AR
Arkansas Senate Bill SB264

Arkansas 2025 Regular Session

Arkansas Senate Bill SB264 Compare Versions

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11 Stricken language would be deleted from and underlined language would be added to present law.
2-Act 483 of the Regular Session
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5-State of Arkansas As Engrossed: S3/18/25 1
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3+State of Arkansas 1
64 95th General Assembly A Bill 2
75 Regular Session, 2025 SENATE BILL 264 3
86 4
97 By: Senator Irvin 5
108 By: Representative L. Johnson 6
119 7
1210 For An Act To Be Entitled 8
1311 AN ACT TO ESTABLISH THE ARKANSAS PRIMARY CARE PAYMENT 9
1412 IMPROVEMENT WORKING GROUP; AND FOR OTHER PURPOSES. 10
1513 11
1614 12
1715 Subtitle 13
1816 TO ESTABLISH THE ARKANSAS PRIMARY CARE 14
1917 PAYMENT IMPROVEMENT WORKING GROUP. 15
2018 16
2119 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 17
2220 18
2321 SECTION 1. DO NOT CODIFY. Legislative findings and intent. 19
2422 (a) The General Assembly finds that: 20
2523 (1) There is extensive data demonstrating that a population’s 21
2624 increased access to quality primary care reduces overall healthcare costs and 22
2725 improves health outcomes; 23
2826 (2) Without access to high -quality primary care, healthcare 24
2927 costs rise, preventable health issues escalate, and chronic disease burden 25
3028 worsens; 26
3129 (3) Studies demonstrate that investing more in primary care 27
3230 reduces health system costs and improves a population’s health; and 28
3331 (4) A population’s increased access to primary care results in 29
3432 fewer emergency department visits, hospital stays, and surgeries. 30
3533 (b) It is the intent of the General Assembly to form a working group 31
3634 to better understand the primary care system in this state and its effect on 32
3735 health outcomes for Arkansans. 33
3836 34
3937 SECTION 2. DO NOT CODIFY. TEMPORARY LANGUAGE. Arkansas Primary Care 35
40-Payment Improvement Working Group. 36 As Engrossed: S3/18/25 SB264
38+Payment Improvement Working Group. 36 SB264
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4541 (a) There is established the Arkansas Primary Care Payment Improvement 1
46-Working Group, to be composed of the following nine (9) members: 2
42+Working Group, to be composed of the following eight (8) members: 2
4743 (1) The Secretary of the Department of Human Services, or his or 3
4844 her designee; 4
4945 (2) The Insurance Commissioner, or his or her designee; 5
5046 (3) A designee of the Arkansas Center for Health Improvement; 6
51- (4) A practicing primary care physician appointed by the Speaker 7
52-of the House of Representatives; 8
53- (5) A representative of the Arkansas commercial health insurance 9
54-community from an Arkansas -based insurer appointed by the Speaker of the 10
55-House of Representatives; 11
56- (6) A pediatrician representative of the primary care community 12
57-in this state appointed by the Speaker of the House of Representatives; 13
58- (7) A practicing primary care physician appointed by the 14
59-President Pro Tempore of the Senate; 15
60- (8) An advanced practice registered nurse representative of the 16
61-primary care community in this state appointed by the President Pro Tempore 17
62-of the Senate; and 18
63- (9) A primary care physician employed by or primarily practicing 19
64-in a federal qualified health center appointed by the President Pro Tempore 20
65-of the Senate. 21
66- (b) The practicing primary care physician appointed by the President 22
67-Pro Tempore of the Senate shall serve as Chair of the Arkansas Primary Care 23
68-Payment Improvement Working Group and be responsible for scheduling regular 24
69-meetings of the working group. 25
70- (c) All members of the working group are voting members. 26
71- (d) Any vacancies that occur for any membership positions that are not 27
72-held as a function of office shall be filled by the selecting body upon 28
73-vacancy. 29
74- (e) The working group shall: 30
75- (1)(A) Establish a definition of primary care to be utilized by 31
76-the working group. 32
77- (B) The definition shall be applicable to primary care and 33
78-services provided under the Arkansas Medicaid Program and commercial 34
79-insurance plans; 35
80- (2) Identify any portion of the Arkansas Medicaid Program 36 As Engrossed: S3/18/25 SB264
47+ (4) A physician representative of the primary care community in 7
48+this state, as selected by the Arkansas Academy of Family Physicians, Inc.; 8
49+ (5) A pediatrician representative of the primary care community 9
50+in this state, as selected by the Arkansas Chapter. American Academy of 10
51+Pediatrics; 11
52+ (6) An advanced practice registered nurse representative of the 12
