A. There is hereby created the Patient's Right to Pharmacy Choice Commission.
B. The Insurance Commissioner shall provide for the receiving and processing of individual complaints alleging violations of the provisions of the Patient's Right to Pharmacy Choice Act, the Pharmacy Audit Integrity Act and Sections 357 through 360 of Title 59 of the Oklahoma Statutes.
C. The Commissioner shall have the power and authority to review complaints, subpoena witnesses and records, initiate prosecution, reprimand, require restitution, approve and sign settlement agreements, place on probation, suspend, revoke and/or levy fines not to exceed Ten Thousand Dollars ($10,000.00) for each count for which any pharmacy benefits manager (PBM) has violated a provision of the Patient's Right to Pharmacy Choice Act, the Pharmacy Integrity Audit Act and Sections 357 through 360 of Title 59 of the Oklahoma Statutes. Any violation that cannot be settled shall go to a hearing before the Pharmacy Choice Commission.
The Pharmacy Choice Commission shall hold hearings and may reprimand, require restitution, place on probation, suspend, revoke or levy fines not to exceed Ten Thousand Dollars ($10,000.00) for each count that a PBM has violated a provision of the Patient's Right to Pharmacy Choice Act, the Pharmacy Integrity Audit Act or Sections 357 through 360 of Title 59 of the Oklahoma Statutes. The Insurance Commissioner or the Pharmacy Choice Commission may impose as part of any disciplinary action restitution to the provider or patient and the payment of costs expended by the Pharmacy Choice Commission or Insurance Department for any legal fees and costs including, but not limited to, staff time, salary and travel expense, witness fees and attorney fees. The Insurance Commissioner or the Pharmacy Choice Commission may review violations singularly or in combination, as the nature of the violation requires.
D. The Pharmacy Choice Commission shall consist of seven (7) persons who shall serve as hearing examiners and shall be appointed as follows:
1. Two persons who are members in good standing of the Oklahoma Pharmacists Association, who shall be appointed by the Oklahoma Board of Pharmacy; a list of eligible appointees shall be sent annually to the Oklahoma Board of Pharmacy by the Oklahoma Pharmacists Association;
2. Two consumer members not employed by or professionally related to the insurance, pharmacy or PBM industry appointed by the Office of the Governor;
3. Two persons representing the PBM or insurance industry appointed by the Insurance Commissioner; and
4. One person representing the Office of the Attorney General appointed by the Attorney General.
E. Pharmacy Choice Commission members first appointed shall serve the initial term staggered as follows: the two members appointed by the Office of the Governor shall serve for one (1) year, the two members appointed by the Insurance Commissioner shall serve for two (2) years, the two members appointed by the Oklahoma Pharmacists Association shall serve for two (2) years and the one member appointed by the Attorney General shall serve for three (3) years. Subsequent terms shall be for five (5) years. The terms of the members shall expire on the thirtieth day of June of the year designated for the expiration of the term for which appointed, but the member shall serve until a qualified successor has been duly appointed. Except for the initial term to establish the Pharmacy Choice Commission, no person shall be appointed to serve more than two consecutive terms. The Commission shall annually elect a chair and vice-chair from among its members. There shall be no limit on the number of times a member may serve as chair or vice-chair. A quorum shall consist of no less than five members and shall be required for the Commission to hold a hearing.
F. Hearings shall be held in the Insurance Commissioner's offices or at such other place as the Insurance Commissioner may deem convenient.
G. The Insurance Commissioner shall issue and serve upon the PBM a statement of the charges and a notice of hearing in accordance with the Administrative Procedures Act, Sections 250 through 323 of Title 75 of the Oklahoma Statutes. A hearing shall be set within thirty (30) days and notice of that hearing date shall be provided to the complainant within a reasonable time period.
H. At the time and place fixed for a hearing, the PBM shall have an opportunity to be heard and to show cause why the Pharmacy Choice Commission should not revoke or suspend the PBM's license and levy administrative fines for each violation. Upon good cause shown, the Commission shall permit any complainant or a duly authorized representative of the complainant to intervene, appear and be heard at the hearing by counsel or in person.
I. All hearings will be public and held in accordance with, and governed by, Sections 250 through 323 of Title 75 of the Oklahoma Statutes.
J. The Insurance Commissioner, upon written request reasonably made by the complainant or the licensed PBM affected by the hearing and at such expense of the requesting party, shall cause a full stenographic record of the proceedings to be made by a competent court reporter.
K. If the Insurance Commissioner or Pharmacy Choice Commission determines that a PBM has engaged in violations of the Patient's Right to Pharmacy Choice Act, the Pharmacy Integrity Act or Sections 357 through 360 of Title 59 of the Oklahoma Statutes with such frequency as to indicate a general business practice and that such PBM should be subjected to closer supervision with respect to such practices, the Insurance Commissioner or the Pharmacy Choice Commission may require the PBM to file a report at such periodic intervals as the Insurance Commissioner or the Pharmacy Choice Commission deems necessary.
Added by Laws 2019, c. 426, § 9, eff. Nov. 1, 2019. Amended by Laws 2021, c. 472, § 10, emerg. eff. May 11, 2021.