Stricken language would be deleted from and underlined language would be added to present law. *JMB451* 03/31/2025 1:46:16 PM JMB451 State of Arkansas 1 95th General Assembly A Bill 2 Regular Session, 2025 SENATE BILL 589 3 4 By: Senator C. Penzo 5 6 7 For An Act To Be Entitled 8 AN ACT TO CREATE THE 340B PROGRAM TRANSPARENCY ACT; 9 TO REQUIRE TRANSPARENCY FROM CERTAIN 340B-COVERED 10 ENTITIES CONCERNING THE USE OF 340B PROGRAM SAVINGS; 11 TO REQUIRE CERTAIN 340B -COVERED ENTITIES TO ANNUALLY 12 REPORT THE UTILIZATION AND DISTRIBUTION OF 340B 13 PROGRAM SAVINGS TO ENSURE ACCOUNTABILITY AND 14 TRANSPARENCY; AND FOR OTHER PURPOSES. 15 16 17 Subtitle 18 TO CREATE THE 340B PROGRAM TRANSPARENCY 19 ACT; AND TO AMEND THE LAW CONCERNING 20 TRANSPARENCY AND ACCOUNTABILITY FOR 21 CERTAIN 340B-COVERED ENTITIES. 22 23 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 24 25 SECTION 1. Arkansas Code Title 20, Chapter 6, is amended to add an 26 additional subchapter to read as follows: 27 Subchapter 5 — 340B Program Transparency Act 28 29 20-6-501. Title. 30 This subchapter shall be known and may be cited as the "340B Program 31 Transparency Act". 32 33 20-6-502. Definitions. 34 As used in this subchapter: 35 (1) "340B program" means the federal drug discount program 36 SB589 2 03/31/2025 1:46:16 PM JMB451 established under Section 340B of the Public Health Service Act, 42 U.S.C. § 1 256b, as it existed on January 1, 2025, that requires a drug manufacturer to 2 provide discounted outpatient medications to a covered entity that serves a 3 significant number of low -income and uninsured patients; 4 (2) "340B savings" means the difference between the actual price 5 paid by a covered entity or its contract pharmacy under the 340B program for 6 a given drug or biological product and one (1) of the following acquisition 7 costs, applied in the order of priority stated below, using date -sensitive 8 and comparable data: 9 (A)(i) The actual acquisition cost the covered entity or 10 contract pharmacy has paid for the same drug or biological product when 11 dispensed to non-340B qualifying patients based on verifiable transaction 12 records from the same month as the 340B purchase. 13 (ii) If data from the same month is not available, 14 then data from the same calendar quarter shall be used; 15 (B) The actual acquisition cost for the same drug or 16 biological product as reflected in published acquisition data from the same 17 month, if available, or from the same calendar quarter if monthly data is not 18 available, and that is accessible to the covered entity or contract pharmacy 19 from a distributor or group purchasing organization, as long as the 20 distributor or group purchasing organization was utilized to acquire the drug 21 or biological product by the covered entity or contract pharmacy within the 22 same month or calendar quarter; or 23 (C)(i) If neither subdivision (2)(A) or subdivision (2)(B) 24 of this section is available for the specific product, the estimated 25 acquisition cost the covered entity or contract pharmacy would have paid for 26 the drug or biological product in the absence of participation in the 340B 27 program, ensuring to the extent possible that the estimation uses data from 28 the same month or, if not available, from the same calendar quarter. 29 (ii) A covered entity or contract pharmacy shall 30 rely on subdivision (2)(C) of this section only if neither subdivision (2)(A) 31 or subdivision (2)(B) of this section is feasible for that specific drug or 32 biological product; 33 (3) "Contract pharmacy" means a pharmacy that has executed a 34 contract with a covered entity to dispense 340B drugs on behalf of the 35 covered entity consistent with federal regulations and guidelines; 36 SB589 3 03/31/2025 1:46:16 PM JMB451 (4) "Covered entity" means a hospital or other healthcare 1 provider located in this state that participates in the 340B program as 2 defined by 42 U.S.C. § 256b, as it existed on January 1, 2025; and 3 (5)(A) "Medically underserved area" means an entire county that, 4 at any point during the reporting period, has an active medically underserved 5 area designation from the United States Health Resources and Services 6 Administration if the medically underserved area designation is for a single 7 county and has not been withdrawn or proposed for withdrawal. 