AR
Arkansas Senate Bill SB103

Arkansas 2025 Regular Session

Arkansas Senate Bill SB103 Compare Versions

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11 Stricken language would be deleted from and underlined language would be added to present law.
2-Act 425 of the Regular Session
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5-State of Arkansas As Engrossed: S3/17/25 1
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3+State of Arkansas 1
64 95th General Assembly A Bill 2
75 Regular Session, 2025 SENATE BILL 103 3
86 4
9-By: Senators C. Penzo, Irvin, M. Johnson 5
7+By: Senator C. Penzo 5
108 By: Representative Lundstrum 6
119 7
1210 For An Act To Be Entitled 8
1311 AN ACT CONCERNING THE STATE'S ANY WILLING PROVIDER 9
1412 LAWS; TO AMEND THE PATIENT PROTECTION ACT OF 1995; TO 10
1513 CREATE THE PHARMACY NONDISCRIMINATION ACT; TO REQUIRE 11
1614 PHARMACY BENEFITS MANAGERS TO ACCEPT ANY PHARMACY OR 12
1715 PHARMACIST WILLING TO ACCEPT RELEVANT AND REASONABLE 13
1816 TERMS OF PARTICIPATION; TO DECLARE AN EMERGENCY; AND 14
1917 FOR OTHER PURPOSES. 15
2018 16
2119 17
2220 Subtitle 18
2321 TO CREATE THE PHARMACY NONDISCRIMINATION 19
2422 ACT; TO REQUIRE PHARMACY BENEFITS 20
2523 MANAGERS TO ACCEPT ANY PHARMACY OR 21
2624 PHARMACIST WILLING TO ACCEPT RELEVANT 22
2725 AND REASONABLE TERMS OF PARTICIPATION; 23
2826 AND TO DECLARE AN EMERGENCY. 24
2927 25
3028 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 26
3129 27
3230 SECTION 1. DO NOT CODIFY. Title. This act shall be known and may be 28
3331 cited as the "Pharmacy Nondiscrimination Act". 29
3432 30
3533 SECTION 2. DO NOT CODIFY. Legislative findings and intent. 31
3634 (a) The General Assembly finds that: 32
3735 (1) The state's any willing provider laws under §§ 23 -99-204 — 33
3836 23-99-210 ensure fair access to healthcare providers, fostering competition 34
3937 and consumer choice; 35
40- (2) Pharmacy benefits managers play a key role in the delivery 36 As Engrossed: S3/17/25 SB103
38+ (2) Pharmacy benefits managers play a key role in the delivery 36 SB103
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4541 and management of pharmacy benefits; and 1
4642 (3) Practices that exclude qualified pharmacies or pharmacists 2
4743 without reasonable justification could restrict competition and limit patient 3
4844 access. 4
4945 (b) It is the intent of the General Assembly that this act shall 5
5046 clarify and update the principles of the state's any willing provider laws 6
5147 applicable to pharmacy benefits managers to ensure that any willing pharmacy 7
5248 or pharmacist that meets relevant and reasonable participation criteria may 8
5349 join a pharmacy benefits manager network consistent with state and federal 9
5450 law, as most healthcare insurers contract with pharmacy benefits managers to 10
5551 administer pharmacy benefits. 11
5652 12
5753 SECTION 3. Arkansas Code § 23 -99-203(d), concerning the definition of 13
5854 "healthcare provider" under the Patient Protection Act of 1995, is amended to 14
5955 read as follows: 15
6056 (d) "Healthcare provider" means those individuals or entities licensed 16
6157 by the State of Arkansas to provide healthcare services, limited to the 17
6258 following: 18
6359 (1) Advanced practice nurses; 19
6460 (2) Athletic trainers; 20
6561 (3) Audiologists; 21
6662 (4) Certified behavioral health providers; 22
6763 (5) Certified orthotists; 23
6864 (6) Chiropractors; 24
6965 (7) Community mental health centers or clinics; 25
7066 (8) Dentists; 26
7167 (9) Home health care; 27
7268 (10) Hospice care; 28
7369 (11) Hospital-based services; 29
7470 (12) Hospitals; 30
7571 (13) Licensed ambulatory surgery centers; 31
7672 (14) Licensed certified social workers; 32
7773 (15) Licensed dieticians; 33
7874 (16) Licensed intellectual and developmental disabilities 34
7975 service providers; 35
80- (17) Licensed professional counselors; 36 As Engrossed: S3/17/25 SB103
76+ (17) Licensed professional counselors; 36 SB103
