§ 23-92-501. Title
This subchapter shall be known and may be cited as the “Arkansas Pharmacy Benefits Manager Licensure Act”.
§ 23-92-502. Purpose
(a) This subchapter establishes the standards and criteria for the regulation and licensure of pharmacy benefits managers providing claims processing services or other prescription drug or device services for health benefit plans. (b) The purpose of this subchapter is to: (1) Promote, preserve, and protect the public health, safety, and welfare through effective regulation and […]
§ 23-92-503. Definitions
As used in this subchapter: (1) “Claims processing services” means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include: (A) Receiving payments for pharmacist services; (B) Making payments to pharmacists or pharmacies for pharmacist services; or (C) Both subdivisions (1)(A) and (B) of this section; […]
§ 23-92-504. License to do business — Application — Fees — Rules
(a) (1) A person or organization shall not establish or operate as a pharmacy benefits manager in Arkansas for health benefit plans without obtaining a license from the Insurance Commissioner under this subchapter. (2) The commissioner shall prescribe the application for a license to operate in Arkansas as a pharmacy benefits manager and may charge […]
§ 23-92-505. Pharmacy benefits manager network adequacy
(a) A pharmacy benefits manager shall provide: (1) (A) A reasonably adequate and accessible pharmacy benefits manager network for the provision of prescription drugs for a health benefit plan that shall provide for convenient patient access to pharmacies within a reasonable distance from a patient’s residence. (B) A mail-order pharmacy shall not be included in […]
§ 23-92-506. Compensation — Prohibited practices
(a) (1) The Insurance Commissioner may review and approve the compensation program of a pharmacy benefits manager with a health benefit plan to ensure that the reimbursement for pharmacist services paid to a pharmacist or pharmacy is fair and reasonable to provide an adequate pharmacy benefits manager network for a health benefit plan under the […]
§ 23-92-507. Gag clauses prohibited
(a) The prohibitions under § 23-99-407 apply to participation contracts between pharmacy benefits managers and pharmacists or pharmacies providing prescription drug coverage for health benefit plans. (b) A pharmacy or pharmacist may provide to an insured information regarding the insured’s total cost for pharmacist services for a prescription drug. (c) A pharmacy or pharmacist shall […]
§ 23-92-508. Enforcement
(a) The Insurance Commissioner shall enforce this subchapter. (b) (1) The commissioner may examine or audit the books and records of a pharmacy benefits manager providing claims processing services or other prescription drug or device services for a health benefit plan to determine if the pharmacy benefits manager is in compliance with this subchapter. (2) […]
§ 23-92-509. Rules
(a) (1) The Insurance Commissioner may adopt rules regulating pharmacy benefits managers that are not inconsistent with this subchapter. (2) Rules that the commissioner may adopt under this subchapter include without limitation rules relating to: (A) Licensing; (B) Application fees; (C) Financial solvency requirements; (D) Pharmacy benefits manager network adequacy; (E) Prohibited market conduct practices; […]
§ 23-92-510. Applicability
(a) This subchapter is applicable to a contract or health benefit plan issued, renewed, recredentialed, amended, or extended on and after September 1, 2018. (b) A contract existing on the date of licensure of the pharmacy benefits manager shall comply with the requirements of this subchapter as a condition of licensure for the pharmacy benefits […]