Governor Stitt of Oklahoma Vetoes a Bill Aimed at Leveling the Playing Field Between PBMs and Independent Pharmacies
The Governor of Oklahoma, Kevin Stitt, recently vetoed Senate Bill 821, a bill that was intended to level the playing field as between pharmacy benefit managers (PBMs) and smaller independent pharmacies operating in Oklahoma. Specifically, the bill aimed to increase transparency among PBMs and rural pharmacies across Oklahoma who struggle to compete with PBM-affiliated pharmacies. There is still a possibility for the legislature to override Governor Stitt’s recent veto with two-thirds vote in the legislature.
While Governor Stitt’s decision to veto the bill is a disappointing one for independent pharmacies in Oklahoma, the governor indicated that he would like the Oklahoma Legislature to continue working on legislation and work to achieve a compromise. Despite the uncertain future of this bill, Oklahoma still has favorable laws that protect independent pharmacies and independent pharmacies in Oklahoma should seek to take advantage of such laws.
For example, the Oklahoma Any Willing Provider Act prohibits discrimination against a provider willing to meet the terms and conditions for participation established by a health insurer and to preclude an insurer from prohibiting or limiting participation in the provision of services through a health benefit plan. Additionally, Oklahoma’s Patient’s Right to Pharmacy Choice Act (“the Act”) regulates PBMs and contains numerous provisions that protect patient access and choice of pharmacy, increase transparency, and rein in anti-competitive practices between PBMs and independent pharmacies. The Act prohibits PBMs from requiring patients to use pharmacies that are owned or affiliated with PBMs, prohibits PBMs from providing higher reimbursement to PBM-owned pharmacies, and charging post-point-of-sale, or retroactive, fees. In addition, the Act prohibits the practice of providing incentives, such as lower co-pays or cost sharing, to direct consumers to preferred pharmacies over a non-preferred pharmacy. The Oklahoma Insurance Department has been charged with the duty of enforcing the Act. If a PBM is violating the Act, then a breach of contract may have occurred.
How Frier Levitt Can Help
Frier Levitt represents numerous pharmacies across the United States in challenging PBM audits, network access, reimbursement practices and has extensive knowledge on all aspects of the pharmacy-PBM relationship. Contact us today to speak with an attorney about how your pharmacy can leverage the various laws and protections afforded to pharmacies, including Oklahoma’s current PBM laws as well as federal laws which regulate PBM conduct.