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8579 (18) Licensed psychological examiners; 1
8680 (19) Long-term care facilities; 2
8781 (20) Occupational therapists; 3
8882 (21) Optometrists; 4
8983 (22) Pharmacists and pharmacies; 5
9084 (23) Physical therapists; 6
9185 (24) Physicians and surgeons (M.D. and D.O.); 7
9286 (25) Podiatrists; 8
9387 (26) Prosthetists; 9
9488 (27) Psychologists; 10
9589 (28) Respiratory therapists; 11
9690 (29) Rural health clinics; and 12
9791 (30) Speech pathologists. 13
9892 14
9993 SECTION 4. Arkansas Code § 23 -99-802(4), concerning the definition of 15
10094 "healthcare provider" as used under the any willing provider laws, is amended 16
10195 to read as follows: 17
10296 (4) "Healthcare provider" or “provider” means those individuals 18
10397 or entities licensed by the State of Arkansas to provide healthcare services, 19
10498 limited to the following: 20
10599 (A) Advanced practice nurses; 21
106100 (B) Athletic trainers; 22
107101 (C) Audiologists; 23
108102 (D) Certified behavioral health providers; 24
109103 (E) Certified orthotists; 25
110104 (F) Chiropractors; 26
111105 (G) Community mental health centers or clinics; 27
112106 (H) Dentists; 28
113107 (I) Home health care; 29
114108 (J) Hospice care; 30
115109 (K) Hospital-based services; 31
116110 (L) Hospitals; 32
117111 (M) Licensed ambulatory surgery centers; 33
118112 (N) Licensed certified social workers; 34
119113 (O) Licensed dieticians; 35
120- (P) Licensed durable medical equipment providers; 36 As Engrossed: S3/17/25 SB103
114+ (P) Licensed durable medical equipment providers; 36 SB103
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125117 (Q) Licensed intellectual and developmental disabilities 1
126118 service providers; 2
127119 (R) Licensed professional counselors; 3
128120 (S) Licensed psychological examiners; 4
129121 (T) Long-term care facilities; 5
130122 (U) Occupational therapists; 6
131123 (V) Optometrists; 7
132124 (W) Pharmacists and pharmacies; 8
133125 (X) Physical therapists; 9
134126 (Y) Physicians and surgeons (M.D. and D.O.); 10
135127 (Z) Podiatrists; 11
136128 (AA) Prosthetists; 12
137129 (BB) Psychologists; 13
138130 (CC) Respiratory therapists; 14
139131 (DD) Rural health clinics; 15
140132 (EE) Speech pathologists; and 16
141133 (FF) Other healthcare practitioners as determined by the 17
142134 State Insurance Department in rules promulgated under the Arkansas 18
143135 Administrative Procedure Act, § 25 -15-201 et seq.; 19
144136 20
145137 SECTION 5. Arkansas Code Title 23, Chapter 99, Subchapter 2, is 21
146138 amended to add an additional section to read as follows: 22
147139 23-99-211. Pharmacy benefits manager network participation — 23
148140 Definitions. 24
149141 (a) As used in this section: 25
150142 (1) "Pharmacist" means an individual licensed as a pharmacist by 26
151143 the Arkansas State Board of Pharmacy; 27
152144 (2) "Pharmacy" means the place licensed by the board in which 28
153145 drugs, chemicals, medicines, prescriptions, and poisons are compounded, 29
154146 dispensed, or sold at retail; 30
155147 (3) "Pharmacy benefits manager" means a person, business, or 31
156148 entity, including a wholly or partially owned or controlled subsidiary of a 32
157149 pharmacy benefits manager, that: 33
158150 (A) Provides claims processing services or other 34
159151 prescription drug or devices services, or both, for health benefit plans; and 35
160- (B) Is licensed under the Arkansas Pharmacy Benefits 36 As Engrossed: S3/17/25 SB103
152+ (B) Is licensed under the Arkansas Pharmacy Benefits 36 SB103
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165155 Manager Licensure Act, § 23 -92-502; 1
166156 (4)(A) "Pharmacy benefits manager network" means any network of 2
167157 pharmacists or pharmacies that are offered by an agreement or insurance 3
168158 contract to provide pharmacist services for health benefit plans. 4
169159 (B) "Pharmacy benefits manager network" includes any 5