53+primary care community in this state, as selected by the Arkansas Nurses 13
54+Association; 14
55+ (7) A representative of the Arkansas commercial health insurance 15
56+community from an Arkansas -based insurer, as selected by America’s Health 16
57+Insurance Plans; and 17
58+ (8) A practicing primary care physician as selected by the 18
59+Arkansas Medical Society, Inc. 19
60+ (b) The member of the working group designated by the Arkansas Chapter 20
61+of the Arkansas Academy of Family Physicians, Inc., shall serve as Chair of 21
62+the Arkansas Primary Care Payment Improvement Working Group and be 22
63+responsible for scheduling regular meetings of the group. 23
64+ (c) All members of the working group are voting members. 24
65+ (d) Any vacancies that occur for any membership positions that are not 25
66+held as a function of office shall be filled by the selecting body upon 26
67+vacancy. 27
68+ (e) The working group shall: 28
69+ (1)(A) Establish a definition of primary care to be utilized by 29
70+the working group. 30
71+ (B) The definition shall be applicable to primary care and 31
72+services provided under the Arkansas Medicaid Program and commercial 32
73+insurance plans; 33
74+ (2) Identify any portion of the Arkansas Medicaid Program 34
75+population that should not be included in the study due to the unique 35
76+circumstances of the population; 36 SB264
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79+ (3) Create templates for data submission from commercial 1
80+insurance carriers and the Arkansas Medicaid Program; 2
81+ (4) Conduct an evaluation of the current amount spent on primary 3
82+care and other healthcare services, both as it relates to the Arkansas 4
83+Medicaid Program and the commercial insurance carriers, including Medicare 5
84+Advantage plans; 6
85+ (5) Determine the adequacy of the primary care delivery system 7
86+in Arkansas, including the effect this system has on the supply of the 8
87+primary care providers in this state; 9
88+ (6) Study the primary care payment landscape in other states, 10
89+specifically considering states that have implemented a primary care spending 11
90+target; and 12
91+ (7) Identify data collection and measurement systems as a basis 13
92+for creation of a primary care spending target for the Arkansas Medicaid 14
93+Program and commercial insurance carriers operating in this state that 15
94+includes a method by which to measure improvements made toward the primary 16
95+care spending target. 17
96+ (f)(1) The working group may request and receive data from commercial 18
97+insurance carriers that do business in this state related to the provision of 19
98+and payment for primary care as a percentage of overall claims payment. 20
99+ (2) Data received under subdivision (f)(1) of this section shall 21
100+include without limitation commercial insurance carrier submitted templates 22
101+that report information such as: 23
102+ (A) Fee-for-service payments; 24
103+ (B) Non-fee-for-service payments; 25
104+ (C) Primary care incentive programs and requirements; 26
105+ (D) The numbers of participating providers; 27
106+ (E) Performance metrics; 28
107+ (F) Prices; 29
108+ (G) Utilization; 30
109+ (H) Total cost trends; and 31
110+ (I) Other information as identified in annual notices. 32
111+ (3) A commercial insurance carrier shall use templates supplied 33
112+by the group in consultation with the State Insurance Department to provide 34
113+prospective and retrospective information to the group. 35
114+ (4) The State Insurance Department shall monitor and ensure 36 SB264
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84-
85-population that should not be included in the study due to the unique 1
86-circumstances of the population; 2
87- (3) Create templates for data submission from commercial 3
88-insurance carriers and the Arkansas Medicaid Program; 4
89- (4) Conduct an evaluation of the current amount spent on primary 5
90-care and other healthcare services, both as it relates to the Arkansas 6
91-Medicaid Program and the commercial insurance carriers, including Medicare 7
92-Advantage plans; 8
93- (5) Determine the adequacy of the primary care delivery system 9
94-in Arkansas, including the effect this system has on the supply of the 10
95-primary care providers in this state; 11
96- (6) Study the primary care payment landscape in other states, 12
97-specifically considering states that have implemented a primary care spending 13
98-target; and 14
99- (7) Identify data collection and measurement systems as a basis 15
100-for creation of a primary care spending target for the Arkansas Medicaid 16
101-Program and commercial insurance carriers operating in this state that 17
102-includes a method by which to measure improvements made toward the primary 18
103-care spending target. 19
