Stricken language would be deleted from and underlined language would be added to present law.
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State of Arkansas 1
94th General Assembly A Bill 2
Regular Session, 2023 SENATE BILL 94 3
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By: Senator K. Hammer 5
By: Representative Achor 6
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For An Act To Be Entitled 8
AN ACT TO MODIFY THE ARKANSAS PHARMACY BE NEFITS 9
MANAGER LICENSURE AC T; TO AMEND THE DEFI NITION OF 10
"HEALTH BENEFIT PLAN " UNDER THE ARKANSAS PHARMACY 11
BENEFITS MANAGER LIC ENSURE ACT; TO REPEA L THE 12
REQUIREMENT FOR QUAR TERLY REPORTS BY A P HARMACY 13
BENEFITS MANAGER; TO CLARIFY THE AUTHORIT Y OF THE 14
INSURANCE COMMISSION ER UNDER THE ARKANSA S PHARMACY 15
BENEFITS MANAGER LIC ENSURE ACT; AND FOR OTHER 16
PURPOSES. 17
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Subtitle 20
TO MODIFY THE ARKANSAS PHARMACY BENEFITS 21
MANAGER LICENSURE ACT. 22
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 25
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SECTION 1. Arkansas Code § 23 -92-503(2), concerning the definition of 27
"health benefit plan" used in the Arkansas Pharmacy Benefits Manager 28
Licensure Act, is amended to read as follows: 29
(2)(A) “Health benefit plan” means any individual, blanket, or 30
group plan, policy, or contract for healthcare services issued or delivered 31
by a healthcare payor in to residents of this state. 32
(B) “Health benefit plan” does not include: 33
(i) Accident-only plans; 34
(ii) Specified disease plans; 35
(iii) Disability income plans; 36 SB94
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(iv) Plans that provide only for indemnity for 1
hospital confinement; 2
(v) Long-term care only plans that do not include 3
pharmacy benefits; 4
(vi) Other limited-benefit health insurance policies 5
or plans; or 6
(vii) Health benefit plans provided under Arkansas 7
Constitution, Article 5, § 32, the Workers' Compensation Law, § 11 -9-101 et 8
seq., and the Public Employee Workers' Compensation Act, § 21 -5-601 et seq. 9
(C) "Health benefit plan" includes any group plan, policy, 10
or contract for healthcare services issued outside this state that provides 11
benefits to residents of this state ; 12
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SECTION 2. Arkansas Code § 23 -92-504(b), concerning the rule -making 14
authority of the Insuran ce Commissioner, is amended to read as follows: 15
(b)(1) The commissioner shall issue rules establishing the licensing, 16
fees, application, financial standards, penalties, compliance and enforcement 17
requirements, and reporting requirements of pharmacy benefits managers under 18
this subchapter. 19
(2)(A) When adopting the initial rules to implement this 20
subchapter, the final rule shall be filed with the Secretary of State for 21
adoption under § 25-15-204(f): 22
(i) On or before September 1, 2018; or 23
(ii) If approval under § 10-3-309 has not occurred 24
by September 1, 2018, as soon as practicable after approval under § 10-3-309. 25
(B) The State Insurance Department shall file the proposed 26
rule with the Legislative Council under § 10-3-309(c) sufficiently in advance 27
of September 1, 2018, so that the Legislative Council may consider the rule 28
for approval before September 1, 2018. 29
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SECTION 3. Arkansas Code § 23 -92-505(b), concerning the requirement 31
for quarterly reports by a pharmacy benefits manager to the Insurance 32
Commissioner, is amended to read as follows: 33
(b)(1) A pharmacy benefits manager shall report to the Insurance 34
Commissioner on a quarterly basis for each healthcare payor the following 35
information: 36 SB94
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(A) The aggregate amount of rebates received by the 1
pharmacy benefits manager; 2
(B) The aggregate amount of rebates distributed to the 3
appropriate healthcare payor; 4
(C) The aggregate amount of rebates passed on to the 5
enrollees of each healthcare payor at the point of sale that reduced the 6
