The proposed bill amends the Arkansas Health and Opportunity for Me Act of 2021 by increasing the medical-loss ratio for health insurance plans from eighty percent (80%) to eighty-five percent (85%). This adjustment is intended to ensure that a larger share of premium income is directed towards medical care and quality improvement rather than administrative expenses. Additionally, the bill introduces provisions for the state to obtain pharmacy rebates from pharmaceutical companies, which will enhance the affordability and accessibility of medications for eligible individuals. The emphasis on these rebates is crucial for maintaining the program's fiscal sustainability.

Moreover, the bill outlines amendments to definitions and administrative processes within the Arkansas Health and Opportunity for Me Program, including the establishment of a tracking process for pharmacy rebates and a mandate for health insurers to actively pursue these rebates. It also introduces work requirements for eligible individuals, specifying exemptions and conditions for potential coverage suspension due to non-compliance. The bill extends the expiration date of the relevant subchapter from December 31, 2026, to December 31, 2031, and modifies reporting requirements for the Department of Human Services to include quarterly reports that reflect the recommendations of the Health and Economic Outcomes Accountability Oversight Advisory Panel. Additionally, insurers are now required to report amounts paid for cost-sharing by the Department of Human Services in their annual insurance premium tax reports, promoting transparency and accountability in the program's financial operations.

Statutes affected:
Old version SB527 Original - 3-19-2025 06:21 PM: 23-61-1002, 23-61-1003, 23-61-801, 20-77-2704, 20-77-2703, 23-61-1004(c), 23-61-1004(d), 23-61-1004(e), 23-61-1004(g), 23-61-1004(h), 23-61-1007(a), 23-61-1007(c), 23-61-1009, 23-61-1011(h), 26-57-603(a)
Old version SB527 V2 - 4-7-2025 03:52 PM: 23-61-1002, 23-61-1003, 04-07-2025, 23-61-801, 20-77-2704, 20-77-2703, 23-61-1004(c), 23-61-1004(d), 23-61-1004(e), 23-61-1004(g), 23-61-1004(h), 23-61-1007(a), 23-61-1007(c), 23-61-1009, 23-61-1011(h), 26-57-603(a)
SB 527: 23-61-1002, 23-61-1003, 23-61-801, 20-77-2704, 20-77-2703, 23-61-1004(c), 23-61-1004(d), 23-61-1004(e), 23-61-1004(g), 23-61-1004(h), 23-61-1007(a), 23-61-1007(c), 23-61-1009, 23-61-1011(h), 26-57-603(a)
Act 774: 23-61-1002, 23-61-1003, 04-07-2025, 23-61-801, 20-77-2704, 20-77-2703, 23-61-1004(c), 23-61-1004(d), 23-61-1004(e), 23-61-1004(g), 23-61-1004(h), 23-61-1007(a), 23-61-1007(c), 23-61-1009, 23-61-1011(h), 26-57-603(a)