The Joint Senate and House Insurance and Commerce Committee is meeting December 16 to discuss Rule 128, which enforces existing law prohibiting below-cost reimbursement in the commercial market. Company testimony and support letters are crucial for the success of this meeting. Rule 128 is critical for fully enforcing Act 3 of 2018, helping to prevent unreasonable underpayments that threaten patient access and addressing excessive overpayments that drive up costs.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

NACDS sent a support letter to Arkansas Commissioner of Insurance Alan McClain on Rule 128, the Pharmacy Benefits Manager Compensation Requirements for Network Adequacy, Fair and Reasonable Pharmacy Reimbursements. Without meaningful actions, like Emergency Rule 128 which protects patients by prohibiting health plans and PBMs administering benefits on behalf of a health plan from recouping or recovering any increased costs to dispense from a patient at the point of sale through increased co-insurance, co-payment, or deductibles, more dollars will continue to flow to PBMs instead of reducing Arkansans’ prescription drug costs and safeguarding access to their trusted and convenient pharmacies. The enforcement of Rule 128 by Commissioner McClain will protect vital access to lifesaving prescription drugs and pharmacy services for Arkansans across the state.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Insurance Department (“AID”) will host a Public Hearing on October 22, on proposed RULE 128 FAIR AND REASONABLE PHARMACY REIMBURSEMENTS that NACDS support. AID provide a summary of the rule.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

NACDS sent a letter to the Arkansas Insurance Commissioner Alan McClain (R) in support of proposed Emergency Rule 128, Pharmacy Benefits Manager Compensation Requirements for Network Adequacy, Fair and Reasonable Pharmacy Reimbursements. This rule is needed to protect pharmacy providers from the abusive PBM business practices that can jeopardize the future of pharmacy and the sustainability of providing pharmacy services and patient access to care.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Gov. Sarah Huckabee Sanders (R) announced that she is joining Insurance Department Commissioner Alan McClain in imposing penalties and hearings against four PBMs – Caremark, Magellan, Express Scripts and MedImpact – for allegedly violating a June 28 bulletin from the Insurance department advising PBMs to stop paying pharmacies below the national average drug acquisition cost (NADAC).

Also in Arkansas: Attorney General Tim Griffin sues PBMs for alleged role in the state’s opioid epidemic.

Also in Arkansas, effective August 1, 2024, Medicaid Fee-for-Service reimburses pharmacies for diabetes testing supplies and continuous glucose monitors (CGMs) through the pharmacy billing system (Prime/Magellan). This includes diabetes lancets, meters, test strips, CGMs and CGM supplies.

Finally in Arkansas, the Pharmacists Association (APA) shared that Blue Cross Blue Shield (BCBS) is paying pharmacists to capture A1c and other diabetes interventions for some patients through Outcomes.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Insurance Department (AIO) issued a Bulletin_10-2024 reminding insurers that Arkansas Health and Opportunity for Me (ARHOME) is the payor of last resort. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Insurance Department issued a Proposed Amended Rule 118: Pharmacy Benefit Manager Regulations in advance of the Public Hearing on September 10, 2024.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Insurance Commissioner (“Commissioner”) issued Advisory Bulletin 8-2024 to all Insurance Department (“AID”) licensed pharmacy benefits managers (“PBMs”) related to PBM reimbursements to pharmacies at minimum levels to NADAC pricing amounts under Ark. Code Ann. § 23-92-506(b)(5)(A). The Commissioner had received several complaints from pharmacies against PBMs in which a PBM has reversed a payment to reduce or to remove a dispensing fee in the pharmacy’s compensation to equalize the payment to NADAC minimum pricing. Questions concerning this Bulletin should be directed to Legal Division at 501-371-2820 or by email at Insurance.Legal@arkansas.gov.

Also in Arkansas, Tim Griffith, the Attorney General is suing PBMs for their role as a cause of the opioid epidemic in Arkansas.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Legislative Council approved a rule that allows Medicaid reimbursement for continuous blood glucose monitors (CGMs).

For more information, contact NACDS’ Mary Staples at 817-442-1155.