Summary — HB 1930 (95th Arkansas General Assembly, 2025 session)
Status: Died in committee (Referred to Appropriations A; listed as Died In Committee / Died on House Calendar at Sine Die).
Introduced: January 17, 2025. Engrossed as amended: 4/8/2025. Primary sponsors: Rep. Wardlaw (House) and Sen. J. Boyd (Senate); many House cosponsors. Companion bill: SB 1028.
Note: the uploaded document contains an unrelated insertion of an Illinois HB1930 appropriations draft; that portion appears to be merged in error and is not part of the Arkansas proposal summarized below.
Purpose / intent
- Mandate minimum reimbursement levels for healthcare services paid by commercial and other nongovernmental health insurers in Arkansas, with the stated aim of improving provider financial stability, workforce recruitment/retention, and infrastructure by raising insurer payments closer to Medicare-based benchmarks.
Key provisions
- Creates Subchapter 19 (23-99-1901 et seq.) in Arkansas Code § 23-99 establishing definitions and rules for “Minimum Reimbursement Rates for Healthcare Services.”
- Definitions include “healthcare insurer,” “healthcare provider” (hospitals, health systems, physicians, physician extenders, ambulatory surgery centers, outpatient facilities), “health benefit plan,” “healthcare service,” and “equivalent Medicare reimbursement” (based on prevailing Medicare collection‑to‑charge ratios and including services not directly covered by Medicare).
- Minimum reimbursement schedule (Amendment H1): sets escalating minimum ratios of insurer payment to the provider’s “equivalent Medicare reimbursement”:
- On/after Jan 1, 2026: 45%
- On/after Jan 1, 2027: 55%
- On/after Jan 1, 2028: 65%
- On/after Jan 1, 2029: 75%
- On/after Jan 1, 2030: 100%
- Provisions on insurer rate review: before approving insurer premium increases, the Insurance Commissioner must consider additional factors including:
- Whether an insurer’s Risk-Based Capital (RBC) is less than 650% (as defined in § 23-63-1302); and
- Whether, to the extent allowed by federal law, the insurer’s medical loss ratio (MLR) on clinical services and quality improvement exceeds 85%.
- The bill directs certain exclusions when calculating MLR (e.g., performance-based compensation, expenses associated with carrying enrollee medical debt, cost sharing) and requires insurers in the fully insured group market to consider these factors before implementing premium or cost-sharing increases.
- Grants authority for rulemaking (“Rules”) to implement the subchapter.
Who would be affected
- Directly: commercial/private healthcare insurers and health benefit plans issued to Arkansas residents (certain plans excluded — e.g., Arkansas Medicaid, Arkansas Health & Opportunity for Me program, provider-led shared savings entities, plans for state/public school employees, some higher education plans).
- Indirectly: hospitals, health systems, ambulatory surgery centers, outpatient providers, physicians and physician extenders (would receive higher minimum payments under the schedule).
- Potential downstream effects on premiums, insurer finances, provider revenues, employer-sponsored coverage, and health care costs in Arkansas.
Procedural / timeline notes
- Amendment H1 (adopted 4/8/2025) added the specific phased percentages and the insurer rate-review provisions.
- The bill was considered in committee, reported as substituted, placed on calendars, read on the floor, amended and engrossed, but ultimately did not become law (died in committee / on House Calendar at sine die adjournment during 2025 session).
- A companion Senate bill (SB 1028) was filed.
Potential impacts (high‑level)
- If enacted, the schedule would progressively increase minimum insurer payments to providers, reaching parity with the bill’s defined “equivalent Medicare reimbursement” by 2030. That may improve provider revenues and financial stability but could also increase insurers’ costs and potentially affect premiums or coverage terms unless offset by other changes. The insurer rate-review provisions would add regulatory scrutiny of premium increases. Exact fiscal impacts would depend on insurer cost structures, negotiated contracts, and federal law interactions; the bill’s record shows it did not advance to enactment in 2025.