170160 network delegated by the healthcare payor to the pharmacy benefits manager; 6
171161 and 7
172- (5) "Relevant and reasonable terms of participation" means terms 8
173-and conditions that: 9
174- (A) Are consistent with applicable state and federal law; 10
175- (B) Are consistent with industry standards; and 11
176- (C) Do not arbitrarily or discriminatorily exclude a 12
177-qualified pharmacy or pharmacist. 13
178- (b)(1) A pharmacy benefits manager shall not deny a pharmacy or 14
179-pharmacist the opportunity to participate in the pharmacy benefits manager's 15
180-network if the pharmacy or pharmacist: 16
181- (A) Is licensed under the laws of this state; and 17
182- (B) Agrees to accept and comply with the relevant and 18
183-reasonable terms of participation as determined under this section. 19
184- (2) A pharmacy benefits manager shall not exclude a pharmacy or 20
185-pharmacist from continued participation in the pharmacy benefits manager's 21
186-pharmacy benefits manager network if the pharmacy or pharmacist continues to: 22
187- (A) Be licensed under the laws of this state; and 23
188- (B) Accept and comply with the relevant and reasonable 24
189-terms of participation as determined under this section. 25
190- (3) A pharmacy benefits manager shall not: 26
191- (A) Condition participation of a pharmacy or pharmacist in 27
192-one (1) pharmacy benefits manager network based on participation in any other 28
193-pharmacy benefits manager network or penalize a pharmacy or pharmacist for 29
194-exercising his, her, or its prerogative not to participate in a specific 30
195-pharmacy benefits manager network; or 31
196- (B) Limit a pharmacy benefits manager network to include 32
197-solely: 33
198- (i) An affiliated pharmacy; or 34
199- (ii) An internet pharmacy or a pharmacy that does 35
200-not have a physical presence in this state for consumer access. 36 As Engrossed: S3/17/25 SB103
162+ (5)(A) "Relevant and reasonable terms of participation” means 8
163+terms and conditions that: 9
164+ (i) Are consistent with applicable state and federal 10
165+law; 11
166+ (ii) Are consistent with industry standards; and 12
167+ (iii) Do not arbitrarily or discriminatorily exclude 13
168+a qualified pharmacy or pharmacist. 14
169+ (B) "Relevant and reasonable terms of participation" does 15
170+not include if the pharmacy benefits manager performs a prohibited practice 16
171+of requiring accreditation standards and certification standards that are 17
172+more stringent or in addition to the standards required by the board for a 18
173+pharmacy licensed in this state. 19
174+ (b)(1) A pharmacy benefits manager shall not deny a pharmacy or 20
175+pharmacist the opportunity to participate in the pharmacy benefits manager's 21
176+network if the pharmacy or pharmacist: 22
177+ (A) Is licensed under the laws of this state; and 23
178+ (B) Agrees to accept and comply with the relevant and 24
179+reasonable terms of participation as determined under this section. 25
180+ (2) A pharmacy benefits manager shall not exclude a pharmacy or 26
181+pharmacist from continued participation in the pharmacy benefits manager's 27
182+pharmacy benefits manager network if the pharmacy or pharmacist continues to: 28
183+ (A) Be licensed under the laws of this state; and 29
184+ (B) Accept and comply with the relevant and reasonable 30
185+terms of participation as determined under this section. 31
186+ (3) A pharmacy benefits manager shall not: 32
187+ (A) Condition participation of a pharmacy or pharmacist in 33
188+one (1) pharmacy benefits manager network based on participation in any other 34
189+pharmacy benefits manager network or penalize a pharmacy or pharmacist for 35
190+exercising his, her, or its prerogative not to participate in a specific 36 SB103
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193+pharmacy benefits manager network; or 1
194+ (B) Limit a pharmacy benefits manager network to include 2
195+solely: 3
196+ (i) An affiliated pharmacy; or 4
