{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-5402","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-5402","heading":"Reimbursement to 340B entities — Restrictions","body":"A. With respect to reimbursement to a 340B entity for 340B\n\ndrugs, a health insurance issuer, pharmacy benefits manager, other\n\nthird-party payor, or its agent shall not:\n\n1. Reimburse a 340B entity for 340B drugs at a rate lower than\n\nthat paid for the same drug to entities that are not 340B entities\n\nor lower reimbursement for a claim on the basis that the claim is\n\nfor a 340B drug;\n\n2. Impose any terms or conditions on any 340B entity with\n\nrespect to any of the following that differ from such terms or\n\nconditions applied to non-340B entities on the basis that the entity\n\nparticipates in the federal 340B drug discount program set forth in\n\nSection 256b of Title 42 of the United States Code or that a drug is\n\na 340B drug including, without limitation, any of the following:\n\na. fees, charges, clawbacks, or other adjustments or\n\nassessments. For purposes of this subsection, the\n\nterm \"other adjustments\" includes placing any\n\nadditional requirements, restrictions, or unnecessary\n\nburdens upon the 340B entity that result in\n\nadministrative costs or fees to the 340B entity that\n\nare not placed upon other entities that do not\n\nparticipate in the 340B drug discount program,\n\nincluding affiliate pharmacies of the health insurance\n\nissuer, pharmacy benefits manager, or other third-\n\nparty payor,\n\nb. dispensing fees that are less than the dispensing fees\n\nfor non-340B entities,\n\nc. restrictions or requirements regarding participation\n\nin standard or preferred pharmacy networks,\n\nd. requirements relating to the frequency or scope of\n\naudits of inventory management systems,\n\ne. requirements that a claim for a drug include any\n\nidentification, billing modifier, attestation, or\n\nother indication that a drug is a 340B drug in order\n\nto be processed or resubmitted unless it is required\n\nby the Centers for Medicare and Medicaid Services or\n\nthe Oklahoma Health Care Authority for the\n\nadministration of the Oklahoma Medicaid program, or\n\nf. any other restrictions, conditions, practices, or\n\npolicies that are not imposed on non-340B entities;\n\n3. Require a 340B entity to reverse, resubmit, or clarify a\n\nclaim after the initial adjudication unless these actions are in the\n\nnormal course of pharmacy business and not related to 340B drug\n\npricing;\n\n4. Discriminate against a 340B entity in a manner that prevents\n\nor interferes with any patient's choice to receive such drugs from\n\nthe 340B entity, including the administration of such drugs. For\n\npurposes of this subsection, it is considered a discriminatory\n\npractice that prevents or interferes with a patient's choice to\n\nreceive drugs at a 340B entity if a health insurance issuer,\n\npharmacy benefits manager, or other third-party payor places any\n\nadditional requirements, restrictions, or unnecessary burdens upon\n\nthe 340B entity that results in administrative costs or fees to the\n\n340B entity, including but not limited to, requiring a claim for a\n\ndrug to include any identification, billing modifier, attestation,\n\nor other indication that a drug is a 340B drug in order to be\n\nprocessed or resubmitted unless it is required by the Centers for\n\nMedicare and Medicaid Services or the Oklahoma Health Care Authority\n\nin administration of the Oklahoma Medicaid program;\n\n5. Include any other provision in a contract between a health\n\ninsurance issuer, pharmacy benefits manager, or other third-party\n\npayor and a 340B entity that discriminates against the 340B entity\n\nor prevents or interferes with an individual's choice to receive a\n\nprescription drug from a 340B entity, including the administration\n\nof the drug, in person or via direct delivery, mail, or other form\n\nof shipment, or creation of a restriction or additional charge on a\n\npatient who chooses to receive drugs from a 340B entity;\n\n6. Require or compel the submission of ingredient costs or\n\npricing data pertaining to 340B drugs to any health insurance\ne to receive a\n\nprescription drug from a 340B entity, including the administration\n\nof the drug, in person or via direct delivery, mail, or other form\n\nof shipment, or creation of a restriction or additional charge on a\n\npatient who chooses to receive drugs from a 340B entity;\n\n6. Require or compel the submission of ingredient costs or\n\npricing data pertaining to 340B drugs to any health insurance\n\nissuer, pharmacy benefits manager, or other third-party payor; or\n\n7. Exclude any 340B entity from the health insurance issuer,\n\npharmacy benefits manager, or other third-party payor network on the\n\nbasis that the 340B entity dispenses drugs subject to an agreement\n\nunder Section 256b of Title 42 of the United States Code, or\n\nrefusing to contract with a 340B entity for reasons other than those\n\nthat apply equally to non-340B entities.\n\nB. Nothing in this section applies to the Oklahoma Medicaid\n\nprogram as payor when Medicaid provides reimbursement for covered\n\noutpatient drugs as defined in Section 1396r-8(k) of Title 42 of the\n\nUnited States Code.","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":"b9b0ac825de613a406aced0da426c3a41815222ae5dbf95237f96336711fa980","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-5401","next":"us-ok/okla.-stat.-tit.-36-36-5403"},"notice":"GroundRules: Original legal text. Not legal advice."}