The PBM Compliance and Enforcement Division works directly with Oklahoma consumers and industry stakeholders to ensure that Pharmacy Benefits Managers (PBMs) comply with the Patient’s Right to Pharmacy Choice Act and other Oklahoma statutes and regulations.

This division:

  • Examines license applications to ensure applicants meet all state requirements
  • Ensures that licensees meet the requirements in the Oklahoma Insurance Code
  • Receives complaints and investigates allegations of PBM regulatory violations
  • Requires and audits pharmacy network access reports from PBMs and health insurers
  • Initiates and takes formal administrative actions against PBMs
  • Provides continuing education at various events
  • Engages in local and multi-state efforts to create and codify uniform legislation related to pharmacy access and regulation of PBMs

Meeting Announcement

Patient’s Right to Pharmacy Choice Commission Agenda 05/12/2022

PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION – SPECIAL MEETING

A Special Meeting of the Patient’s Right to Pharmacy Choice Commission as established by 36 O.S. § 6966 et seq. will be held on Thursday, May 12, 2022, at 10:00 a.m. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department (“OID”), 400 NE 50th Street, Oklahoma City, Oklahoma 73105. See HB 2123, 2021. This public meeting is being held consistent with the Open Meeting Act, 25 O.S. § 301 et seq.

A teleconference line will be available for the public to utilize during the business portion of the meeting. A teleconference line will not be available during any hearings set before the Commission.

CONFERENCE LINE: +1-866-846-9071 United States (Toll Free) PIN: 65715

Loss of connectivity: If connection is lost at any time during this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the meeting will be stopped, and a special meeting will be scheduled.

The Patient’s Right to Pharmacy Choice Commission currently consists of the following members who will appear in-person:
Mark Lewandowski, James F. Consedine, II, Melanie Maxwell, Rose Thomas-Bendel, Kimberly Baker, Gregory S. Huenergardt and Anthony J. “A.J.” Ferate.
The following OID staff are expected to attend in-person: Kelli Price, Dilan Lyda, Ashley Scott and Benna Nye

AGENDA

The following items will be discussed and considered by the Commission. It is anticipated that action may be taken on any item listed on the agenda, at the discretion of the Commission. Pursuant to Title 25 O.S. § 307(B)(4), (7), and (8), executive session may be necessary regarding any case which is set for hearing before the Commission. * Breaks may be taken as necessary.

I. Call Business Meeting to Order & Commission Roll Call

II. Introduction of OID PBM Compliance and Enforcement Division attorney, Dilan Lyda

III. Review & approval of Pharmacy Choice Commission meeting minutes from 1/20/22 meeting

IV. Status Review: PCMA v. Mulready case in U.S. District Court for the Western District of Oklahoma

a. Presented by Kelli Price, OID Managing Counsel / Director of PBM Compliance & Enforcement Division

V. Legislative update:

a. Presented by Ashley Scott, OID Government & Community Affairs Director

VI. Review of Quarterly Report to Pharmacy Choice Commission:

a. Presented by Kelli Price, OID Managing Counsel / Director of PBM Compliance & Enforcement Division

VII. Review and Discussion of statutory requirements and procedures

a. Additions to PCC Binders
b. Open Meetings Act

i. Discuss and Vote on adoption of Commission policy regarding participation of the public during business meetings

c. Commission procedures:

i. Review and discuss Oklahoma County District Court rules;
ii. Discussion and vote on adoption of standard Commission rules/procedures, particularly when a party to a case requests a continuance of a hearing already scheduled

VIII. Questions / Comments from Commission members, OID, and audience 

IX. Adjournment of Business Meeting

X. PBM Compliance & Enforcement Hearings before Commission:

a. Call scheduled hearing(s) to Order & Commission Roll Call
b. Presentation of Hearing(s):

1. Case Number 22-0122-DIS, State of Oklahoma v. Prime Therapeutics L.L.C.:

i. Prime Therapeutics L.L.C.’s Motion for Continuance

IX. Adjournment of PBM Compliance & Enforcement Hearing(s)

 

Patient’s Right to Pharmacy Choice Commission Agenda 01/20/2022

PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION

A regular meeting of the Patient’s Right to Pharmacy Choice Commission as established by 36 O.S. § 6966 et seq. will be held on Thursday, January 20, 2022, at 10:00 a.m. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department (“OID”), 400 NE 50th Street, Oklahoma City, Oklahoma 73105. See HB 2123, 2021. This public meeting is being held consistent with the Open Meeting Act, 25 O.S. § 301 et seq. 

