Pharmacy benefit managers; establishing requirements and limits for certain audit reports and findings. Emergency.

Document header changed from 'FLOOR SUBSTITUTE' to 'COMMITTEE SUBSTITUTE' and 'HOUSE OF REPRESENTATIVES - FLOOR VERSION', indicating the bill's procedural status changed from Senate to House.

Page headers updated from 'Req. No. 1843' to 'SB993 HFLR' with added notation that 'BOLD FACE denotes Committee Amendments'.

Minor formatting adjustments to spacing and alignment in section headers and text blocks throughout the document.

Added co-sponsors Jech and Stinson to the bill's authorship list.

Expanded the bill to amend additional statutes (Sections 357, 358, and 360) covering pharmacy benefits manager licensure and contractual duties.

Added a new definition for 'Pharmacy benefits manager contractual duties' in the amended statutes.

Added requirements for pharmacy benefits managers to provide certain documented proof and establish certain denials for appeals.

Added provisions prohibiting certain collection of additional monies by pharmacy benefits managers and establishing certain filing periods after lifting of disaster declarations.

Added a new definition for 'pharmacy benefits manager' or 'PBM' referencing Section 6960 of Title 36 of the Oklahoma Statutes.

Modified audit notice requirements to require at least 14 calendar days' notice for most audits, but 30 calendar days' notice for wholesale purchase audits.

Added requirements for pharmacies to have the opportunity to reschedule audits no more than seven calendar days from the date designated on the original audit notification.

Added protections stating that clerical or record-keeping errors (such as typographical errors or computer errors) should not be considered fraud or subject to recoupment unless there is proof of intent to commit fraud.

Expanded the scope of entities subject to audits to include third-party payors, health programs administered by state departments, and entities representing these organizations.

Modified statutory references and updated section numbers throughout the bill to reflect the Committee Substitute version.

Added requirement that audits involving clinical or professional judgment must be conducted in consultation with a licensed pharmacist

Added protection that clerical or record-keeping errors such as typos or computer errors cannot be considered fraud and cannot be subject to financial recoupment

Updated document identification numbers from Req. No. 13499 to Req. No. 13515 and restructured the committee substitute title and page headers

The entire bill text was replaced with identical content, indicating a procedural reformatting rather than substantive policy modification.

Audit notice periods are now standardized: 14 days for most audits and 30 days for wholesale purchase audits, with clearer definitions of when audit dates begin.

PBMs must consult licensed pharmacists for audits involving clinical or professional judgment.

Pharmacies can use hospital or physician records to validate prescription orders during audits.

Pharmacies are protected from recoupment for clerical errors (typos, computer errors) unless the PBM can prove intent to commit fraud.

Criminal penalties for clerical errors are prohibited without proof of fraudulent intent.

Dispensing fees and actual prescription costs cannot be included in audit recoupment findings unless the prescription wasn't actually dispensed or was denied.

Formatting and page numbering changes reflect the transition from engrossed to enrolled version.

Added a 30-day minimum written notice requirement specifically for wholesale purchase audits, while maintaining 14-day notice for other audit types like on-site or desk audits.

Clarified that wholesale purchase audits require a minimum of 30 calendar days' written notice, distinguishing them from other audit types.

Strengthened protections against recoupment by explicitly stating that clerical errors (typos, scrivener's errors, computer errors) should not be considered fraud and pharmacies can submit amended claims instead of being penalized.

Changed the bill designation from 'Engrossed House Amendment' to 'Engrossed Senate Bill' and updated page headers accordingly.

Added Section 360 to the list of statutes being amended, expanding the scope of the bill's statutory changes.

Reordered and clarified the definition of 'Disaster declaration' and 'declared disaster' to list specific examples of qualifying events.

Clarified that audit provisions apply to entities representing managed care companies, hospitals, insurance companies, third-party payors, PBMs, state health programs, or any entity representing these groups.

Corrected formatting issues and consolidated text after applying the House amendment to the Senate bill.