Stricken language would be deleted from and underlined language would be added to present law.
Act 775 of the Regular Session
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State of Arkansas 1
95th General Assembly A Bill 2
Regular Session, 2025 SENATE BILL 544 3
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By: Senators M. Johnson, K. Hammer 5
By: Representatives Gazaway, Lundstrum 6
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For An Act To Be Entitled 8
AN ACT TO AMEND THE ARKANSAS PHARMACY BENEFITS 9
MANAGER LICENSURE ACT; AND FOR OTHER PURPOSES. 10
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Subtitle 13
TO AMEND THE ARKANSAS PHARMACY BENEFITS 14
MANAGER LICENSURE ACT. 15
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 17
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SECTION 1. Arkansas Code § 23-92-503, concerning definitions used 19
under the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to add 20
additional subdivisions to read as follows: 21
(16)(A) "Opt-out contract" means an agreement or a contract in 22
which a pharmacy must proactively notify the pharmacy benefits manager if the 23
pharmacy wishes to opt -out of certain terms potentially leading to lower 24
reimbursement rates or network exclusions if the pharmacy does not opt -out of 25
the contract. 26
(B) "Opt-out contract" includes a term that requires a 27
pharmacy to take affirmative action to opt -out of certain terms or conditions 28
of the contract; 29
(17)(A) "Pharmacy benefits manager national contract to 30
pharmacies" means a standardized agreement entered into by a pharmacy 31
benefits manager and a network of pharmacies across the United States in 32
which a pharmacy is, either directly or indirectly, passed through a pharmacy 33
services administrative organization messenger model to agree to certain 34
pricing terms and conditions for a patient if that pharmacy is managed or 35
represented by a pharmacy benefits manager network. 36 SB544
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(B) "Pharmacy benefits manager national contract to 1
pharmacies" includes a nationwide network of pharmacies that have entered 2
into a contract for national reimbursement rates, terms, and conditions that 3
are not Arkansas-specific with a pharmacy benefits manager to provide 4
pharmacist services, including without limitation dispensing medications to a 5
patient within the pharmacy benefits manager network; 6
(18)(A) "Place on probation" means an enforcement action against 7
a pharmacy benefits manager for lack of compliance with the requirements of 8
the Arkansas Pharmacy Benefits Manager Licensure Act, § 23 -92-501 et seq. 9
(B) "Place on probation" includes penalties of probation 10
and may include: 11
(i) Prohibiting on advertising or bidding on new 12
business or requests for proposals; 13
(ii) Requiring notification of probation to a 14
current contracted plan or program that is directly or indirectly funded by a 15
state appropriation to furnish, cover the cost of, or otherwise provide for 16
pharmacist services to an individual who resides in or is employed in this 17
state; or 18
(iii) Other penalties established by rule of the 19
Insurance Commissioner; 20
(19) "Underpayment violation" means: 21
(A) A violation of § 23 -92-506(b); 22
(B) A violation of § 17 -92-507; or 23
(C) A fair and reasonable compensation payment violation 24
as defined under § 23 -92-506(a) and by rule of the commissioner; and 25
(20) "Unique combination for pharmacy claims" means a pharmacy 26
claims bank identification number, pharmacy claims group number, pharmacy 27
claims processor control number, or any combination of a pharmacy claims bank 28
identification number, pharmacy claims group number, and pharmacy claims 29
processor control number that is used by a pharmacy benefits manager to 30
process a pharmacy claim. 31
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SECTION 2. Arkansas Code § 23 -92-506, concerning prohibited practices 33
of a pharmacy benefits manager, is amended to add additional subsections to 34
read as follows: 35
(f) Upon request, a pharmacy benefits manager, including pharmacy 36 SB544
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benefits managers contracting for Medicare pharmacy and pharmacist benefits, 1
shall provide a pharmacy services administrative organization, pharmacy, or 2
pharmacist with each pharmacy claims bank identification number, pharmacy 3
claims group number, pharmacy claims processor control number, and each 4
unique combination for pharmacy claims for each pharmacy network established 5
or administered by a pharmacy benefits manager to enable the pharmacy 6
services administrative organization, pharmacy, or pharmacist to make an 7
informed healthcare contracting decision to support negotiating a new 8
contract or to exit or renew an existing contract. 9
(g) For a new contract, an opt -out contract, a contract amendment, or 10
a renewal of an existing network, a pharmacy benefits manager, including 11
pharmacy benefits managers contracting for Medicare pharmacy and pharmacist 12
benefits, shall clearly list for the pharmacy services administrative 13
organization, a pharmacy, or pharmacist each pharmacy claims bank 14
identification number, pharmacy claims group number, pharmacy claims 15
processor control number, and each unique combination for pharmacy claims for 16
