Stricken language would be deleted from and underlined language would be added to present law.
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State of Arkansas 1
95th General Assembly A Bill 2
Regular Session, 2025 SENATE BILL 103 3
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By: Senator C. Penzo 5
By: Representative Lundstrum 6
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For An Act To Be Entitled 8
AN ACT CONCERNING THE STATE'S ANY WILLING PROVIDER 9
LAWS; TO AMEND THE PATIENT PROTECTION ACT OF 1995; TO 10
CREATE THE PHARMACY NONDISCRIMINATION ACT; TO REQUIRE 11
PHARMACY BENEFITS MANAGERS TO ACCEPT ANY PHARMACY OR 12
PHARMACIST WILLING TO ACCEPT RELEVANT AND REASONABLE 13
TERMS OF PARTICIPATION; TO DECLARE AN EMERGENCY; AND 14
FOR OTHER PURPOSES. 15
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17
Subtitle 18
TO CREATE THE PHARMACY NONDISCRIMINATION 19
ACT; TO REQUIRE PHARMACY BENEFITS 20
MANAGERS TO ACCEPT ANY PHARMACY OR 21
PHARMACIST WILLING TO ACCEPT RELEVANT 22
AND REASONABLE TERMS OF PARTICIPATION; 23
AND TO DECLARE AN EMERGENCY. 24
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 26
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SECTION 1. DO NOT CODIFY. Title. This act shall be known and may be 28
cited as the "Pharmacy Nondiscrimination Act". 29
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SECTION 2. DO NOT CODIFY. Legislative findings and intent. 31
(a) The General Assembly finds that: 32
(1) The state's any willing provider laws under §§ 23 -99-204 — 33
23-99-210 ensure fair access to healthcare providers, fostering competition 34
and consumer choice; 35
(2) Pharmacy benefits managers play a key role in the delivery 36 SB103
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and management of pharmacy benefits; and 1
(3) Practices that exclude qualified pharmacies or pharmacists 2
without reasonable justification could restrict competition and limit patient 3
access. 4
(b) It is the intent of the General Assembly that this act shall 5
clarify and update the principles of the state's any willing provider laws 6
applicable to pharmacy benefits managers to ensure that any willing pharmacy 7
or pharmacist that meets relevant and reasonable participation criteria may 8
join a pharmacy benefits manager network consistent with state and federal 9
law, as most healthcare insurers contract with pharmacy benefits managers to 10
administer pharmacy benefits. 11
12
SECTION 3. Arkansas Code § 23 -99-203(d), concerning the definition of 13
"healthcare provider" under the Patient Protection Act of 1995, is amended to 14
read as follows: 15
(d) "Healthcare provider" means those individuals or entities licensed 16
by the State of Arkansas to provide healthcare services, limited to the 17
following: 18
(1) Advanced practice nurses; 19
(2) Athletic trainers; 20
(3) Audiologists; 21
(4) Certified behavioral health providers; 22
(5) Certified orthotists; 23
(6) Chiropractors; 24
(7) Community mental health centers or clinics; 25
(8) Dentists; 26
(9) Home health care; 27
(10) Hospice care; 28
(11) Hospital-based services; 29
(12) Hospitals; 30
(13) Licensed ambulatory surgery centers; 31
(14) Licensed certified social workers; 32
(15) Licensed dieticians; 33
(16) Licensed intellectual and developmental disabilities 34
service providers; 35
(17) Licensed professional counselors; 36 SB103
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(18) Licensed psychological examiners; 1
(19) Long-term care facilities; 2
(20) Occupational therapists; 3
(21) Optometrists; 4
(22) Pharmacists and pharmacies; 5
(23) Physical therapists; 6
(24) Physicians and surgeons (M.D. and D.O.); 7
(25) Podiatrists; 8
(26) Prosthetists; 9
(27) Psychologists; 10
(28) Respiratory therapists; 11
(29) Rural health clinics; and 12
(30) Speech pathologists. 13
14
SECTION 4. Arkansas Code § 23 -99-802(4), concerning the definition of 15
"healthcare provider" as used under the any willing provider laws, is amended 16
to read as follows: 17
(4) "Healthcare provider" or “provider” means those individuals 18
or entities licensed by the State of Arkansas to provide healthcare services, 19
limited to the following: 20
(A) Advanced practice nurses; 21
(B) Athletic trainers; 22
(C) Audiologists; 23
(D) Certified behavioral health providers; 24
(E) Certified orthotists; 25
(F) Chiropractors; 26
(G) Community mental health centers or clinics; 27
(H) Dentists; 28
(I) Home health care; 29
(J) Hospice care; 30
(K) Hospital-based services; 31
(L) Hospitals; 32
(M) Licensed ambulatory surgery centers; 33
(N) Licensed certified social workers; 34
(O) Licensed dieticians; 35
(P) Licensed durable medical equipment providers; 36 SB103
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(Q) Licensed intellectual and developmental disabilities 1