197+ (ii) An internet pharmacy or a pharmacy that does 5
198+not have a physical presence in this state for consumer access. 6
199+ (c)(1) If a pharmacy or pharmacist alleges that a pharmacy benefits 7
200+manager has denied or excluded the pharmacy or pharmacist from participation 8
201+in the pharmacy benefits manager's pharmacy benefits manager network without 9
202+justification, the pharmacy or pharmacist may submit a written complaint to 10
203+the Insurance Commissioner. 11
204+ (2) If a dispute arises as to whether there are "relevant and 12
205+reasonable terms of participation" as that term is defined in this section, 13
206+the commissioner shall decide the issue by determining whether the terms or 14
207+conditions: 15
208+ (A) Are consistent with applicable state and federal law; 16
209+ (B) Are consistent with industry standards; and 17
210+ (C) Do not arbitrarily or discriminatorily exclude a 18
211+qualified pharmacy or pharmacist. 19
212+ (3) Within thirty (30) days of receipt of the complaint under 20
213+subdivision (c)(1) of this section, the commissioner, after a hearing 21
214+conducted under § 23 -61-301 and consideration of evidence from all parties, 22
215+shall issue a determination. 23
216+ (4) The determination of the commissioner under subdivision 24
217+(c)(3) of this section is binding on all parties, subject to judicial review 25
218+under § 23-61-307. 26
219+ (d) A pharmacy benefits manager shall not: 27
220+ (1) Impose terms or conditions that do not meet the definition 28
221+of "relevant and reasonable terms of participation" under this section; 29
222+ (2) Utilize reimbursement methodologies or contractual clauses 30
223+intended to indirectly exclude a willing pharmacy or pharmacist from 31
224+participation; or 32
225+ (3) Engage in a practice that discriminates against a pharmacy 33
226+or pharmacist based on the pharmacy's or pharmacist's geographic location, 34
227+size, or ownership structure, unless the geographic location, size, or 35
228+ownership structure is directly relevant to patient care or network adequacy. 36 SB103
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231+ (e) This section does not: 1
232+ (1) Regulate the design or administration of employee benefit 2
233+plans; or 3
234+ (2) Impose requirements directly on employee benefit plans. 4
235+ (f) This section applies to the trade practices of pharmacy benefits 5
236+managers operating in this state, including a pharmacy benefits manager's 6
237+pharmacy benefits manager network participation requirements and marketing or 7
238+sale of pharmacy benefits manager network products and services, as permitted 8
239+under state law. 9
240+ (g) This section is enforceable with respect to a pharmacy benefits 10
241+manager's compliance with state rules regarding healthcare provider equity 11
242+and market practices. 12
243+ (h)(1) The commissioner may promulgate rules necessary to implement, 13
244+administer, and enforce this section. 14
245+ (2) Rules that the commissioner may adopt under this section 15
246+include without limitation rules relating to: 16
247+ (A) Providing a process for resolving disputes between 17
248+pharmacies, pharmacists, and pharmacy benefits managers; 18
249+ (B) Ensuring compliance with state and federal laws; and 19
250+ (C) Monitoring compliance with this section by licensed 20
251+pharmacy benefits managers. 21
252+ (i)(1) After notice and opportunity for a hearing, if a pharmacy 22
253+benefits manager is found to have violated this section, the commissioner 23
254+may: 24
255+ (A) Impose a fine of up to one hundred thousand dollars 25
256+($100,000) per violation; 26
257+ (B) Prohibit the pharmacy benefits manager from marketing, 27
258+selling, or utilizing one (1) or more offending products, pharmacy benefits 28
259+manager networks, or services within this state until the pharmacy benefits 29
260+manager complies with this section; and 30
261+ (C) Revoke or suspend the license of a pharmacy benefits 31