8 (B) "Medically underserved area" does not include a 9 medically underserved area that is for a county subdivision, partial areas of 10 a county, a census tract, or other smaller geographic unit or that has been 11 withdrawn or proposed for withdrawal. 12 13 20-6-503. Annual 340B transparency report. 14 (a)(1) Each covered entity shall submit an annual 340B transparency 15 report to the Department of Health on or before March 31 of each year, 16 covering the previous calendar year. 17 (2) The department shall develop a standard reporting form 18 consistent with the requirements of this subchapter. 19 (b) At a minimum, a covered entity shall report: 20 (1) Aggregate 340B savings for the prior calendar year, 21 including without limitation: 22 (A) The total number of prescription, infusion, and 23 injection drug claims processed by the covered entity or its contract 24 pharmacies; 25 (B) The total number of 340B -eligible prescription, 26 infusion, and injection drug claims processed by the covered entity or its 27 contract pharmacies; 28 (C) An estimate of the total 340B savings realized by the 29 covered entity; and 30 (D) A description of the methodology used to calculate the 31 aggregate 340B savings; 32 (2) Utilization of 340B savings, including a detailed accounting 33 of how the 340B savings were allocated or reinvested, specifying: 34 (A)(i)(a) The aggregate amount directed toward offsetting 35 the cost of uncompensated care or charity care. 36 SB589 4 03/31/2025 1:46:16 PM JMB451 (b) The amount reported under subdivision 1 (b)(2)(A)(i)(a) of this section shall reflect only the funds actually 2 disbursed or redeemed from the 340B savings, rather than merely allocated or 3 earmarked for future use. 4 (ii) However, for purposes of this calculation: 5 (a) Contractual discounts or adjustments 6 already applied by insurance companies or government healthcare programs 7 shall not be included; 8 (b) Charges for denied services or medical 9 supplies unrelated to the drug or biological product, or unrelated to the 10 administration of the drug or biological product, shall not be included; and 11 (c) Any other discounts, reductions, 12 incentives, or offsets that covered entity patients customarily receive in 13 the normal course of business shall not be included; 14 (B)(i) The aggregate amount directed to patient financial 15 assistance or support programs, including without limitation transportation, 16 nutritional counseling, and housing assistance. 17 (ii) The amount reported shall reflect only the 18 funds actually disbursed or redeemed from the 340B savings, rather than 19 merely allocated or earmarked for future use; 20 (C) The aggregate amount used to expand patient access to 21 healthcare services, including without limitation new facility or clinic 22 sites, extended hours, or additional programs that directly expand patient 23 access to healthcare services for populations living in and having a primary 24 residence located in a medically underserved area in this state; 25 (D) The aggregate amount directed, used, or allocated to 26 administrative operations, including without limitation: 27 (i) Salaries, wages, bonuses, and other forms of 28 employee compensation; 29 (ii) Benefits, such as retirement contributions, 30 health insurance premiums, or stipends; 31 (iii) General overhead expenses, including without 32 limitation facility maintenance, utilities, office supplies, and information 33 technology; 34 (iv) Marketing, public relations, or advertising 35 costs; 36 SB589 5 03/31/2025 1:46:16 PM JMB451 (v) Management or consulting fees; and 1 (vi) Any other administrative expenditures not 2 directly related to patient care or financial assistance; 3 (E) The amount allocated to any foundations or charitable 4 organizations affiliated with the covered entity; 5 (F) Any other uses of 340B savings, itemized to provide 6 meaningful transparency without disclosing confidential business information 7 that is protected by state or federal law; and 8 (G) The total amounts disclosed under subdivisions 9 (b)(2)(A)-(F) of this section, which do not exceed the total amount reported 10 under subdivision (b)(1)(C) of this section; 11 (3) The charity care and uncompensated care metrics provided by 12 the covered entity, including without limitation: 13 (A) The total dollar value of charity care or 14 uncompensated care provided by the covered entity; 15 (B) The total dollar value of bad debt or unreimbursed 16 care; and 17 (C)(i) The distinct number of patients receiving charity 18 care or financial assistance. 