AGENDA 

The following items will be discussed and considered by the Commission. It is anticipated that action may be taken on any item listed on the agenda, at the discretion of the Commission. Pursuant to Title 25 O.S. § 307(B)(4), (7), and (8), executive session may be necessary regarding any case which is set for hearing before the Commission. * Breaks may be taken as necessary. 

I. Call to Order & Commission Roll Call 

II. Welcome to the Attorney General’s appointee to the Commission, Anthony J. “A.J.” Ferate. 

III. Review & approval of Pharmacy Choice Commission meeting minutes from 7/15/21 (not previously approved due to lack of quorum), 9/16/21, 10/21/21, and 12/16/2021 meetings 

IV. Review and Discussion of statutory requirements and procedures

a. Additions to PCC Binders 

b. Open Meetings Act

i. Discuss and consider Commission policy on breaks, lunch break, length of time of meetings & hearings, cancellation of meetings, and participation of the public during meetings 

ii. Vote on adoption of Commission policy on breaks, lunch break, length of time of meetings & hearings, cancellation of meetings, and participation of the public during meetings 

c. Code of Judicial Conduct & Administrative Procedures Act: Disqualification of a Hearing Examiner 

d. Witnesses and “Invoking the Rule”

V. Potential requests during a hearing for recusal of a Commission member:

a. Discuss and draft procedure for consideration of a recusal request 

b. Vote on adoption of recusal procedure 

VI. Review of Quarterly Report to Pharmacy Choice Commission:

a. Presented by Kelli Price, OID Managing Counsel 

VII. Questions / Comments from Commission members, OID, and audience 

VIII. Adjournment 

Patient’s Right to Pharmacy Choice Commission Agenda 12/16/2021

PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION

 A special meeting of the Patient’s Right to Pharmacy Choice Commission as established by 36 O.S. § 6966 et seq. will be held on Thursday, December 16, 2021, at 10:00 a.m. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department (“OID”), 400 NE 50th Street, Oklahoma City, Oklahoma 73105. See HB 2123, 2021. 

This public meeting is being held consistent with the Open Meeting Act, 25 O.S. § 301 et seq. 

I. Call to Order & Commission Roll Call 

II. Review & approval of Pharmacy Choice Commission meeting minutes from 7/15/21, 9/16/21, and 10/21/21 meetings 

III. Status of Oklahoma Attorney General’s appointee to the Commission 

IV. PCC Binders with Judicial Code of Conduct, PBM related Statutes and Rules, etc. 

V. Updates on Referrals to Legal from OID – PBM Compliance and pending legal actions 

VI. Status review: PCMA v. Mulready Case in OKWD 

VII. Review of Fines/Penalties recommended by Advisory Committee and Consideration of Minimum Fines/Penalties for each type of potential violation by a PBM 

VIII. Review meeting dates for 2022 Monthly meetings/hearings 

IX. Questions / Comments from Commission members, OID, and audience 

X. Adjournment 

Documents

PRPCC Fine & Penalty Recommendations
Advisory Committee Fine & Penalty Recommendations
PCC Meeting Minutes 7.15.21

Patient’s Right to Pharmacy Choice Commission Agenda 10/21/2021

PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION

The first special meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by 36 O.S. § 6966 et seq. will be held on Thursday, October 21, 2021, at 9:30 am. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105. See HB 2123, 2021. 

This public meeting is being held consistent with the Open Meeting Act, 25 O.S. § 301 et seq.

I. Call to Order & Commission Roll Call 

II. Review & approval of Pharmacy Choice Commission meeting minutes from 7/16/21 meeting 

III. Status of Oklahoma Attorney General’s appointee to the Commission 

IV. Review of Quarterly report from OID to PRPC Commission 

V. Updates on Referrals to Legal from OID – PBM Compliance and pending legal actions 

VI. Review of Pharmacy Network Access requirements and potential for failure to comply within certain area zip codes, and proposed “best efforts” admin rules / PRPC guidelines to determine compliance with regulations a. Presentation by Glenn Disher, PBM Compliance Investigator for OID and Ron White, Pharmacist Consultant 

VII. Status review: PCMA v. Mulready Case in OKWD 

VIII. Review of Fines/Penalties recommended by Advisory Committee and Consideration of Minimum Fines/Penalties for each type of potential violation by a PBM 

