July 29, 2020

UPDATE: Status of Patient’s Right to Pharmacy Choice Act

The Patient’s Right to Pharmacy Choice Act (“Act”) was passed by the Oklahoma legislature in 2019 with a stated purpose to establish minimum and uniform access by patients to pharmacy providers. Among other things, the Act provides for network adequacy, transparency, and uniformity. The Insurance Commissioner was tasked with the responsibility to enforce the Act.

Since the Act has been in effect it has been the subject of litigation in federal court, Pharmaceutical Care Management Association, v. Glen Mulready and Oklahoma Insurance Department, Case No. CIV-19-77-J pending in the United States District Court for the Western District of Oklahoma, which has prevented the Commissioner from moving forward with enforcement. However, on July 9, 2020, Judge Jones of the federal district court for the Western District of Oklahoma ruled the Commissioner could proceed with enforcement of the majority of the provisions of the Act. PCMA has appealed that ruling to the 10^th Circuit Court of Appeals in Denver.

The Commissioner will now proceed forward with enforcement of the Act, currently excluding Medicare Advantage and Medicare Part D plans per the Court’s order. The Commissioner has been maintaining a record of all complaints received, to-date there are approximately 180. The majority of those complaints relate to MAC list pricing and “choice of pharmacy concerns.” The Oklahoma Insurance Department has begun the process of investigating complaints received, and based upon such investigations, will proceed to take necessary action as authorized by the Act.

Stakeholders can expect to see violations, established through investigation, prosecuted through public hearings, conducted pursuant to the Oklahoma Administrative Procedures Act, 75 O.S. §§ 250 et seq. The Oklahoma Insurance Department’s enforcement will remain compliant with Judge Jones’ order and any future ruling by the 10^th Circuit.

Section 6933 of the Act created an Advisory Committee made up of  seven appointees;  two people nominated by the Oklahoma Pharmacists Association, two consumer members not employed or related to insurance, pharmacy or PBM nominated  by the Governor’s office, two persons representing PBM or insurance industry nominated by the Insurance Commissioner, and one person representing the Office of the Attorney General nominated by the Attorney General. The purpose of the Committee is to assist the Commissioner’s regulatory activities by bringing the viewpoints of various constituencies represented by the committee to the Department. On July 9, 2020, the Commissioner welcomed the advisory committee at its first meeting held at the offices of the Insurance Commissioner, 400 NE 50^th Street, Oklahoma City, OK  73105.  Mr. Ron White, Director of the Department’s PRPCA Division, briefed the committee on the Commissioner’s thoughts concerning enforcement and strategized with the Committee concerning “next steps”.

Questions or comments should be directed to
PBM Regulatory Compliance Division at PBMcomplaints@oid.ok.gov.

Special Notice to Oklahoma Insurance Professionals June 18, 2020
To: Oklahoma Insurance Companies and Licensed Insurance Professionals
From: Oklahoma Insurance Department- Licensing Division
RE: Temporary Producer and Apprentice Adjuster License Applications and Expiration

On March 26, 2020, the Oklahoma Insurance Department (OID), led by Commissioner Glen Mulready, made available Temporary Producer and Apprentice Adjuster licenses due to the COVID-19 related closure of PROMETRIC testing centers nationwide. On June 1, 2020, PROMETRIC opened all Oklahoma testing centers at 100% seating capacity.

For the past few weeks, the OID has been monitoring testing capacity and has determined that testing availability is sufficient to support the current need. Therefore, effective June 25, 2020, the OID will no longer accept Temporary Producer and Apprentice Adjuster license applications. Pending applications received in our office by June 25, 2020, will continue to be processed.

All Temporary Producer and Apprentice Adjuster licenses shall expire on September 1, 2020. We will work with our Database provider (SBS) to accurately reflect these expiration dates on issued temporary licenses. The OID will email temporary licensees a reminder that the temporary license will expire. The Licensing Division encourages all temporary licensees to prepare for and schedule their examinations. Study material is available for purchase from our webpage www.licensing.oid.ok.gov as well as the most recent Licensing Information Bulletin from the Exam Vendor which includes outlines for each examination.

As always, the OID will continue to monitor the public health event and act accordingly. Additional notices related to the temporary license will be posted on the OID website and emailed.

The mission of the Oklahoma Insurance Department is to protect and enhance the financial security of Oklahoma and Oklahomans. Thank you in advance for your patience and understanding as we all work together to minimize delays and hardships to our licensees and the industry while still providing the protection needed to Oklahoma Consumers.

Oklahoma Insurance Department
Licensing Division
400 NE 50th Street
Oklahoma City, Oklahoma 73105
405.521.3916 phone
www.licensing.oid.ok.gov