Oklahoma Bill Would Eliminate Third-Party Pharmacy Benefit Managers

If passed, proposed legislation would have Oklahoma joining the growing number of states backing away from using Pharmacy Benefit Managers (PBMs) to administer prescription-drug programs.

Sen. Paul Scott, R-Duncan, has filed Senate Bill 1901 to replace the state’s third-party PBMs with a direct-to-pharmacy payment system – a move he said could save the state millions and help significantly lower prescription drug prices for state employees.

SB 1901 would direct the Oklahoma Employees Insurance and Benefits Board to collaborate with the Oklahoma Health Care Authority (OHCA) to make the change. By July 1, 2021, the two entities would establish pricing to lower prescription drug prices for all enrollees of any health insurance plans offered under the Oklahoma Employee Insurance and Benefits Act.

Scott said OHCA is already doing this for SoonerCare recipients and his proposal would allow them to do the same for all state employees.

A PBM is a third-party administrator of prescription drug programs for state and federal government employee plans, self-insured employer plans, commercial health plans and Medicare Part D plans.

By utilizing preferring formularies and exclusion lists, PBMs decide which drugs consumers can receive from their plan without facing additional out-of-pocket costs. They develop and maintain the list of medicines that can be used in a particular health system or under a particular health insurance policy.

Source: Oklahoma Senate

Topics Oklahoma