OK SB2007

PBMs must remit administrative fees to pharmacies when they increase reimbursement for a drug following an appeal and then reduce it within 30 days: $100 per occurrence, escalating to $500 after 90 days and $1,000 after 180 days of non-payment

Appeals resulting in reimbursement increases that still fall below the pharmacy's acquisition cost are classified as denials, triggering requirements for PBMs to provide documented proof of drug availability at lower prices from wholesalers

Reimbursement appeal requirements apply to all payment methodologies including average acquisition cost, average wholesale price, wholesale acquisition cost, and generic/brand effective rates

PBMs cannot require pharmacies to collect additional money from patients or plan sponsors following successful below-cost reimbursement appeals

Effective date: November 1, 2026