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 – REGULAR MEETING
Agenda
October 20, 2022 Meeting Minutes
November 17, 2022 Meeting Minutes
4th Quarterly Accounting Report
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 19, 2023 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, OK, and in accordance with the Open Meetings 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 scheduled 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 the business portion of this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the business portion of the meeting will be stopped, and a special meeting may be scheduled.
This meeting has been cancelled.
PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION – REGULAR MEETING
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, December 15, at 10:00 a.m. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department (“OID”), at the address above and in accordance with the Open Meetings 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 scheduled 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 the business portion of this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the business portion of the meeting will be stopped, and a special meeting may be scheduled.
The following OID staff are expected to attend in-person: Kelli Price, Dilan Lyda, Ashley Scott, Glenn Disher, Tracy Keeley, Sarah Smith-Drozdov, Sherry Standerfer, and Maria Torres.
PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION – REGULAR MEETING
Minutes of the Regular Meeting of October 20, 2022
The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department (“OID”), at the address above and in accordance with the Open Meetings 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 scheduled 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 the business portion of this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the business portion of the meeting will be stopped, and a special meeting may be scheduled.
The following OID staff are expected to attend in-person: Kelli Price, Dilan Lyda, Ashley Scott, Glenn Disher, Tracy Keeley, Sherry Standerfer, and Maria Torres.
CALL TO ORDER …………………………………………………………. Commission’s Chair, Chairman Mark Lewandowski
CALL ……………………………………………………………………………Commission’s Chair, Chairman Mark Lewandowski
*STATEMENT OF QUORUM AND COMPLIANCE BY CHAIRMAN*
BUSINESS ……………………………………………………………………Commission’s Chair, Chairman Mark Lewandowski
THE FOLLOWING MATTERS ARE PRESENTED FOR CONSIDERATION AND ACTION, IF ANY, DEEMED APPROPRIATE BY THE COMMISSION. Executive sessions of the Commission will be permitted for purposes pursuant to Title 25 O.S. § 307(B)(4) and (7).*
- MINUTES:
- The drafted Minutes of the Regular Meeting of October 20, 2022 will be considered for approval.
- Review of posted 2023 Pharmacy Choice Commission regular meeting dates.
- Public Comment :
- Comments shall be limited to 3 minutes per person and shall pertain only to items listed on the business portion of the Pharmacy Choice Commission meeting Agenda. Any audience member wishing to address the Commission shall first identify themselves to the Commission prior to making their address.
- Adjournment of Pharmacy Choice Commission – Business portion of the meeting and disconnection of teleconference line.
HEARINGS …………………………………………………………………… Commission’s Chair, Chairman Mark Lewandowski
Hearings before the Commission:
The hearings before the Commission will be conducted pursuant to the authority and jurisdiction of the Oklahoma Insurance Code, Title 36 O.S. §§ 101 et seq., Title 59 O.S. § 356-360, and specifically Title 36 O.S. §§ 307, and the Patient’s Right to Pharmacy Choice Act Title 36 O.S. §§ 6958-6968 and the Oklahoma Insurance Department’s Permanent Rules, OAC 365.
The procedure for the hearings before the Commission is as follows:
- Each side will be allowed five (5) minutes for Opening statements.
- The State will present first.
- Both parties are subject to questioning by Commissioners.
THE FOLLOWING MATTERS ARE PRESENTED FOR CONSIDERATION AND ACTION, IF ANY, DEEMED APPROPRIATE BY THE COMMISSION. Executive sessions of the Commission will be permitted for purposes pursuant to Title 25 O.S. § 307(B)(4), (7) and (8).* The Commission may recess for lunch and breaks may be taken as necessary.
- Case Number 22-0443-DIS, State of Oklahoma v. Prime Therapeutics, L.L.C.:
- Scheduling Conference regarding Statement of Charges, Notice of Hearing, and Order to Show Cause
Possible Action:
Possible action may include, but is not limited to: taking no action; continuing the matter; issuing an order; or taking preliminary action in the matter. The Commission may instruct State or Respondent Counsel or staff to draft a proposed order to be considered in further deliberations and at a future Commission meeting.
ADJOURNMENT ………………………………………………………….. Commission’s Chair, Chairman Mark Lewandowski
Note: The Commission may, at its discretion, discuss, vote to approve, vote to disapprove, vote to table, change the sequence of any agenda item, vote to strike or not discuss any agenda item. Any conflicts of interest must be disclosed prior to the discussion, and the conflicted Comission member must recuse from all discussion and votes pertaining to the item.
