1 | 1 | | Stricken language would be deleted from and underlined language would be added to present law. |
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2 | 2 | | *JMB316* 02/12/2025 4:18:10 PM JMB316 |
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3 | 3 | | State of Arkansas 1 |
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4 | 4 | | 95th General Assembly A Bill 2 |
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5 | 5 | | Regular Session, 2025 SENATE BILL 221 3 |
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6 | 6 | | 4 |
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7 | 7 | | By: Senators B. Davis, J. Dismang, Gilmore, B. Johnson, C. Tucker, D. Wallace, G. Leding 5 |
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8 | 8 | | By: Representatives L. Johnson, Hudson, Beaty Jr., A. Collins, Achor, K. Brown, Brooks 6 |
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9 | 9 | | 7 |
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10 | 10 | | For An Act To Be Entitled 8 |
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11 | 11 | | AN ACT TO PROHIBIT RISK -BASED PROVIDER ORGANIZATIONS 9 |
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12 | 12 | | FROM USING CERTAIN TYPES OF CONTRACTING PRACTICES 10 |
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13 | 13 | | WHEN CONTRACTING WITH PROVIDERS; TO AMEND THE 11 |
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14 | 14 | | MEDICAID PROVIDER-LED ORGANIZED CARE ACT; TO DECLARE 12 |
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15 | 15 | | AN EMERGENCY; AND FOR OTHER PURPOSES. 13 |
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16 | 16 | | 14 |
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17 | 17 | | 15 |
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18 | 18 | | Subtitle 16 |
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19 | 19 | | TO PROHIBIT RISK-BASED PROVIDER 17 |
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20 | 20 | | ORGANIZATIONS FROM USING CERTAIN TYPES 18 |
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21 | 21 | | OF CONTRACTING PRACTICES WHEN 19 |
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22 | 22 | | CONTRACTING WITH PROVIDERS; TO AMEND THE 20 |
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23 | 23 | | MEDICAID PROVIDER-LED ORGANIZED CARE 21 |
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24 | 24 | | ACT; AND TO DECLARE AN EMERGENCY. 22 |
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25 | 25 | | 23 |
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26 | 26 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 24 |
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27 | 27 | | 25 |
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28 | 28 | | SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 27, is 26 |
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29 | 29 | | amended to add an additional section to read as follows: 27 |
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30 | 30 | | 20-77-2709. Prohibitions on discrimination and tying of services in 28 |
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31 | 31 | | contracts with risk-based provider organizations — Legislative findings. 29 |
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32 | 32 | | (a) The General Assembly finds that: 30 |
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33 | 33 | | (1) Risk-based provider organizations, also known as provider -31 |
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34 | 34 | | led shared savings entities, have engaged in unfair tactics with direct 32 |
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35 | 35 | | service providers; 33 |
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36 | 36 | | (2) When a provider will not agree to below costs rates for one 34 |
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37 | 37 | | (1) service, the risk -based provider organization terminates the direct 35 |
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38 | 38 | | service provider’s network status for all other services; 36 SB221 |
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41 | 41 | | (3) This practice is often referred to as “tying” or "all or 1 |
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42 | 42 | | nothing" and restricts access to healthcare services by reducing the number 2 |
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43 | 43 | | of providers available to serve individuals with disabilities; and 3 |
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44 | 44 | | (4) These negotiating tactics diminish or eliminate the ability 4 |
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45 | 45 | | of the provider to fairly negotiate rates with the risk -based provider 5 |
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46 | 46 | | organization. 6 |
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47 | 47 | | (b) A risk-based provider organization shall not: 7 |
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48 | 48 | | (1) Tie contracting for one (1) service to another service 8 |
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49 | 49 | | against a direct service provider’s will; 9 |
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50 | 50 | | (2) Penalize, terminate, or refuse network admission to a direct 10 |
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51 | 51 | | service provider who agrees to the terms and conditions for at least one (1) 11 |
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52 | 52 | | service offered by the risk -based provider organization on the basis that the 12 |
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53 | 53 | | provider has declined to provide one (1) or more other services on the terms 13 |
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54 | 54 | | and conditions that the direct service provider is not willing to accept; or 14 |
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55 | 55 | | (3) Discriminate against or penalize in any way a provider for 15 |
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56 | 56 | | exercising the rights under this section. 16 |
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57 | 57 | | (c)(1) A violation of this section is: 17 |
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58 | 58 | | (A) An unfair trade practice under the Trade Practices 18 |
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59 | 59 | | Act, § 23-66-201 et seq.; 19 |
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60 | 60 | | (B) A violation of the Patient Protection Act of 1995, 23 -20 |
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61 | 61 | | 99-201 et seq.; 21 |
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62 | 62 | | (C) A violation of the any willing provider laws under § 22 |
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63 | 63 | | 23-99-801 et seq.; and 23 |
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64 | 64 | | (D) A violation of the Unfair Practices Act, § 4 -75-201 et 24 |
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65 | 65 | | seq. 25 |
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66 | 66 | | (2) If a healthcare contract with a risk -based provider 26 |
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67 | 67 | | organization contains a provision that violates this section, that provision 27 |
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68 | 68 | | is void. 28 |
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69 | 69 | | 29 |
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70 | 70 | | SECTION 2. EMERGENCY CLAUSE. It is found and determined by the 30 |
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71 | 71 | | General Assembly of the State of Arkansas that contracting and negotiating 31 |
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72 | 72 | | practices of risk-based provider organizations are negatively impacting the 32 |
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73 | 73 | | ability of providers to deliver healthcare services to Medicaid 33 |
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74 | 74 | | beneficiaries; that these practices harm access to healthcare to the most 34 |
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75 | 75 | | vulnerable individuals such as individuals with disabilities who need 35 |
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76 | 76 | | healthcare services on an ongoing basis; and that this act is immediately 36 SB221 |
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77 | 77 | | |
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79 | 79 | | necessary to protect the health and safety of the most vulnerable populations 1 |
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80 | 80 | | in the Arkansas Medicaid Program being served by risk -based provider 2 |
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81 | 81 | | organizations who are restricting healthcare access. Therefore, an emergency 3 |
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82 | 82 | | is declared to exist, and this act being immediately necessary for the 4 |
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83 | 83 | | preservation of the public peace, health, and safety shall become effective 5 |
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84 | 84 | | on: 6 |
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85 | 85 | | (1) The date of its approval by the Governor; 7 |
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86 | 86 | | (2) If the bill is neither approved nor vetoed by the Governor, 8 |
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87 | 87 | | the expiration of the period of time during which the Governor may veto the 9 |
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88 | 88 | | bill; or 10 |
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89 | 89 | | (3) If the bill is vetoed by the Governor and the veto is 11 |
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90 | 90 | | overridden, the date the last house overrides the veto. 12 |
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