262+manager to operate in this state. 32
263+ (2) A penalty under subdivision (i)(1) of this section shall be 33
264+enforced by the commissioner according to rules promulgated under this 34
265+section. 35
266+ (j) A prohibition under this section is applicable to a person or 36 SB103
204267
205- (c)(1) If a pharmacy or pharmacist alleges that a pharmacy benefits 1
206-manager has denied or excluded the pharmacy or pharmacist from participation 2
207-in the pharmacy benefits manager's pharmacy benefits manager network without 3
208-justification, the pharmacy or pharmacist may submit a written complaint to 4
209-the Insurance Commissioner. 5
210- (2) If a dispute arises as to whether there are "relevant and 6
211-reasonable terms of participation" as that term is defined in this section, 7
212-the commissioner shall decide the issue by determining whether the terms or 8
213-conditions: 9
214- (A) Are consistent with applicable state and federal law; 10
215- (B) Are consistent with industry standards; and 11
216- (C) Do not arbitrarily or discriminatorily exclude a 12
217-qualified pharmacy or pharmacist. 13
218- (3) Within thirty (30) days of receipt of the complaint under 14
219-subdivision (c)(1) of this section, the commissioner, after a hearing 15
220-conducted under § 23 -61-301 and consideration of evidence from all parties, 16
221-shall issue a determination. 17
222- (4) The determination of the commissioner under subdivision 18
223-(c)(3) of this section is binding on all parties, subject to judicial review 19
224-under § 23-61-307. 20
225- (d) A pharmacy benefits manager shall not: 21
226- (1) Impose terms or conditions that do not meet the definition 22
227-of "relevant and reasonable terms of participation" under this section; 23
228- (2) Utilize reimbursement methodologies or contractual clauses 24
229-intended to indirectly exclude a willing pharmacy or pharmacist from 25
230-participation; or 26
231- (3) Engage in a practice that discriminates against a pharmacy 27
232-or pharmacist based on the pharmacy's or pharmacist's geographic location, 28
233-size, or ownership structure, unless the geographic location, size, or 29
234-ownership structure is directly relevant to patient care or network adequacy. 30
235- (e) This section does not: 31
236- (1) Regulate the design or administration of employee benefit 32
237-plans; or 33
238- (2) Impose requirements directly on employee benefit plans. 34
239- (f) This section applies to the trade practices of pharmacy benefits 35
240-managers operating in this state, including a pharmacy benefits manager's 36 As Engrossed: S3/17/25 SB103
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244-
245-pharmacy benefits manager network participation requirements and marketing or 1
246-sale of pharmacy benefits manager network products and services, as permitted 2
247-under state law. 3
248- (g) This section is enforceable with respect to a pharmacy benefits 4
249-manager's compliance with state rules regarding healthcare provider equity 5
250-and market practices. 6
251- (h)(1) The commissioner may promulgate rules necessary to implement, 7
252-administer, and enforce this section. 8
253- (2) Rules that the commissioner may adopt under this section 9
254-include without limitation rules relating to: 10
255- (A) Providing a process for resolving disputes between 11
256-pharmacies, pharmacists, and pharmacy benefits managers; 12
257- (B) Ensuring compliance with state and federal laws; and 13
258- (C) Monitoring compliance with this section by licensed 14
259-pharmacy benefits managers. 15
260- (i)(1) After notice and opportunity for a hearing, if a pharmacy 16
261-benefits manager is found to have violated this section, the commissioner 17
262-may: 18
263- (A) Impose a fine of up to one hundred thousand dollars 19
264-($100,000) per violation; 20
265- (B) Prohibit the pharmacy benefits manager from marketing, 21
266-selling, or utilizing one (1) or more offending products, pharmacy benefits 22