service providers; 2
(R) Licensed professional counselors; 3
(S) Licensed psychological examiners; 4
(T) Long-term care facilities; 5
(U) Occupational therapists; 6
(V) Optometrists; 7
(W) Pharmacists and pharmacies; 8
(X) Physical therapists; 9
(Y) Physicians and surgeons (M.D. and D.O.); 10
(Z) Podiatrists; 11
(AA) Prosthetists; 12
(BB) Psychologists; 13
(CC) Respiratory therapists; 14
(DD) Rural health clinics; 15
(EE) Speech pathologists; and 16
(FF) Other healthcare practitioners as determined by the 17
State Insurance Department in rules promulgated under the Arkansas 18
Administrative Procedure Act, § 25 -15-201 et seq.; 19
20
SECTION 5. Arkansas Code Title 23, Chapter 99, Subchapter 2, is 21
amended to add an additional section to read as follows: 22
23-99-211. Pharmacy benefits manager network participation — 23
Definitions. 24
(a) As used in this section: 25
(1) "Pharmacist" means an individual licensed as a pharmacist by 26
the Arkansas State Board of Pharmacy; 27
(2) "Pharmacy" means the place licensed by the board in which 28
drugs, chemicals, medicines, prescriptions, and poisons are compounded, 29
dispensed, or sold at retail; 30
(3) "Pharmacy benefits manager" means a person, business, or 31
entity, including a wholly or partially owned or controlled subsidiary of a 32
pharmacy benefits manager, that: 33
(A) Provides claims processing services or other 34
prescription drug or devices services, or both, for health benefit plans; and 35
(B) Is licensed under the Arkansas Pharmacy Benefits 36 SB103
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Manager Licensure Act, § 23 -92-502; 1
(4)(A) "Pharmacy benefits manager network" means any network of 2
pharmacists or pharmacies that are offered by an agreement or insurance 3
contract to provide pharmacist services for health benefit plans. 4
(B) "Pharmacy benefits manager network" includes any 5
network delegated by the healthcare payor to the pharmacy benefits manager; 6
and 7
(5)(A) "Relevant and reasonable terms of participation” means 8
terms and conditions that: 9
(i) Are consistent with applicable state and federal 10
law; 11
(ii) Are consistent with industry standards; and 12
(iii) Do not arbitrarily or discriminatorily exclude 13
a qualified pharmacy or pharmacist. 14
(B) "Relevant and reasonable terms of participation" does 15
not include if the pharmacy benefits manager performs a prohibited practice 16
of requiring accreditation standards and certification standards that are 17
more stringent or in addition to the standards required by the board for a 18
pharmacy licensed in this state. 19
(b)(1) A pharmacy benefits manager shall not deny a pharmacy or 20
pharmacist the opportunity to participate in the pharmacy benefits manager's 21
network if the pharmacy or pharmacist: 22
(A) Is licensed under the laws of this state; and 23
(B) Agrees to accept and comply with the relevant and 24
reasonable terms of participation as determined under this section. 25
(2) A pharmacy benefits manager shall not exclude a pharmacy or 26
pharmacist from continued participation in the pharmacy benefits manager's 27
pharmacy benefits manager network if the pharmacy or pharmacist continues to: 28
(A) Be licensed under the laws of this state; and 29
(B) Accept and comply with the relevant and reasonable 30
terms of participation as determined under this section. 31
(3) A pharmacy benefits manager shall not: 32
(A) Condition participation of a pharmacy or pharmacist in 33
one (1) pharmacy benefits manager network based on participation in any other 34
pharmacy benefits manager network or penalize a pharmacy or pharmacist for 35
exercising his, her, or its prerogative not to participate in a specific 36 SB103
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pharmacy benefits manager network; or 1
(B) Limit a pharmacy benefits manager network to include 2
solely: 3
(i) An affiliated pharmacy; or 4
(ii) An internet pharmacy or a pharmacy that does 5
not have a physical presence in this state for consumer access. 6
(c)(1) If a pharmacy or pharmacist alleges that a pharmacy benefits 7
manager has denied or excluded the pharmacy or pharmacist from participation 8
in the pharmacy benefits manager's pharmacy benefits manager network without 9
justification, the pharmacy or pharmacist may submit a written complaint to 10
the Insurance Commissioner. 11
(2) If a dispute arises as to whether there are "relevant and 12
reasonable terms of participation" as that term is defined in this section, 13
the commissioner shall decide the issue by determining whether the terms or 14
conditions: 15
(A) Are consistent with applicable state and federal law; 16
(B) Are consistent with industry standards; and 17
(C) Do not arbitrarily or discriminatorily exclude a 18
