Arkansas

SUMMARY

Arkansas is a leader in price transparency, as it is a state that passed legislation establishing an APCD in the state. The APCD infrastructure is in place to receive and house data. The Arkansas Health Insurance Rate Review Division was awarded a grant from the Centers for Medicare and Medicaid Services/Center for Consumer Information and Insurance Oversight which includes specific funding for an APCD. After a competitive bidding process, the Arkansas Center for Health Improvement was awarded the contract to develop the APCD.

In the 2018 legislative session, Arkansas passed the Arkansas Pharmacy Benefits Manager Licensure Act, which requires PBMs to disclose information to the state and prohibits unfair competitive practices.

 

LEGISLATION/REGULATION

Legislative Calendar

Arkansas’ most recent regular legislative session ran from 2/12/2018 – 3/14/2018.

Legislative Updates 

Healthcare Transparency

2015-2016 SB956

 

THE ARKANSAS HEALTHCARE TRANSPARENCY INITIATIVE ACT OF 2015: establishes an all-payer claims database that is funded through, and governed by the Arkansas State Insurance Department. Entities required to submit data include: health and dental plans, state insurance agencies, federal insurance agencies, The Workers’ Compensation Commission, any entity offering a plan to 2,000 or more people, and health benefit plans that are subject to ERISA. Entities will need to file reports, quarterly.

The Department must receive and store data from submitting entities and will include medical, dental, pharmaceutical and other insurance claims information. The Department may collect, validate, analyze, and present that data and assess penalties for non-compliance (including fines of up to $1,000 per day). The Department may disclose the de-identified data, as a resource, to insurers, employers, purchaser of health care, researchers, state agencies, and healthcare providers for the purposes of assessing healthcare utilization, expenditures, and performance.

Passed—Signed by the Governor on 4/8/15. Act 1233.

 

Healthcare Cost 

2018 SB 2 / HB 1010

 

THE ARKANSAS PHARMACY BENEFITS MANAGER LICENSURE ACT: Beginning September 2018, this law requires pharmacy benefits managers to become licensed, file an annual statement about its sales and contracts within the state, and provide a report that shows how a PBM provides convenient access to pharmacies and fair and reasonable reimbursement rates to pharmacists, and does not financially incentivize the patient to use one pharmacist or pharmacy over another. The bill also applies several other restrictions to PBM advertising, promotion, and reimbursement practices, including a prohibition on deceitful advertising, gag clauses, and failure to reimburse pharmacists. Passed—Signed by Governor on 3/20/18.

 

Healthcare Markets

  • None identified.

 

Key Statutes

We compile state statutes that relate to healthcare price and competition, including healthcare transparency, markets, and costs. For a complete listing of all health related statutes visit the State Health Practice Database for Research.

 

Transparency in Healthcare

    • THE ARKANSAS HEALTHCARE TRANSPARENCY INITIATIVE ACT OF 2015: establishes an all-payer claims database that is funded through and governed by the Arkansas State Insurance Department. Entities required to submit data include: health and dental plans, state insurance agencies, federal insurance agencies, The Workers’ Compensation Commission, any entity offering a plan to 2,000 or more people, and health benefit plans that are subject to ERISA. Entities will need to file reports, quarterly.
    • The Department must receive and store data from submitting entities and will include medical, dental, pharmaceutical and other insurance claims information. The Department may collect, validate, analyze, and present that data and assess penalties for non-compliance (including fines of up to $1,000 per day). The Department may disclose the de-identified data, as a resource, to insurers, employers, purchaser of health care, researchers, state agencies, and healthcare providers for the purposes of assessing healthcare utilization, expenditures, and performance.

 

  • Code § 20-7-301 through 306:
    • The “State Health Data Clearinghouse Act,” directs the Division of Health within the Department of Health and Human Services to act as a clearinghouse for the compilation and dissemination of health data. All hospitals and outpatient surgery centers licensed in the state must submit information as prescribed by the Department. The Division of Health is authorized, but not required, to release health data.
    • Additionally, the Department is directed to provide data to the Arkansas Hospital Association “for its price transparency and consumer-driven health care project that will make price and quality information about Arkansas hospitals available to the general public (implanted as the HospitalConsumerAssist website). The Department shall also prepare a report biennially to the Governor and the Legislature respecting healthcare issues.

 

  • Code § 20-8-401 through 403:
    • The “Arkansas Health Data Initiative,” directs the Arkansas Center for Health Improvement to establish and maintain a health data initiative as an access point for studies concerning state and federal health information in order to better inform state health policy decisions. Pendant upon the consent of the state’s executive agencies, the Center may access data to facilitate the operation of the initiative, including public health databases, health care utilization data, financial data, data from the state health data clearinghouse, and other data supplied through mandatory reporting.

 

Healthcare Markets

  • Code § 23-99-201 through 23-99-209, the “Patient Protection Act of 1995,” enacts an Any Willing Provider (AWP) which prohibits a carrier from excluding from their network any health care provider that is willing and able to accept the health benefit plan’s operating terms and conditions. Under the Act, a benefit plan is also prohibited from imposes a monetary advantage or penalty that would affect a beneficiary’s choice among healthcare providers who participate in the plan.

 

  • Code § 20-8-101 through 114 prohibits certain healthcare facilities from acquiring, replacing, or adding to their facilities and equipment, except in specified circumstances, without the prior approval of the Health Services Permit Commission through the state’s Certificate of Need process (called a Permit of Approval in Arkansas). A Certificate of Need regime aims to reduce healthcare overheard by reducing unnecessary or duplicative services, but can be anticompetitive by increasing regulatory barriers for new entrants.

 

FY 2018-2019 BUDGET

Arkansas enacts budgets on a two-year cycle, beginning July 1 of each odd-numbered year. Arkansas’ new Biennial Budget will take effect on July 1, 2017 and is valid through June 30, 2019. To view Arkansas’ Department of Health 2018-2019 Budget, visit page 79.

 

LITIGATION/ENFORCEMENT

  • None identified.

 

KEY RESOURCES

Arkansas State Legislature

Arkansas Office of the Attorney General

HospitalConsumerAssist