or technology.\n\nA. 1. It is the intent of the Legislature to:\n\na. lessen waiting times of patients,\n\nb. decrease administrative burdens for pharmacies, and\n\nc. improve care to patients,\n\nby minimizing confusion, eliminating unnecessary paperwork and\n\nstreamlining dispensing of prescription products paid for by third-\n\nparty payors.\n\n2. This section shall be broadly applied and interpreted to\n\neffectuate this purpose.\n\nB. 1. Each health benefit plan that provides coverage for\n\nprescription drugs or devices, or administers such a plan including,\n\nbut not limited to, third-party administrators for self-insured\n\nplans, to the extent permitted by the Employee Retirement Income\n\nSecurity Act of 1974 (ERISA), and state-administered plans, or the\n\nplan’s agents or contractors that issue a card or other technology\n\nfor prescription claims submission and adjudication, shall issue to\n\nits insureds covered by such plan a card or other technology\n\ncontaining uniform prescription drug information. Nothing in this\n\nsection shall require any health benefit plan, or the plan’s agents\n\nor contractors to issue a separate card of other technology for\n\nprescription coverage, provided that the card issued can accommodate\n\nthe information required by this section.\n\n2. The uniform prescription drug information contained on the\n\ninsured’s card or other technology shall include the following\n\nfields:\n\na. card issuer name or logo on the front of the card,\n\nb. complete information for electronic claims routing\n\nincluding:\n\n(1) issuer identification number (IIN/BIN) labeled as\n\nIIN or BIN,\n\n(2) the Processor Control Number (PCN), labeled as\n\nPCN, if required for proper routing of electronic\n\nclaim transactions for prescription benefits, and\n\n(3) the group number, labeled as GRP, if required for\n\nproper routing of electronic claim transactions\n\nfor prescription benefits,\n\nc. card issuer identification,\n\nd. card holder identification, which shall be displayed\n\non the front of the card,\n\ne. card holder name, which shall be displayed on the\n\nfront of the card,\n\nf. claims processor name and, if not filed\n\nelectronically, address, and\n\ng. a help desk phone number that pharmacy providers may\n\ncall for pharmacy benefit claims assistance.\n\nC. 1. The new uniform prescription drug information contained\n\non the insured’s card or other technology, as required by subsection\n\nB of this section, shall be issued by a health benefit plan or the\n\nplan’s administrators, agents or contractors upon enrollment, and\n\nreissued within a reasonable time upon any change in the coverage of\n\nthe insured person that impacts data contained on the card.\n\n2. Newly issued cards or technology shall be updated with the\n\nlatest coverage information.\n\nD. As used in this section, \"health benefit plan\" means an\n\naccident and health insurance policy or certificate, a nonprofit\n\nhospital or medical service corporation contract, a health\n\nmaintenance organization subscriber contract, a plan provided by a\n\nmultiple employer welfare arrangement, or a plan provided by another\n\nbenefit arrangement, to the extent permitted by ERISA of 1974, as\n\namended, or by any waiver of or other exception to that act provided\n\nunder federal law or regulation. The term \"health benefit plan\"\n\nshall not include the following types of insurance:\n\n1. Accident;\n\n2. Credit;\n\n3. Disability income;\n\n4. Long-term or nursing home care;\n\n5. Specified disease;\n\n6. Dental or vision;\n\n7. Coverage issued as a supplement to liability insurance;\n\n8. Medical payments under automobile or homeowners;\n\n9. Insurance under which benefits are payable with or without\n\nregard to fault and this is statutorily required to be contained in\n\nany liability policy or equivalent self-insurance;\n\n10. Health benefit plans that participate or contract with the\npecified disease;\n\n6. Dental or vision;\n\n7. Coverage issued as a supplement to liability insurance;\n\n8. Medical payments under automobile or homeowners;\n\n9. Insurance under which benefits are payable with or without\n\nregard to fault and this is statutorily required to be contained in\n\nany liability policy or equivalent self-insurance;\n\n10. Health benefit plans that participate or contract with the\n\nOklahoma Health Care Authority as the state Medicaid agency; and\n\n11. Hospital income or indemnity.\n\nE. The provisions of this section shall apply to health benefit\n\nplans that are delivered, issued for delivery, or renewed on and\n\nafter January 1, 2004.\n\nF. 1. Enforcement of the provisions of this section shall be\n\nthe responsibility of the Insurance Commissioner.\n\n2. The Insurance Commissioner shall promulgate rules necessary\n\nto effectuate the provisions of this section.\n\n3. The Insurance Commissioner shall take action or impose\n\nappropriate penalties to bring noncomplying entities into full\n\ncompliance with the provisions of this section.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"6a7a63b2985bf8e6f805d7eb829514569744278030439aafe2c7e8cc46a11503","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-3634.3","next":"us-ok/okla.-stat.-tit.-36-36-3634.5"},"notice":"GroundRules: Original legal text. Not legal advice."}