enrollees' applicable deductible, copayment, coinsurance, or other cost-7
sharing amount; 8
(D) The individual and aggregate amount paid by the 9
healthcare payor to the pharmacy benefits manager for pharmacist services 10
itemized by pharmacy, by product, and by goods and services; and 11
(E) The individual and aggregate amount a pharmacy 12
benefits manager paid for pharmacist services itemized by pharmacy, by 13
product, and by goods and services The Insurance Commissioner may examine the 14
books and records of a pharmacy benefits manager as necessary to determine: 15
(A) The aggregate amount of rebates received by a pharmacy 16
benefits manager; 17
(B) The aggregate amount of rebates distributed by a 18
pharmacy benefits manager to an appropriate healthcare payor; and 19
(C) The aggregate amount of rebates passed on to an 20
enrollee of each healthcare payor at the point of sale that reduced the 21
enrollee's applicable deductible, copayment, coinsurance, or other cost 22
sharing amount. 23
(2) The report required under subdivision (b)(1) of this section 24
is: 25
(A) Proprietary and confidential under § 23-61-107(a)(4) 26
and § 23-61-207; and 27
(B) Not subject to the Freedom of Information Act of 1967, 28
§ 25-19-101 et seq The commissioner may examine the books and records of a 29
pharmacy benefits manager as necessary to determine: 30
(A) The individual and aggregate amount paid by a 31
healthcare payor to the pharmacy benefits manager for pharmacist services 32
itemized by pharmacy, product, and goods and services, including other 33
prescription drug or device services; and 34
(B) The individual and aggregate amount a pharmacy 35
benefits manager paid for pharmacist services itemized by pharmacy, product, 36 SB94
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and goods and services, including other prescription drug or device services. 1
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SECTION 4. Arkansas Code § 23 -92-508 is amended to read as follows: 3
23-92-508. Enforcement. 4
(a) The Insurance Commissioner shall enforce this subchapter through 5
any action that the commissioner deems necessary. 6
(b)(1) The commissioner may examine or audit the books and records of 7
a pharmacy benefits manager providing claims processing services or other 8
prescription drug or device services for a health benefit plan to determine 9
if the pharmacy benefits manager is in compliance with this subchapter. 10
(2) The information or data acquired during an examination under 11
subdivision (b)(1) of this section is: 12
(A) Considered proprietary and confidential under § 23-61-13
107(a)(4) and § 23-61-207; and 14
(B) Not subject to the Freedom of Information Act of 1967, 15
§ 25-19-101 et seq. 16
(c) After notice and opportunity for hearing, the commissioner may: 17
(1) Impose a penalty of ten thousand dollars ($10,000) per 18
violation against a pharmacy benefits manager if the commiss ioner finds that 19
the pharmacy benefits manager has not: 20
(A) Followed the process established for determining 21
pricing or costs under the Maximum Allowable Cost List under § 17 -92-507; or 22
(B) Used the national average drug acquisition cost under 23
§ 23-92-506(b); or 24
(2) Revoke or suspend the license of a pharmacy benefits manager 25
if the commissioner finds that the pharmacy benefits manager: 26
(A) Has committed a pattern of violations of this 27
subchapter; 28
(B) Has not followed the process establi shed for 29
determining pricing and costs under the Maximum Allowable Cost List under § 30
17-92-507; or 31
(C) Has not used the national average drug acquisition 32
cost under § 23-92-506(b). 33
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SECTION 5. Arkansas Code § 23 -92-510, concerning the applicability of 35
the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to add an 36 SB94
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additional subsection to read as follows: 1
(d) This subchapter applies to a health benefit plan that is issued 2
outside this state if that health benefit plan provides benefits for 3
healthcare services to residents of this state. 4
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