IX. Set hearing/meeting dates for December 2021 and 2022 Monthly meetings/hearings 

X. Procedure review of an Administrative Hearing 

XI. Questions / Comments from Commission members, OID, and audience 

XII. Adjournment 

Documents

PBM Rural Rules Proposal Presentation
Quarterly Report to Pharmacy Choice Commission – Complaints and Resolutions
Fine & Penalty Recommendations – Pharmacy Choice Commission
Fine & Penalty Recommendations – Advisory Committee 2020 to 2021
PCC Meeting Minutes 7/15/21
Administrative Hearing Procedure Example for PCC

Patient’s Right to Pharmacy Choice Commission Agenda 09/16/2021

PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION

The first special meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by 36 O.S. § 6966 et seq. will be held on Thursday, September 16, 2021, at 10:00 am. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105. See HB 2123, 2021. 

 I. Call to Order 

II. Commission Roll Call 

III. Status of Oklahoma Attorney General’s appointee to the Commission 

IV. Discussion & consideration of voting on an Interim Chair and Interim Co-Chair 

V. (Tentative) Vote on Interim Chair and Interim Co-Chair 

VI. Discussion & consideration of Commission communication and procedures 

VII. PCMA v. Mulready Case in OKWD – Review of status and timeline 

VIII. Overview of PBM related statutes and administrative rules that may need clarification and/or revisions 

IX. Updates on Referrals to Legal from OID – PBM Compliance and pending legal actions a. Kelli Price, Managing Counsel, OK Insurance Department 

X. Set hearing/meeting dates for October and November 2021 

XI. Adjournment 

Documents

NOTICE OF SPECIAL MEETING

Patient’s Right to Pharmacy Choice Commission Meeting Agenda 7.15.2021

PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION

The first special meeting of the Patient’s Right to Pharmacy Choice Commission as established by 36 O.S. § 6966 et seq. will be held on Thursday, July 15, 2021, at 10:00 am.  The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

I. Call to Order 

II. Commission Roll Call 

III. Review of HB 2123 (2021) & HB 2677 (2021) 

IV. PBM Complaints and License Review
      a. Kelli Price, Managing Counsel, OK Insurance Department 

V. Discussion & consideration of general Commission procedures 

VI. Review of obstacles, schedules & availability 

VII. Vote on Chair & Co-Chair 

VIII. Presentation on Administrative Procedures Act:
a. Professor Michael Mitchelson, Clinical Professor and Director of Externships, Oklahoma City University School of Law 

IX. Adjournment

Documents

Patient’s Right to Pharmacy Choice Commission Confidentiality and Conflict of Interest Disclosure Form 

PBM Advisory Committee Meeting Agenda 4.15.2021

PATIENT’S RIGHT TO PHARMACY CHOICE

ADVISORY COMMITTEE

AGENDA – EXHIBIT A

The next special meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Thursday, April 15, 2021, at 10:00 am. The meeting will take place via videoconference and in-person in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

This public meeting is being held consistent with the amendments to the Open Meeting Act, 25 O.S. § 301 et seq., signed into law by Gov. Stitt on February 8, 2021. See SB 1031, 2021

CONFERENCE LINE: +1-844-621-3956 United States (Toll-Free) Conference ID: 182 526 7517#

The following advisory committee members will be attending via the WebEx virtual platform: Mark Lewandowski, Jim Consedine, Melanie Maxwell, Bill Moore, The Honorable Bryan Dixon, Rose Thomas-Bendel, Toby Baldwin

The following OID staff will be attending via WebEx virtual platform: Mike Rhoads, Kelli Price, Rick Wagnon, Ashley Scott and Benna Nye

Loss of connectivity: If connection is lost at any time during this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the meeting will be stopped, and a special meeting will be scheduled.

Meeting Etiquette: In an effort to provide the best connectivity for all virtual attendees, we ask that only the advisory members and OID staff use the video option when attending the meeting. All others attending virtually should join the meeting by audio connection only. Thank you for your cooperation.

