Arkansas HB 1703: TO PROVIDE A DRUG REIMBURSEMENT PROCESS FOR CERTAIN HEALTHCARE PROVIDERS.

Bill Text

Stricken language would be deleted from and underlined language would be added to present law. 
Act 570 of the Regular Session 
*ANS211* 03-18-2025 10:58:48 ANS211 
 
State of Arkansas As Engrossed:  H3/18/25   1 
95th General Assembly  A Bill     2 
Regular Session, 2025  HOUSE BILL 1703 3 
 4 
By: Representative L. Johnson 5 
By: Senator Irvin 6 
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For An Act To Be Entitled 8 
AN ACT TO PROVIDE A DRUG REIMBURSEMENT PROCESS FOR 9 
CERTAIN HEALTHCARE PROVIDERS; AND FOR OTHER PURPOSES. 10 
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 12 
Subtitle 13 
TO PROVIDE A DRUG REIMBURSEMENT PROCESS 14 
FOR CERTAIN HEALTHCARE PROVIDERS. 15 
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 17 
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 SECTION 1.  Arkansas Code Title 23, Chapter 99, is amended to add an 19 
additional subchapter to read as follows: 20 
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Subchapter 19 — Drug Reimbursement Process 22 
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 23-99-1901.  Definitions. 24 
 (a)  As used in this subchapter: 25 
  (1)  "Contracting entity” means a healthcare insurer or a 26 
subcontractor, affiliate, or other entity that contracts directly or 27 
indirectly with a healthcare provider for the delivery of healthcare services 28 
to patients; 29 
  (2)(A)  "Drug" means a substance prescribed, administered, or 30 
employed by a healthcare provider that is used to prevent, diagnose, treat, 31 
or relieve symptoms of a disease, injury, or abnormal condition. 32 
   (B)  "Drug" includes a prescription drug, medicine, 33 
biological product, pharmaceutical, radiopharmaceutical, or other medical 34 
supply; 35 
  (3)(A)  "Health benefit plan" means a plan, policy, contract, 36 

As Engrossed:  H3/18/25 HB1703 
 
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certificate, agreement, or other evidence of coverage for healthcare services 1 
offered or issued by a healthcare insurer in this state. 2 
   (B)  "Health benefit plan" includes indemnity and managed 3 
care plans. 4 
   (C)  "Health benefit plan" does not include: 5 
    (i)  A plan that provides only dental benefits or eye 6 
and vision care benefits; 7 
    (ii)  A disability income plan; 8 
    (iii)  A credit insurance plan; 9 
    (iv)  Insurance coverage issued as a supplement to 10 
liability insurance; 11 
    (v)  A medical payment under an automobile or 12 
homeowners insurance plan; 13 
    (vi)  A health benefit plan provided under Arkansas 14 
Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et 15 
seq., or the Public Employee Workers' Compensation Act, § 21-5-601 et seq.; 16 
    (vii)  A plan that provides only indemnity for 17 
hospital confinement; 18 
    (viii)  An accident-only plan; 19 
    (ix)  A specified disease plan; 20 
    (x)  A long-term-care-only plan; or 21 
    (xi)  Nonfederal governmental plans as defined in 29 22 
U.S.C. § 1002(32), as it existed on January 1, 2025; 23 
  (4)(A)  "Healthcare insurer" means an entity that is subject to 24 
state insurance regulation and provides health insurance in this state. 25 
   (B)  "Healthcare insurer" includes: 26 
    (i)  An insurance company; 27 
    (ii)  A health maintenance organization; or 28 
    (iii)  A hospital and medical service corporation. 29 
   (C)  "Healthcare insurer" does not include an entity that 30 
provides only dental benefits or eye and vision care benefits; 31 
  (5)  "Healthcare provider" means a person or entity that is 32 
licensed, certified, or otherwise authorized by the laws of this state to 33 
provide healthcare services; and 34 
  (6)(A)  "Healthcare services" means services or goods provided 35 
for the purpose of or incidental to the purpose of preventing, diagnosing, 36 

As Engrossed:  H3/18/25 HB1703 
 
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treating, alleviating, relieving, curing, or healing human illness, disease, 1 
condition, disability, or injury. 2 
   (B)  "Healthcare services” includes services for the 3 
diagnosis, prevention, treatment, or cure of a condition, illness, injury, or 4 
disease. 5 
   (C)  "Healthcare services" does not include a service 6 
reimbursed through a pharmacy benefits manager licensed under the Arkansas 7 
Pharmacy Benefits Manager Licensure Act, § 23-92-501 et seq. 8 
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 23-99-1902.  Drug reimbursement process. 10 
 (a)(1)  A contracting entity shall provide a reasonable administrative 11 
appeal procedure to allow a healthcare provider to challenge the 12 
reimbursement for a specific drug as being below the healthcare provider’s 13 
drug acquisition cost. 14 
  (2)  The reasonable administrative appeal procedure under 15 
subdivision (a)(1) of this section shall include: 16 
   (A)  A dedicated telephone number, email address, and 17 
website for the purpose of submitting an administrative appeal; 18 
   (B)  The ability to submit an administrative appeal 19 
directly to the healthcare insurer or health benefit plan; and 20 
   (C)  The ability to file an administrative appeal no less 21 
than sixty (60) business days following the adjudication of a claim. 22 
 (b)  If a challenge is made under s