OK SB252

Excludes prescription drug services from capitated contracts with health plans; directs OHCA to cover prescription drugs through a fee-for-service delivery model upon federal approval.

OHCA shall transition all Medicaid members' prescription drug coverage from contracted entities to direct Authority coverage and directly reimburse pharmacists and pharmacy providers.

Allows OHCA to contract with a pharmacy benefits administrator located in Oklahoma for claims processing but prohibits contracting with a pharmacy benefits manager.

Authorizes OHCA to implement value-based payment arrangements with providers and participate in the Medicaid Drug Rebate Program for cost savings on prescription drugs.

Effective date: November 1, 2025.