each pharmacy network established or administered by a pharmacy benefits 17
manager to enable the pharmacy services administrative organization, 18
pharmacy, or pharmacist to make an informed healthcare contracting decision. 19
(h)(1) An opt-out contract shall include at least sixty -days notice to 20
the pharmacy services administrative organization, pharmacy, or pharmacist. 21
(2) The notice required under subdivision (h)(1) of this section 22
shall be sent by both email and fax. 23
(3) The opt-out option in an opt -out contract shall offer the 24
pharmacy services administrative organization, pharmacy, or pharmacist the 25
ability to notify the pharmacy benefits manager of the decision to opt -out or 26
remain in the network. 27
(4) If a pharmacy benefits manager has not received a reply from 28
the pharmacy services administrative organization, pharmacy, or pharmacist 29
within thirty (30) days of the first notice that the opt -out notice was 30
received, the pharmacy benefits manager shall send a notice to the pharmacy 31
services administrative organization, pharmacy, or pharmacist a notification 32
by certified mail of the opt -out contract. 33
(i)(1) A pharmacy benefits manager shall not offer "take it or leave 34
it" terms and conditions in a contract that would violate requirements of 35
state law. 36 SB544
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(2) A pharmacy benefits manager shall actively respond, 1
communicate, and adjust to the concerns of a pharmacy services administrative 2
organization, pharmacy, or pharmacist that proposed or existing contract and 3
provider manual terms do not follow state law. 4
(j) A pharmacy benefits manager shall not utilize a pharmacy benefits 5
manager national contract to pharmacies that does not include a separate 6
Arkansas-based amendment or Arkansas -specific contract that clearly complies 7
with this subchapter and other state laws. 8
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SECTION 3. Arkansas Code § 23 -92-508(c), concerning the penalties 10
under the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to 11
read as follows: 12
(c) After notice and opportunity for hearing, the commissioner may: 13
(1) Impose a penalty of up to five thousand dollars ($5,000) per 14
violation against a pharmacy benefits manager if the commissioner finds that 15
the pharmacy benefits manager has not: 16
(A) Followed the process established for determining 17
pricing or costs under the Maximum Allowable Cost List under § 17 -92-507; or 18
(B) Used the national average drug acquisition cost under 19
§ 23-92-506(b); or 20
(C) Complied with the requirements of this subchapter; 21
(2) Revoke, place on probation, or suspend the license of a 22
pharmacy benefits manager or revoke, place on probation, or suspend the use 23
of a specific network used by a pharmacy benefits manager and identified by a 24
registered unique combination for pharmacy claims if the commissioner finds 25
that the pharmacy benefits manager: 26
(A) Has committed a pattern of violations of this 27
subchapter; 28
(B) Has not followed the process established 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); or 33
(D) Has violated this subchapter; and 34
(3) For a pattern of more than two (2) violations of this 35
subchapter, revoke, or prohibit a pharmacy benefits manager for up to three 36 SB544
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(3) years from bidding on new business opportunities with a plan or program 1
that is directly or indirectly funded by a state appropriation to furnish, 2
cover the cost of, or otherwise provide for pharmacist services to an 3
individual who resides in or is employed in this state . 4
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SECTION 4. Arkansas Code § 23 -92-508, concerning enforcement of the 6
Arkansas Pharmacy Benefits Manager Licensure Act, is amended to add an 7
additional subsection to read as follows: 8
(d)(1) The commissioner shall require a pharmacy benefits manager that 9
has an underpayment violation to: 10
(A) Pay twelve percent (12%) interest per month as a 11
penalty to the impacted pharmacy or pharmacist for pharmacist services on an 12
underpayment violation that is calculated on the number of days after the 13
claim was adjudicated until resolution of the underpayment violation; and 14
(B) Pay the entire amount of the amount of the 15
underpayment violation plus the required interest under subdivision (d)(1) of 16
this section to the impacted pharmacy or pharmacist for pharmacist services 17
on an underpayment violation. 18
(2) A pharmacy or pharmacist shall not be required to collect an 19
amount of an underpayment violation or interest from a patient in the form of 20
copay or out-of-pocket expense to the patient. 21
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SECTION 5. Arkansas Code § 23 -92-509(b)(1), concerning the rules for 23
the Arkansas Pharmacy Benefits Manager Licensure Act, is amended to read as 24
follows: 25
(b)(1) Rules adopted under this subchapter shall set penalties or 26
fines, including without limitation monetary fines, probation, suspension of 27
licensure or unique combination for pharmacy claims , and revocation of 28
licensure or unique combination for pharmacy claims for violations of this 29
subchapter and rules adopted under this subchapter. 30
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APPROVED: 4/17/25 33
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