qualified pharmacy or pharmacist. 19
(3) Within thirty (30) days of receipt of the complaint under 20
subdivision (c)(1) of this section, the commissioner, after a hearing 21
conducted under § 23 -61-301 and consideration of evidence from all parties, 22
shall issue a determination. 23
(4) The determination of the commissioner under subdivision 24
(c)(3) of this section is binding on all parties, subject to judicial review 25
under § 23-61-307. 26
(d) A pharmacy benefits manager shall not: 27
(1) Impose terms or conditions that do not meet the definition 28
of "relevant and reasonable terms of participation" under this section; 29
(2) Utilize reimbursement methodologies or contractual clauses 30
intended to indirectly exclude a willing pharmacy or pharmacist from 31
participation; or 32
(3) Engage in a practice that discriminates against a pharmacy 33
or pharmacist based on the pharmacy's or pharmacist's geographic location, 34
size, or ownership structure, unless the geographic location, size, or 35
ownership structure is directly relevant to patient care or network adequacy. 36 SB103
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(e) This section does not: 1
(1) Regulate the design or administration of employee benefit 2
plans; or 3
(2) Impose requirements directly on employee benefit plans. 4
(f) This section applies to the trade practices of pharmacy benefits 5
managers operating in this state, including a pharmacy benefits manager's 6
pharmacy benefits manager network participation requirements and marketing or 7
sale of pharmacy benefits manager network products and services, as permitted 8
under state law. 9
(g) This section is enforceable with respect to a pharmacy benefits 10
manager's compliance with state rules regarding healthcare provider equity 11
and market practices. 12
(h)(1) The commissioner may promulgate rules necessary to implement, 13
administer, and enforce this section. 14
(2) Rules that the commissioner may adopt under this section 15
include without limitation rules relating to: 16
(A) Providing a process for resolving disputes between 17
pharmacies, pharmacists, and pharmacy benefits managers; 18
(B) Ensuring compliance with state and federal laws; and 19
(C) Monitoring compliance with this section by licensed 20
pharmacy benefits managers. 21
(i)(1) After notice and opportunity for a hearing, if a pharmacy 22
benefits manager is found to have violated this section, the commissioner 23
may: 24
(A) Impose a fine of up to one hundred thousand dollars 25
($100,000) per violation; 26
(B) Prohibit the pharmacy benefits manager from marketing, 27
selling, or utilizing one (1) or more offending products, pharmacy benefits 28
manager networks, or services within this state until the pharmacy benefits 29
manager complies with this section; and 30
(C) Revoke or suspend the license of a pharmacy benefits 31
manager to operate in this state. 32
(2) A penalty under subdivision (i)(1) of this section shall be 33
enforced by the commissioner according to rules promulgated under this 34
section. 35
(j) A prohibition under this section is applicable to a person or 36 SB103
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entity that: 1
(1) Performs the prohibited activity; 2
(2) Causes another person or entity to perform the prohibited 3
activity; 4
(3) Solicits, advises, encourages, or coerces another person or 5
entity to perform the prohibited activity; 6
(4) Aids or attempts to aid another person or entity in 7
performing a prohibited activity; or 8
(5) Indirectly performs the prohibited activity. 9
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SECTION 6. EMERGENCY CLAUSE. It is found and determined by the 11
General Assembly of the State of Arkansas that many Arkansans rely on access 12
to a diverse and competitive pharmacy network for their healthcare needs; 13
that the inability of some pharmacies or pharmacists to participate in 14
pharmacy benefits manager networks under relevant and reasonable terms of 15
participation poses an immediate threat to the availability and affordability 16
of pharmacy services; and that this act is immediately necessary to protect 17
public health and ensure equitable access to pharmacy care across the state. 18
Therefore, an emergency is declared to exist, and this act being immediately 19
necessary for the preservation of the public peace, health, and safety shall 20
become effective on: 21
(1) The date of its approval by the Governor; 22
(2) If the bill is neither approved nor vetoed by the Governor, 23
the expiration of the period of time during which the Governor may veto the 24
bill; or 25
(3) If the bill is vetoed by the Governor and the veto is 26
overridden, the date the last house overrides the veto. 27
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