OID Adopts Rules on PBM-Provider Contract Costs, Noncompliance

The Oklahoma Insurance Department has adopted rules on maximum allowable contract costs and noncompliance penalties for pharmacy benefit managers, according to Director of Public Policy Buddy Combs. Combs said in an email Friday that the rule draft had been filed with Gov. Mary Fallin and the state Legislature on Friday morning. Under the rules, if a provider’s reimbursement claim is paid at or below the provider’s acquisition cost of the drug from a regional or national wholesaler, the PBM is required to provide a “reasonable appeals procedure” for the provider or a ...