  1. Call to Order
  2. Committee Roll Call
  3. Review and Approval of the Minutes
  4. Staffing Changes
  5. Follow-Up on GEO Access Reports
  6. PBM Complaints and License Review
    • Kelli Price, Managing Counsel, OK Insurance Department
  7. Adjournment
Documents

PBM ACM Agenda 3.18.21

PATIENT’S RIGHT TO PHARMACY CHOICE
ADVISORY COMMITTEE

AMENDED AGENDA – EXHIBIT A

The next special meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Thursday, March 18, 2021, at 10:00 am.  The meeting will take place via videoconference and in-person in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

This public meeting is being held consistent with the amendments to the Open Meeting Act, 25 O.S. § 301 et seq., signed into law by Gov. Stitt on February 8, 2021. See SB 1031, 2021

CONFERENCE LINE: +1-844-621-3956 United States (Toll Free) Conference ID: 182 316 0852#

The following advisory committee members will be attending via the WebEx virtual platform: Mark Lewandowski, Melanie Maxwell, The Honorable Bryan Dixon, Rose Thomas-Bendel, Toby Baldwin

The following OID staff will be attending via WebEx virtual platform:  Ron White, Mike Rhoads, Kim Bailey, Kelli Price, Rick Wagnon and Benna Nye

Loss of connectivity: If connection is lost at any time during this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the meeting will be stopped, and a special meeting will be scheduled.

Meeting Etiquette: In an effort to provide the best connectivity for all virtual attendees, we ask that only the advisory members and OID staff use the video option when attending the meeting. All others attending virtually should join the meeting by audio connection only. Thank you for your cooperation.

I. Call to Order
II. Committee Roll Call
III. Review and Approval of the Minutes
IV. GEO Access Update
V. PBM Complaint Case Review
VI. Director’s Report
   a. Ron White, Director of PBM Regulatory Compliance, OK Insurance Department
   b. Kelli Price, Managing Counsel, OK Insurance Department
VII. Adjournment

PBM ACM Agenda 2.18.21
Advisory Committee Cases
Advisory Committee PowerPoint

PATIENT’S RIGHT TO PHARMACY CHOICE
ADVISORY COMMITTEE

REVISED A G E N D A – EXHIBIT A

The next regular meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Thursday, February 18, 2021, at 10:00 am.  The meeting will take place virtually or by phone due to the weather that has transpired.

This public meeting is being held consistent with the amendments to the Open Meeting Act, 25 O.S. § 301 et seq., signed into law by Gov. Stitt on February 8, 2021. See SB 1031, 2021

CONFERENCE LINE: +1-844-621-3956 United States (Toll Free) Conference ID: 182 951 4772#

The following advisory committee members will be attending via the WebEx virtual platform: Mark Lewandowski, Jim Consedine, Bill Moore, Melanie Maxwell, The Honorable Bryan Dixon, Rose Thomas-Bendel, Toby Baldwin

The following OID staff will be attending via WebEx virtual platform: Ron White, Kim Bailey, Ashley Scott, Rick Wagnon and Benna Nye

Loss of connectivity: If connection is lost at any time during this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the meeting will be stopped and a special meeting will be scheduled.

Meeting Etiquette: In an effort to provide the best connectivity for all virtual attendees, we asked that only the advisory members use the video option when attending the meeting. All other attendees should join the meeting by audio connection only. Thank you for your cooperation.

Agenda

I. Call to Order
II. Committee Roll Call
III. Review and Approval of the Minutes
IV. PBM Complaint Case Review
V. Director’s Report
    a. Ron White, Director of PBM Regulatory Compliance, OK Insurance Department

VI. New Business
VII.
Adjournment

PBM Advisory Committee Meeting Agenda 1.21.2021

PATIENT’S RIGHT TO PHARMACY CHOICE

ADVISORY COMMITTEE

A G E N D A – EXHIBIT A

The next regular meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Thursday, January 21, 2021 at 10 am.  The meeting will take place in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

This Agenda will be posted at the Main entrance of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105 on January 4, 2021. Copies were transmitted to the committee members. This agenda will be posted to the Oklahoma Insurance Department website (www.oid.ok.gov) on January 4, 2021.

  1. Call to Order
  2. Committee Roll Call
  • Discussion and Action to Designate a Chairperson and Vice-Chairperson of the Advisory Committee
  1. PBM Complaint Case Review
  2. Director’s Report
    1. Ron White, Director of PBM Regulatory Compliance, OK Insurance Department
  3. New Business
  • Adjournment

PBM Advisory Committee Meeting Cancellation 12.17.2020

ANNOUNCEMENT

Please take notice that the December 17, 2020 PBM Advisory Committee meeting has been cancelled.  The next meeting is tentatively rescheduled for January 21, 2021.

