Oklahoma § 36-3634.5 - Synchronization of prescription drug refills

§ 36-3634.5. Synchronization of prescription drug refills

A. A health benefit plan that provides benefits for

prescription drugs delivered, issued or renewed after November 1,

2017, shall provide for synchronization of prescription drug refills

on at least one occasion per insured per year, provided all of the

following conditions are met:

1. The prescription drugs are covered by the health benefit

plan's clinical coverage policy or have been approved by a formulary

exceptions process;

2. The prescription drugs are maintenance medications as

defined by the plan and have available refill quantities at the time

of synchronization;

3. The medications are not Schedule II, III or IV controlled

substances;

4. The insured meets all utilization management criteria to the

prescription drugs at the time of synchronization;

5. The prescription drugs are of a formulation that can be

safely split into short-fill periods to achieve synchronization;

Oklahoma Statutes - Title 36. Insurance

6. The prescription drugs do not have special handling or

sourcing needs as determined by the plan, contract, or agreement

that require a single, designated pharmacy to fill or refill the

prescription; and

7. The covered person agrees to the synchronization.

B. When necessary to permit synchronization, the health benefit

plan shall apply a prorated daily cost-sharing rate to any

medication dispensed by a network pharmacy pursuant to this section.

No dispensing fees shall be prorated, and all dispensing fees shall

be based on the number of prescriptions filled or refilled.

C. As used in this section, "synchronization" means the

coordination of medication refills for a patient taking two or more

medications for one or more chronic conditions such that the

patient's medications are refilled on the same schedule for a given

time period.

Added by Laws 2017, c. 140, § 1, eff. Nov. 1, 2017.