{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6969","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6969","heading":"Restrictions on health benefit plans and pharmacy benefit","body":"managers — White bagged drugs.\n\nA. As used in this section:\n\n1. \"Health benefit plan\" means a health benefit plan as defined\n\npursuant to Section 6060.4 in Title 36 of the Oklahoma Statutes;\n\n2. \"Pharmacy benefits manager\" means a person that performs\n\npharmacy benefits management and any other person acting for such\n\nperson under a contractual or employment relationship in the\n\nperformance of pharmacy benefits management for a managed-care\n\ncompany, not-for-profit hospital, medical services organization,\n\ninsurance company, third-party payor, or a health program\n\nadministered by a state agency; and\n\n3. \"White bagged drugs\" means the distribution of physician\n\nadministered medication from a pharmacy, typically a specialty\n\npharmacy, to the physician's office, hospital, or clinic for\n\nadministration.\n\nB. All health benefit plans and pharmacy benefits managers in\n\nthis state shall not refuse to authorize, approve, or pay a\n\nparticipating provider for providing covered physician-administered\n\ndrugs to covered persons.\n\nC. All white bagged drugs distributed in this state shall meet\n\nsupply chain security controls set forth by the federal Drug Supply\n\nChain Security Act as amended.\n\nD. A health benefit plan or a pharmacy benefits manager of a\n\nplan shall not require a covered patient to self-administer an\n\ninjectable drug against a health care provider's recommendation in\n\naccordance with the manufacturer's approved guidelines.\n\nE. Health benefit plans shall not require a covered patient to\n\npay additional fees for white bagged drugs beyond cost-sharing\n\nobligations as outlined in the individual's plan.\n\nF. Providers and health care facilities shall be permitted to\n\ndispense and administer a covered physician-administered drug based\n\non a patient's best interest, provided that the health care facility\n\nor provider that administers the drug shall agree to the terms and\n\nconditions of network participation and accept, as payment in full,\n\nreimbursement for the drug at the health insurer's negotiated\n\ncontracted rate. The health care facility or provider is prohibited\n\nfrom billing or collecting from the patient any amount in excess of\n\nor in addition to the patient's cost sharing obligations as outlined\n\nin the individual's plan.\n\nG. Any payor in violation of this act shall be fined a minimum\n\nof Five Thousand Dollars ($5,000.00) per violation, but not more\n\nthan Ten Thousand Dollars ($10,000.00) per violation. Fines related\n\nto this section shall not be used when calculating payors, plans, or\n\nmembers loss ratios and losses incurred pursuant to this subsection\n\nshall not be passed on to the consumer in future rate increases.","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":"2ffdd18b91084e14a09468750e784f0acdfb96af43152130f39d1c710494f857","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6968","next":"us-ok/okla.-stat.-tit.-36-36-6971"},"notice":"GroundRules: Original legal text. Not legal advice."}