Okla. Stat. tit. 36, § 36-6961
This is the official text of Okla. Stat. tit. 36, § 36-6961, 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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Retail pharmacy network access standards
Official statutory text
A. Pharmacy benefits managers (PBMs) shall comply with the
following retail pharmacy network access standards:
1. At least ninety percent (90%) of covered individuals
residing in an urban service area live within two (2) miles of a
retail pharmacy participating in the PBM's retail pharmacy network;
2. At least ninety percent (90%) of covered individuals
residing in an urban service area live within five (5) miles of a
retail pharmacy designated as a preferred participating pharmacy in
the PBM's retail pharmacy network;
3. At least ninety percent (90%) of covered individuals
residing in a suburban service area live within five (5) miles of a
retail pharmacy participating in the PBM's retail pharmacy network;
4. At least ninety percent (90%) of covered individuals
residing in a suburban service area live within seven (7) miles of a
retail pharmacy designated as a preferred participating pharmacy in
the PBM's retail pharmacy network;
Oklahoma Statutes - Title 36. Insurance Page 1433
5. At least seventy percent (70%) of covered individuals
residing in a rural service area live within fifteen (15) miles of a
retail pharmacy participating in the PBM's retail pharmacy network;
and
6. At least seventy percent (70%) of covered individuals
residing in a rural service area live within eighteen (18) miles of
a retail pharmacy designated as a preferred participating pharmacy
in the PBM's retail pharmacy network.
B. Mail-order pharmacies shall not be used to meet access
standards for retail pharmacy networks.
C. Pharmacy benefits managers shall not require patients to use
pharmacies that are directly or indirectly owned by the pharmacy
benefits manager, including all regular prescriptions, refills or
specialty drugs regardless of day supply.
D. Pharmacy benefits managers shall not in any manner on any
material, including but not limited to mail and ID cards, include
the name of any pharmacy, hospital or other providers unless it
specifically lists all pharmacies, hospitals and providers
participating in the preferred and nonpreferred pharmacy and health
networks.
following retail pharmacy network access standards:
1. At least ninety percent (90%) of covered individuals
residing in an urban service area live within two (2) miles of a
retail pharmacy participating in the PBM's retail pharmacy network;
2. At least ninety percent (90%) of covered individuals
residing in an urban service area live within five (5) miles of a
retail pharmacy designated as a preferred participating pharmacy in
the PBM's retail pharmacy network;
3. At least ninety percent (90%) of covered individuals
residing in a suburban service area live within five (5) miles of a
retail pharmacy participating in the PBM's retail pharmacy network;
4. At least ninety percent (90%) of covered individuals
residing in a suburban service area live within seven (7) miles of a
retail pharmacy designated as a preferred participating pharmacy in
the PBM's retail pharmacy network;
Oklahoma Statutes - Title 36. Insurance Page 1433
5. At least seventy percent (70%) of covered individuals
residing in a rural service area live within fifteen (15) miles of a
retail pharmacy participating in the PBM's retail pharmacy network;
and
6. At least seventy percent (70%) of covered individuals
residing in a rural service area live within eighteen (18) miles of
a retail pharmacy designated as a preferred participating pharmacy
in the PBM's retail pharmacy network.
B. Mail-order pharmacies shall not be used to meet access
standards for retail pharmacy networks.
C. Pharmacy benefits managers shall not require patients to use
pharmacies that are directly or indirectly owned by the pharmacy
benefits manager, including all regular prescriptions, refills or
specialty drugs regardless of day supply.
D. Pharmacy benefits managers shall not in any manner on any
material, including but not limited to mail and ID cards, include
the name of any pharmacy, hospital or other providers unless it
specifically lists all pharmacies, hospitals and providers
participating in the preferred and nonpreferred pharmacy and health
networks.
Status: in_force · Read it on the official government site
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