104- (f)(1) The working group may request and receive data from commercial 20
105-insurance carriers that do business in this state related to the provision of 21
106-and payment for primary care as a percentage of overall claims payment. 22
107- (2) Data received under subdivision (f)(1) of this section shall 23
108-include without limitation commercial insurance carrier submitted templates 24
109-that report information such as: 25
110- (A) Fee-for-service payments; 26
111- (B) Non-fee-for-service payments; 27
112- (C) Primary care incentive programs and requirements; 28
113- (D) The numbers of participating providers; 29
114- (E) Performance metrics; 30
115- (F) Prices; 31
116- (G) Utilization; 32
117- (H) Total cost trends; and 33
118- (I) Other information as identified in annual notices. 34
119- (3) A commercial insurance carrier shall use templates supplied 35
120-by the group in consultation with the State Insurance Department to provide 36 As Engrossed: S3/18/25 SB264
121-
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123-
124-
125-prospective and retrospective information to the group. 1
126- (4) The State Insurance Department shall monitor and ensure 2
127-compliance with this section. 3
128- (g)(1) No later than April 1, 2026, the working group shall submit a 4
129-report of its findings and recommendations to the Legislative Council. 5
130- (2) The report shall include a recommendation for a primary care 6
131-spending target for both commercial insurance carriers and the Arkansas 7
132-Medicaid Program designed to achieve better health outcomes and decreased 8
133-healthcare costs for the people of Arkansas. 9
134- (3) If the Arkansas Medicaid Program or any commercial insurance 10
135-carrier fails to meet the primary care spending targets adopted by the 11
136-Legislative Council based on the report under subdivision (g)(1) of this 12
137-section, the Legislative Council may request that a representative of the 13
138-entity failing to meet the primary care spending target appear before the 14
139-Legislative Council and provide details on the efforts the entity is making 15
140-to meet the primary care spending target. 16
141- 17
142- SECTION 3. Arkansas Code § 23 -61-906(a), concerning data submission 18
143-under the Arkansas Healthcare Transparency Initiative, is amended to read as 19
144-follows: 20
145- (a) Except as provided in subsection (d) of this section, no later 21
146-than January 1, 2016, and every quarter thereafter, a submitting entity shall 22
147-submit health and dental claims data, unique identifiers, and geographic and 23
148-demographic information for covered individuals as permitted in this 24
149-subchapter, nonclaims-based payments made to providers, and provider files to 25
150-the Arkansas Healthcare Transparency Initiative in accordance with standards 26
151-and procedures adopted by the State Insurance Department. 27
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117+compliance with this section. 1
118+ (g)(1) No later than April 1, 2026, the working group shall submit a 2
119+report of its findings and recommendations to the Legislative Council. 3
120+ (2) The report shall include a recommendation for a primary care 4
121+spending target for both commercial insurance carriers and the Arkansas 5
122+Medicaid Program designed to achieve better health outcomes and decreased 6
123+healthcare costs for the people of Arkansas. 7
124+ (3) If the Arkansas Medicaid Program or any commercial insurance 8
125+carrier fails to meet the primary care spending targets adopted by the 9
126+Legislative Council based on the report under subdivision (g)(1) of this 10
127+section, the Legislative Council may request that a representative of the 11
128+entity failing to meet the primary care spending target appear before the 12
129+Legislative Council and provide details on the efforts the entity is making 13
130+to meet the primary care spending target. 14
131+ 15
132+ SECTION 3. Arkansas Code § 23 -61-906(a), concerning data submission 16
133+under the Arkansas Healthcare Transparency Initiative, is amended to read as 17
134+follows: 18
135+ (a) Except as provided in subsection (d) of this section, no later 19
136+than January 1, 2016, and every quarter thereafter, a submitting entity shall 20
137+submit health and dental claims data, unique identifiers, and geographic and 21
138+demographic information for covered individuals as permitted in this 22
139+subchapter, nonclaims-based payments made to providers, and provider files to 23
140+the Arkansas Healthcare Transparency Initiative in accordance with standards 24
141+and procedures adopted by the State Insurance Department. 25
142+ 26
143+ 27
152144 28
153-/s/Irvin 29
145+ 29
154146 30
155147 31
156-APPROVED: 4/8/25 32
148+ 32
157149 33
158150 34
159151 35
160152 36