OK SB993

Limits pharmacy benefits manager (PBM) audits to 50 prescription claims per pharmacy per calendar year, inclusive of all audits by the PBM or its agents, and requires 14 calendar days written notice with specific prescription numbers, fill dates, drug names, and NDC numbers before conducting audits

Requires PBMs to deliver preliminary audit findings within 45 calendar days, allows pharmacies 90 days to respond to discrepancies (with possible 45-day extension), and mandates final audit reports within 10 calendar days of receiving pharmacy documentation

Tolls all PBM audit timelines during declared disasters (floods, tornadoes, earthquakes, wildfires, terrorist attacks) plus 30 additional days after the disaster declaration ends for pharmacies in affected counties

Prohibits PBMs from assessing fines or penalties on pharmacies unless there is a valid recoupment, bars extrapolation audits, and requires fraud referrals to the Attorney General be reported with specific notification requirements

Strengthens below-cost reimbursement appeal protections by requiring PBMs to provide documented proof of drug availability at the claimed price, treating any appeal resulting in reimbursement still below acquisition cost as a denial, and prohibiting PBMs from requiring pharmacies to collect additional money from patients or plan sponsors after successful appeals