The proposed bill seeks to amend the Arkansas Pharmacy Benefits Manager Licensure Act with the goal of enhancing patient rights and improving access to medications. It establishes a legislative intent to regulate healthcare payors and pharmacy benefits managers, ensuring that patients are protected from unfair trade practices and have adequate access to pharmacy services. The bill introduces new definitions, such as "affiliate," "carve-out network," "ghost network," and "self-administered prescription drug," which clarify the relationships and practices within pharmacy benefits management. It also prohibits unfair practices, including coercing enrollees to use specific affiliates and restricting pharmacy choices, while mandating clear communication regarding coverage exceptions and appeals.

Additionally, the bill includes provisions that require healthcare payors and pharmacy benefits managers to provide accurate information about participating pharmacies and to consider individual enrollee limitations when enforcing the use of specific affiliates. It allows enrollees to choose their pharmacy if the services provided are unsuitable due to specified limitations and prohibits retaliation against enrollees or healthcare providers for exercising their rights. The Insurance Commissioner is empowered to create rules for enforcement, including penalties for non-compliance, and an emergency clause is included to ensure the bill's immediate implementation upon approval by the Governor or after the veto period.

Statutes affected:
Old version SB104 V2 - 3-19-2025 03:11 PM: 23-92-503, 03-19-2025, 23-92-506(b)
Old version SB104 V3 - 4-1-2025 02:35 PM: 23-92-503, 04-01-2025, 23-92-506(b)
Old version SB104 Original - 1-27-2025 09:03 AM: 23-92-503, 23-92-506(b)
SB 104: 23-92-503, 23-92-506(b)
Act 514: 23-92-503, 04-01-2025, 23-92-506(b)