Patient’s Right to Pharmacy Choice Commission Agenda 10/20/2022
2nd Quarterly Accounting Report to Pharmacy Choice Commission
3rd Quarterly Accounting Report to Pharmacy Choice Commission
PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION REGULAR MEETING- MINUTES AUGUST 18, 2022
PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION – REGULAR MEETING
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, October 20, at 10:00 a.m. The meeting will take place in-person in the Public Conference Room of the Oklahoma Insurance Department (“OID”), at the address above and in accordance with the Open Meetings 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 scheduled 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 the business portion of this meeting, the meeting will be stopped and reconvened once connection is reestablished. If connection cannot be restored after thirty (30) minutes, the business portion of the meeting will be stopped, and a special meeting may be scheduled.
The following OID staff are expected to attend in-person: Kelli Price, Dilan Lyda, Ashley Scott, Glenn Disher, Tracy Keeley, Sarah Smith-Drozdov, Sherry Standerfer, and Maria Torres.
AGENDA
CALL TO ORDER – Commission’s Chair, Chairman Mark Lewandowski
CALL – Commission’s Chair, Chairman Mark Lewandowski
*STATEMENT OF QUORUM AND COMPLIANCE BY CHAIRMAN*
BUSINESS – Commission’s Chair, Chairman Mark Lewandowski
THE FOLLOWING MATTERS ARE PRESENTED FOR CONSIDERATION AND ACTION, IF ANY, DEEMED APPROPRIATE BY THE COMMISSION. Executive sessions of the Commission will be permitted for purposes pursuant to Title 25 O.S. § 307(B)(4) and (7).*
A. MINUTES:
The drafted Minutes of the Regular Appeals Meeting of August 18, 2022 will be considered for approval.
B. Introduction of new Commission members Gina Perry and Teah Corley.
C. Introduction of newly appointed Counsel for the Pharmacy Choice Commission for FY 2023, Liz Stevens and Overview of the role and duties of Counsel for the Pharmacy Choice Commission: a. Presented by Liz Stevens
D. Discussion and possible action on dates to be scheduled for 2023 Pharmacy Choice Commission regular meetings.
E. Discussion and possible action to enter into Executive Session pursuant to 25 O.S. §307(B)(7) for discussion of the dismissal of Case Number 22-0122-DIS, State of Oklahoma v. Prime Therapeutics L.L.C., where disclosure of information would violate confidentiality requirements of state law.
a. Vote to enter Executive Session
b. Exit Executive Session and vote to re-enter Open Session
F. Review of Amended 2022 – 2nd Quarterly Report and 2022 – 3rd Quarterly Report to Pharmacy Choice Commission:
a. Presented by Kelli Price, OID Managing Counsel
G. Public Comment :
a. Comments shall be limited to 3 minutes per person and shall pertain only to items listed on the business portion of the Pharmacy Choice Commission meeting Agenda. Any audience member wishing to address the Commission shall first identify themselves to the Commission prior to making their address.
H. Adjournment of Pharmacy Choice Commission – Business portion of the meeting and disconnection of teleconference line.
HEARINGS – Commission’s Chair, Chairman Mark Lewandowski
Hearings before the Commission En Banc:
The hearings before the Commission en banc will be conducted pursuant to the authority and jurisdiction of the Oklahoma Insurance Code, Title 36 O.S. §§ 101 et seq., Title 59 O.S. § 356-360, and specifically Title 36 O.S. §§ 307, and the Patient’s Right to Pharmacy Choice Act Title 36 O.S. §§ 6958-6968 and the Oklahoma Insurance Department’s Permanent Rules, OAC 365.
The procedure for the hearings before the Commission en banc is as follows:
- Each side will be allowed five (5) minutes for Opening statements.
- The State will present first.
- Both parties are subject to questioning by Commissioners.
THE FOLLOWING MATTERS ARE PRESENTED FOR CONSIDERATION AND ACTION, IF ANY, DEEMED APPROPRIATE BY THE COMMISSION. Executive sessions of the Commission will be permitted for purposes pursuant to Title 25 O.S. § 307(B)(4), (7) and (8).* The Commission may recess for lunch and breaks may be taken as necessary.
- Case Number 22-0419-DIS, State of Oklahoma v. CVS Caremark, L.L.C.:
a) Scheduling Conference regarding Statement of Charges, Notice of Hearing, and Order to Show Cause
Possible Action:
Possible action may include, but is not limited to: taking no action; continuing the matter; issuing an order; or taking preliminary action in the matter. The Commission may instruct State or Respondent Counsel or staff to draft a proposed order to be considered in further deliberations and at a future Commission meeting.
