Representative Aaron Pilkington

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:32:02)

and have a few members who will be from the Insurance Commission, a designee from Arkansas Center for Health Improvement, the Secretary of the Department of Human Services, or his or her designee. And so it's essentially just a working group to try to figure out ways that we can improve payments on primary care. It doesn't force anything to happen. It's just a working group. And so with that, I don't take any questions, but it's a pretty straightforward bill. Any questions by the committee?

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:31:42)

264 thank you uh represent baron pilgdon district 45 um here to redeem myself today actually no this is uh this is a good bill by senator ervin and lee johnson i know in the essence of time i think just getting off the agenda would be great so essentially we're just creating a primary care Payment Improvement Working Group that's going to be appointed by the Speaker, the Pro Temp,

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:30:28)

it's actually A1C, sorry, not ALC, sorry. Thank you, Dr. Pilkington. All right,

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:26:00)

talk a lot about cemeteries all the time, and I just was curious if we need to get more aggressive.

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:25:43)

on violating this, because it sounds like it's a recurring problem, is there any way to remove them from the management of the cemetery? or have

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:02:37)

so we're not going to need legislation on that. Thank you. Representative Johnson, do

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (1:02:28)

health commission one is that it yes we can move that to deferred They have agreed to work with me in the interim to create that program,

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (57:58)

but it also protects the original agreements we made back in the 2017 session about exempting certain populations. So we're honoring our commitments there. We're giving ourselves the flexibility of some of these new groups like the Traumatic Brain Injury Waiver being able to go in here so that we can treat them and utilize some of the specialties that the passes have to better take care of these patients and save the state a little bit of money. So with that, I make a motion to do pass. As amended, correct? As amended, yes, Chairman. All

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (57:26)

That was part of the deal we made back then. We're still honoring that. We just, like I said, there's some smaller groups that we may want to be able to move into the PASS so that we can get better efficiencies, and that's simply it. Like I said, ALC still gets to, you know, approve if the governor makes this move or not, so it still gives us a lot of control on this and have a lively discussion when it happens so there's nothing going to be arbitrary about it. Pretty simple, and so I think, you know, obviously, like I said, we're just worried about the future and, you know, what things are coming down for the federal government. We just want to have more tools in the toolbox, and to me this is a tool in the toolbox,

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (57:10)

bill? Seeing none, you're recognized to close for your bill. Thank you, committee. I appreciate the discussion. I just want to reiterate, you know, when we ran the PASS legislation in the 2017 session, it was almost a decade ago, you know, there were certain populations we exempted. We're still maintaining that we're going to keep those populations exempted.

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (54:20)

no. Well, it's not an add money because you're just moving money. You're moving money into this bucket. The

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (53:53)

it works is the money follows the patient. So if we were to move a population, the money that is going towards that population would move as well. Just like when we moved Tier 2 and Tier 3 in the passes, I mean, we took that Medicaid money and it went into the passes to follow them. So it would be if you moved a population, you'd be taking the existing money you're already paying into the program with them. So it's not like you're adding people but not adding the money that was paying for their services originally. Does that make sense?

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (49:43)

a special session or trying to wait until we have, you know, two more years until we're back into a regular session. So that's kind of why

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (49:25)

and think it's a good policy to create the savings that we want to do. So I think that's good. I just think there's also maybe some other areas that as time goes on and we need to produce more savings, and especially when the feds come down and need us to do certain things, we just have this in our back pocket, and we're not having to be called in for

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (48:52)

as opposed to some third-party managed care company out of Dallas or, you know, San Francisco or something like that. I mean, I would hate to see us go to a full-blown managed care model. Oh, I agree with you. And so this is kind of a counterweight. We need to produce savings, but we want to make sure that we have a better utilization of care. Now, granted, this doesn't mean that the governor is going to do it tomorrow. We can, as ALC, say no to every single request there is. I know there's current legislation dealing with our Medicaid expansion population by Representative Lee Johnson and Missy Irvin, which I fully support

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (48:21)

Arkansas? Well, I would say it's actually a countermeasure against going full-blown managed care because instead

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (48:26)

you have provider-led organized care which you know that may seem like semantics but the reality is we actually have the providers in control making these determinations uh you know on on care and i think we've seen success with the tier one and tier two populations it has reduced has produced the savings we thought it was going to um and so and once again i would much rather if we were to move population to great savings we're putting them in organizations that are based here in arkansas that are arkansas provider-led companies

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (48:08)

would not affect anyone with private insurance. Okay, so

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (47:16)

Well, I just think any populations in which we're trying to create savings and better utilization of care. You know, I've actually been an advocate for moving maternal health into this as well. And then, of course, we've also talked about the CHIP population as well. Those are kind of two areas where we think better utilization can be ripe for savings, but at the same time, you know, provide those quality. You know, my understanding, too, is there were certain, when we originally ran the PASS legislation back in 2017, there were certain populations that were exempt from going into the PASSes. What are some of those? Long-term care is one to think of, and they are still exempt even with this bill.

Public Health, Welfare & Labor Committee (House) — April 1, 2025 (46:09)

the right move for our constituents. And so that's essentially what the bill does, and that's it, short and sweet. Appreciate DHS's help on this. Any questions from the members?