PATIENT’S RIGHT TO PHARMACY CHOICE
ADVISORY COMMITTEE

A G E N D A

The next regular meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Thursday, October 29, 2020 at 10 am.  The meeting will take place in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

This Agenda will be posted at the Main entrance of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105 on October 29, 2020. Copies were transmitted to the committee members. This agenda will be posted to the Oklahoma Insurance Department website (www.oid.ok.gov) on October 19, 2020.

  1. Call to Order
    1. Glen Mulready, Insurance Commissioner
  2. Committee Roll Call
  • Introduction of New Committee Members and Support Personnel
  1. Welcome to Committee Members and announcements
  2. PBM Complaint Case Review
  3. Director’s Report
    1. Ron White, Director of PBM Regulatory Compliance, OK Insurance Department
  • New Business
    1. Glen Mulready, Insurance Commissioner
  • Adjournment

PATIENT’S RIGHT TO PHARMACY CHOICE
ADVISORY COMMITTEE

A G E N D A

The second regular meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Tuesday, August 4, 2020 at 10 am.  The meeting will take place in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

This Agenda was posted at the Main entrance of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105 on July 29, 2020. Copies were transmitted to the committee members on July 28, 2020. This agenda was posted to the Oklahoma Insurance Department website (www.oid.ok.gov) on July 29, 2020.

I.   Call to Order
Glen Mulready, Insurance Commissioner

II.   Committee Roll Call

III.  Introduction of New Committee Members and Support Personnel

IV.  Welcome to Committee Members

V.   The Patient’s Right to Pharmacy Choice Act
Sara Worten, with the OID Legal Department

VI.   PSAO 101 Presentation
Melanie Maxwell, with Pharmacy Providers of Oklahoma

VII.  Director’s Report
Ron White, Director of PBM Regulatory Compliance, OK Insurance Department

VIII.  New Business
Glen Mulready, Insurance Commissioner

IX.    Adjournment

PATIENT’S RIGHT TO PHARMACY CHOICE
ADVISORY COMMITTEE

AGENDA

The first regular meeting of the Patient’s Right to Pharmacy Choice Advisory Committee as established by Insurance Commissioner Glen Mulready will be held on Thursday, July 9, 2020 at 10 am. The meeting will take place in the Public Conference Room of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105.

This Agenda was posted at the Main entrance of the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, Oklahoma 73105 on July 2, 2020 at 1pm. Copies were transmitted to the committee members on July 2, 2020. This agenda was posted to the Oklahoma Insurance Department website (www.oid.ok.gov) on July 2, 2020.

I. Call to Order

II. Committee Roll Call

III. Introduction of Committee Members and Support Personnel

IV. Welcome to Committee Members
Glen Mulready, Insurance Commissioner

V. Pharmacy 101 Presentation
Justin Wilson, D.Ph., Member, OK State Board of Pharmacy

VI. PBM 101 Presentation
Melodie Shrader, Pharmaceutical Care Management Association (PCMA)

VII. Director’s Report
Ron White, Director of PBM Regulatory Compliance, OK Insurance Department

VIII. New Business

IX. Adjournment

Patient's Right to Pharmacy Choice Commission

Appointing Authority Representing Appointee Term Begins Term Expires
Governor Consumer not employed by or professionally related to the insurance, pharmacy or PBM industry Rose Thomas-Bendel 6/1/2021 6/30/2022
Governor Consumer not employed by or professionally related to the insurance, pharmacy or PBM industry Kimberly Baker 6/29/2021 6/30/2022
Insurance Commissioner Pharmacy Benefits Manager/Insurance Industry James F. Consedine,II 6/1/2021 6/30/2023
Insurance Commissioner Pharmacy Benefits Manager/Insurance Industry Mark Lewandowski 6/1/2021 6/30/2023
Oklahoma State Board of Pharmacy Pharmacists Melanie Maxwell 5/19/2021 6/30/2023
Oklahoma State Board of Pharmacy Pharmacists Greg Huenergardt, DPh 5/19/2021 6/30/2023
Attorney General Office of the Attorney General Anthony J. Ferate 1/3/2022 6/30/2024

*Commission Members shall be appointed for initial staggered terms. Subsequent terms will be for five (5) years. The terms of the Commission Members shall expire on the thirtieth (30th) day of June of the year designated for the expiration of the term for which appointed, but the member shall serve until a qualified successor has been duly appointed. Except for the initial staggered terms, developed in HB2123 (2021) no person shall be appointed to serve more than two (2) consecutive terms.

Forms and Documents

Resources

Notices