- Case Number 21-0568-DIS, State of Oklahoma v. Express Scripts, Inc.:
a) Respondent’s Unopposed Motion for Continuance of Hearing
Possible Action:
Possible action may include, but is not limited to: taking no action; continuing the matter; issuing an order; or taking preliminary action in the matter. The Commission may instruct State or Respondent Counsel or staff to draft a proposed order to be considered in further deliberations and at a future Commission meeting.
ADJOURNMENT – Commission’s Chair, Chairman Mark Lewandowski
Note: The Commission may, at its discretion, discuss, vote to approve, vote to disapprove, vote to table, change the sequence of any agenda item, vote to strike or not discuss any agenda item. Any conflicts of interest must be disclosed prior to the discussion, and the conflicted Comission member must recuse from all discussion and votes pertaining to the item.
Patient’s Right to Pharmacy Choice Commission Agenda 08/18/2022
PATIENT’S RIGHT TO PHARMACY CHOICE COMMISSION – REGULAR MEETING
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, August 18, 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, Glenn Disher, Tracy Keeley, Sarah Smith-Drozdov 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 to Order & Commission Roll Call
II. Review & approval of Pharmacy Choice Commission meeting minutes from May 12, 2022 meeting
III. Review of Quarterly Report to Pharmacy Choice Commission: a. Presented by Kelli Price, OID Managing Counsel
IV. Status review: PCMA v. Mulready before the 10th Circuit Court of Appeals
V. Review of SB737, aggregate reporting requirements, OID Bulletin 5-2022 (at https://www.oid.ok.gov/bulletin-5-2022/), and the reporting template (available at https://www.oid.ok.gov/regulated-entities/pbm/)
VI. Review and discussion of pharmacy network adequacy standards as provided by the Patient’s Right to Pharmacy Choice Act, inquiry and reporting procedures, and reporting template a. Presented by Glenn Disher, PBM Compliance and Enforcement Officer
VII. Review of NCPA’s ERISA and Medicare Part D Preemption Analysis
VIII. Questions / Comments from Commission members, OID, and audience
IX. Adjournment of Business Meeting
PBM Compliance & Enforcement Hearings before Commission:
1) Call scheduled hearing(s) to Order & Commission Roll Call
2) Presentation of Case(s) for Hearing(s):
i) Case Number 22-0122-DIS, State of Oklahoma v. Prime Therapeutics L.L.C.:
(1) ALJ’S ruling on Prime Therapeutics L.L.C.’s Motion for Disqualification of Commission Member Gregory Huenergardt
(2) ALJ’S ruling on Prime Therapeutics L.L.Cc’s Motion for Disqualification of Commission Member Melanie Maxwell
(3) State’s Statement of Charges and Notice of Hearing
ii) Case Number 21-0568-DIS, State of Oklahoma v. Express Scripts:
(1) Express Scripts’ Motion for Continuance and Request for Hearing
3) Adjournment of PBM Compliance & Enforcement Hearing(s)
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
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
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.
- Call to Order
- Committee Roll Call
- Review and Approval of the Minutes
- Staffing Changes
- Follow-Up on GEO Access Reports
- PBM Complaints and License Review
- Kelli Price, Managing Counsel, OK Insurance Department
- Adjournment
Documents
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.
- Call to Order
- Committee Roll Call
- Discussion and Action to Designate a Chairperson and Vice-Chairperson of the Advisory Committee
- PBM Complaint Case Review
- Director’s Report
- Ron White, Director of PBM Regulatory Compliance, OK Insurance Department
- 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.
- Call to Order
- Glen Mulready, Insurance Commissioner
- Committee Roll Call
- Introduction of New Committee Members and Support Personnel
- Welcome to Committee Members and announcements
- PBM Complaint Case Review
- Director’s Report
- Ron White, Director of PBM Regulatory Compliance, OK Insurance Department
- New Business
- 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 | 6/30/2027 |
Governor | Consumer not employed by or professionally related to the insurance, pharmacy or PBM industry | Gena Perry | 8/26/2022 | 6/30/2027 |
Insurance Commissioner | Pharmacy Benefits Manager/Insurance Industry | Teah Corley | 9/20/2022 | 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
- PBM Special Notice on Patient’s Right to Pharmacy Choice Act, title 36 O.S. § 6958 et seq.
- UPDATE: Status of Patient’s Right to Pharmacy Choice Act
- General Hunter’s Legal Interpretation: Designation of Preferred Pharmacies under the Patient’s Right to Pharmacy Choice Act
- Bulletin No. 5-2022 (Senate Bill 737)