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HB 1602

INC TX-R AND D CREDIT

104th Regular Session Introduced by Rita Mayfield

Act 633 mandates licensing and fees for pharmacy benefits managers in Arkansas, enhancing transparency and accountability to improve pharmacy claims processing for patients.

Rule 19(a) / Re-referred to Rules Committee
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Bill Summary · HB 1602

Summary of House Bill 1602 (Act 633)

Purpose and Intent

House Bill 1602, now known as Act 633, amends the Arkansas Pharmacy Benefits Manager Licensure Act. The primary goals of the bill are to establish licensing fees for pharmacy benefits managers (PBMs), enhance the regulatory framework governing their operations, and mandate the reporting of specific information related to pharmacy claims.

Key Provisions

The bill introduces several significant changes to the existing law:

1. Definitions and Clarifications

  • Clean Pharmacy Claim: A claim without defects or documentation issues that can be processed in real-time.
  • Pharmacy Claims Identifiers: New definitions for identifiers used in processing pharmacy claims, including:
    • Pharmacy Claims Bank Identification Number (RXBIN)
    • Pharmacy Claims Group Number (RxGroup)
    • Pharmacy Claims Processor Control Number (PCN)

2. Licensing and Fees

  • Licensing Requirement: No person or organization may operate as a PBM in Arkansas without a license from the Insurance Commissioner.
  • Application Fees:
    • An initial application fee of $20,000.
    • An annual renewal fee of $20,000.
    • The Commissioner has the authority to reduce fees in cases of financial hardship.

3. Reporting Requirements

  • PBMs must report various identifiers and combinations used in pharmacy claims at the time of license renewal, including:
    • Each pharmacy claims bank identification number.
    • The estimated number of covered lives for each combination.
    • Breakdown by plan type (e.g., employer-sponsored, fully-insured, self-funded).

4. Regulatory Authority

  • The Insurance Commissioner is empowered to establish rules regarding:
    • Licensing and application processes.
    • Financial solvency and compliance requirements.
    • Data reporting and market conduct practices.

Impact

Who is Affected?

  • Pharmacy Benefits Managers: The bill directly impacts PBMs operating in Arkansas, requiring them to adhere to new licensing and reporting standards.
  • Pharmacies and Pharmacists: Increased transparency and regulation may affect how pharmacies interact with PBMs and how claims are processed.
  • Patients: The changes aim to improve the efficiency and reliability of pharmacy claims, potentially benefiting patients through better access to medications.

Procedural Timeline

  • Introduced: February 26, 2025
  • Passed: April 9, 2025
  • Signed into Law: April 16, 2025

The bill underwent several amendments and was reviewed by both the House and Senate before being enacted. The legislative process included recommendations from committees and multiple readings before final approval.

Conclusion

HB 1602 (Act 633) represents a significant update to the regulatory framework governing pharmacy benefits managers in Arkansas. By establishing clear licensing fees and reporting requirements, the legislation aims to enhance transparency and accountability in the pharmacy benefits sector.

Compiled from official sources — confirm details with the bill’s official record.

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