267-manager networks, or services within this state until the pharmacy benefits 23
268-manager complies with this section; and 24
269- (C) Revoke or suspend the license of a pharmacy benefits 25
270-manager to operate in this state. 26
271- (2) A penalty under subdivision (i)(1) of this section shall be 27
272-enforced by the commissioner according to rules promulgated under this 28
273-section. 29
274- (j) A prohibition under this section is applicable to a person or 30
275-entity that: 31
276- (1) Performs the prohibited activity; 32
277- (2) Causes another person or entity to perform the prohibited 33
278-activity; 34
279- (3) Solicits, advises, encourages, or coerces another person or 35
280-entity to perform the prohibited activity; 36 As Engrossed: S3/17/25 SB103
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283-
284-
285- (4) Aids or attempts to aid another person or entity in 1
286-performing a prohibited activity; or 2
287- (5) Indirectly performs the prohibited activity. 3
288- 4
289- SECTION 6. EMERGENCY CLAUSE. It is found and determined by the 5
290-General Assembly of the State of Arkansas that many Arkansans rely on access 6
291-to a diverse and competitive pharmacy network for their healthcare needs; 7
292-that the inability of some pharmacies or pharmacists to participate in 8
293-pharmacy benefits manager networks under relevant and reasonable terms of 9
294-participation poses an immediate threat to the availability and affordability 10
295-of pharmacy services; and that this act is immediately necessary to protect 11
296-public health and ensure equitable access to pharmacy care across the state. 12
297-Therefore, an emergency is declared to exist, and this act being immediately 13
298-necessary for the preservation of the public peace, health, and safety shall 14
299-become effective on: 15
300- (1) The date of its approval by the Governor; 16
301- (2) If the bill is neither approved nor vetoed by the Governor, 17
302-the expiration of the period of time during which the Governor may veto the 18
303-bill; or 19
304- (3) If the bill is vetoed by the Governor and the veto is 20
305-overridden, the date the last house overrides the veto. 21
306- 22
307-/s/C. Penzo 23
308- 24
309- 25
310-APPROVED: 4/3/25 26
311- 27
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269+entity that: 1
270+ (1) Performs the prohibited activity; 2
271+ (2) Causes another person or entity to perform the prohibited 3
272+activity; 4
273+ (3) Solicits, advises, encourages, or coerces another person or 5
274+entity to perform the prohibited activity; 6
275+ (4) Aids or attempts to aid another person or entity in 7
276+performing a prohibited activity; or 8
277+ (5) Indirectly performs the prohibited activity. 9
278+ 10
279+ SECTION 6. EMERGENCY CLAUSE. It is found and determined by the 11
280+General Assembly of the State of Arkansas that many Arkansans rely on access 12
281+to a diverse and competitive pharmacy network for their healthcare needs; 13
282+that the inability of some pharmacies or pharmacists to participate in 14
283+pharmacy benefits manager networks under relevant and reasonable terms of 15
284+participation poses an immediate threat to the availability and affordability 16
285+of pharmacy services; and that this act is immediately necessary to protect 17
286+public health and ensure equitable access to pharmacy care across the state. 18
287+Therefore, an emergency is declared to exist, and this act being immediately 19
288+necessary for the preservation of the public peace, health, and safety shall 20
289+become effective on: 21
290+ (1) The date of its approval by the Governor; 22
291+ (2) If the bill is neither approved nor vetoed by the Governor, 23
292+the expiration of the period of time during which the Governor may veto the 24
293+bill; or 25
294+ (3) If the bill is vetoed by the Governor and the veto is 26
295+overridden, the date the last house overrides the veto. 27
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