Okla. Stat. tit. 36, § 36-3634.5
This is the official text of Okla. Stat. tit. 36, § 36-3634.5, part of Oklahoma’s Stat. tit. 36, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 36,." Browse the sections below, each linked to its official government source.
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Synchronization of prescription drug refills
Official statutory text
A. A health benefit plan that provides benefits for
prescription drugs delivered, issued or renewed after November 1,
2017, shall provide for synchronization of prescription drug refills
on at least one occasion per insured per year, provided all of the
following conditions are met:
1. The prescription drugs are covered by the health benefit
plan's clinical coverage policy or have been approved by a formulary
exceptions process;
2. The prescription drugs are maintenance medications as
defined by the plan and have available refill quantities at the time
of synchronization;
3. The medications are not Schedule II, III or IV controlled
substances;
4. The insured meets all utilization management criteria to the
prescription drugs at the time of synchronization;
5. The prescription drugs are of a formulation that can be
safely split into short-fill periods to achieve synchronization;
Oklahoma Statutes - Title 36. Insurance Page 805
6. The prescription drugs do not have special handling or
sourcing needs as determined by the plan, contract, or agreement
that require a single, designated pharmacy to fill or refill the
prescription; and
7. The covered person agrees to the synchronization.
B. When necessary to permit synchronization, the health benefit
plan shall apply a prorated daily cost-sharing rate to any
medication dispensed by a network pharmacy pursuant to this section.
No dispensing fees shall be prorated, and all dispensing fees shall
be based on the number of prescriptions filled or refilled.
C. As used in this section, "synchronization" means the
coordination of medication refills for a patient taking two or more
medications for one or more chronic conditions such that the
patient's medications are refilled on the same schedule for a given
time period.
prescription drugs delivered, issued or renewed after November 1,
2017, shall provide for synchronization of prescription drug refills
on at least one occasion per insured per year, provided all of the
following conditions are met:
1. The prescription drugs are covered by the health benefit
plan's clinical coverage policy or have been approved by a formulary
exceptions process;
2. The prescription drugs are maintenance medications as
defined by the plan and have available refill quantities at the time
of synchronization;
3. The medications are not Schedule II, III or IV controlled
substances;
4. The insured meets all utilization management criteria to the
prescription drugs at the time of synchronization;
5. The prescription drugs are of a formulation that can be
safely split into short-fill periods to achieve synchronization;
Oklahoma Statutes - Title 36. Insurance Page 805
6. The prescription drugs do not have special handling or
sourcing needs as determined by the plan, contract, or agreement
that require a single, designated pharmacy to fill or refill the
prescription; and
7. The covered person agrees to the synchronization.
B. When necessary to permit synchronization, the health benefit
plan shall apply a prorated daily cost-sharing rate to any
medication dispensed by a network pharmacy pursuant to this section.
No dispensing fees shall be prorated, and all dispensing fees shall
be based on the number of prescriptions filled or refilled.
C. As used in this section, "synchronization" means the
coordination of medication refills for a patient taking two or more
medications for one or more chronic conditions such that the
patient's medications are refilled on the same schedule for a given
time period.
Status: in_force · Read it on the official government site
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