19 (ii) The metric under subdivision (b)(3)(C)(i) of 20 this section shall be disclosed: 21 (a) As an aggregate; and 22 (b) By county, where county is based on the 23 patient’s home address or primary place of residence; 24 (4) Populations served, including without limitation: 25 (A)(i) The total number of distinct patients who receive 26 services from the covered entity. 27 (ii) The metric under subdivision (b)(4)(A)(i) of 28 this section shall be disclosed: 29 (a) As an aggregate; and 30 (b) By county, where county is based on the 31 patient's home address or primary place of residence; and 32 (B)(i) The total number of distinct patients who received 33 services from the covered entity with a home address or primary place of 34 residence located within a medically underserved area. 35 (ii) The metric under subdivision (b)(4)(B)(i) of 36 SB589 6 03/31/2025 1:46:16 PM JMB451 this section shall be disclosed: 1 (a) As an aggregate; and 2 (b) By county, where county is based on the 3 patient's home address or primary place of residence; 4 (5) The total number of distinct clinics or facilities, listed 5 by physical address, operated by the covered entity located within a 6 medically underserved area; 7 (6) The total number of distinct patients who received services 8 from the clinics or facilities operated by the covered entity located within 9 a medically underserved area; and 10 (7) Contract pharmacy arrangements, including without 11 limitation: 12 (A) The name and address of each contract pharmacy; and 13 (B) The total number of 340B -eligible claims processed 14 through each contract pharmacy. 15 (c)(1) The department shall post each covered entity’s 340B 16 transparency report on a publicly accessible website no later than sixty (60) 17 days after the annual submission deadline, redacting any trade secrets or 18 proprietary data that is exempt from disclosure under Arkansas law. 19 (2) A covered entity may request that specific information be 20 classified as confidential, subject to review and approval by the department 21 under the Freedom of Information Act of 1967, § 25 -19-101 et seq. 22 23 20-6-504. Enforcement — Penalties. 24 (a) The Department of Health may: 25 (1) Receive and review annual 340B transparency reports for 26 completeness and accuracy; and 27 (2) Conduct compliance audits or investigations of a covered 28 entity’s 340B activities, as necessary, to verify the accuracy of reported 29 information. 30 (b)(1) If the department determines that a covered entity has failed to 31 submit a timely or complete 340B transparency report, the department shall 32 notify the covered entity in writing and provide thirty (30) days for the 33 covered entity to cure the deficiency. 34 (2) If the covered entity fails to cure the deficiency within 35 thirty (30) days, the department may impose an administrative penalty not to 36 SB589 7 03/31/2025 1:46:16 PM JMB451 exceed five hundred dollars ($500) per day for each day of noncompliance, 1 subject to a maximum of one hundred fifty thousand dollars ($150,000) per 2 year. 3 (3) The department may waive or reduce penalties upon a showing 4 of good cause. 5 6 20-6-505. Rules. 7 (a) The Department of Health shall promulgate rules to implement and 8 administer this subchapter. 9 (b) The rules under subsection (a) of this section shall include 10 without limitation: 11 (1) The development of standardized reporting forms and 12 procedures; 13 (2) The process for requesting confidential treatment of 14 proprietary information; and 15 (3) The criteria for determining penalties for noncompliance. 16 17 20-6-506. Construction. 18 (a) This subchapter does not conflict with or preempt any federal law 19 or regulation governing the 340B program. 20 (b) To the extent a provision of this subchapter is in conflict with 21 federal law, that provision of this subchapter is void. 22 23 20-6-507. Severability. 24 If a section, subsection, subdivision, sentence, or clause of this 25 subchapter is held invalid or unconstitutional, the remaining provisions 26 shall remain in force and shall be construed to give effect to the intent of 27 the subchapter. 28 29 SECTION 2. DO NOT CODIFY. Effective date. 30 This act is effective on and after January 1, 2026. 31 32 33 34 35 36