Representative Lee Johnson

Meeting — April 2, 2025 (2:06:40)

was create a working group to have a better studied approach as to how much that spend should look like. And I think that's the responsible way to approach this. So this bill creates a working group of a variety of different kind of primary care providers that will look into how much money is appropriate to be spent within an insurance carrier on primary care. And then it will make those reports back to ALC for ALC to look at. And then ALC may, it's permissive language, bring insurance companies in to talk about that primary care spend. And I'd be happy to answer any questions on this bill.

Meeting — April 2, 2025 (2:06:22)

- Thank you, Mr. Speaker. Members, primary care physicians came to me in the interim looking at maybe how much money should insurance companies be spending on primary care and how much spend should they have in the Medicaid space. They talked about running a bill to define that. Instead of running that bill, what they decided to do instead

Meeting — April 2, 2025 (54:45)

needed to carve back in. This is the language that accomplishes that. I'd be happy to answer any questions. Thank you. Appreciate a

Meeting — April 2, 2025 (54:25)

the bill. Thank You Mr. Speaker. Members, last session we created some laws around what, how insurance companies could lease their networks, so they have a network of providers, they can lease that network to other insurance companies. We set up some rules around that. In setting up those rules we missed a few things in the definitions and ended up accidentally carving some people out that we

Insurance & Commerce (House) — April 2, 2025 (36:48)

for how long? What's the outcome? Actually, at this time, Ed

Insurance & Commerce (House) — April 2, 2025 (32:58)

the specialized imaging testing or

Insurance & Commerce (House) — April 2, 2025 (28:57)

because I think there are some drugs out there, and whether this qualifies as that, I don't know. That's why we left it up to the pharmacy board and medical board to decide where those drugs, where that line is drawn. And so my question would be, does this allow them to seek a prior

Insurance & Commerce (House) — April 2, 2025 (28:20)

Yeah. And I didn't know if this bill allowed for prior authorization. Because, you know, the members of the committee are very familiar with my stance on prior authorization, right? I have a pretty strong opinion about that in general. But when we did the go-kart legislation, I very specifically carved out pharmacy benefits because I recognized that, hey, look, there are some drugs that are so expensive, they should require prior authorization every time. And so we put the pharmacy board in charge of deciding which drugs might be eligible for exemption for prior authorization and which ones we said, hey, look, under no circumstances, this is always going to require PA.

Insurance & Commerce (House) — April 2, 2025 (28:12)

step therapy and prior authorization are two different things. I mean, prior authorization is an approval. Step therapy is, you know, fail-first therapy.

Insurance & Commerce (House) — April 2, 2025 (27:45)

them to seek a power authorization?

Insurance & Commerce (House) — April 2, 2025 (27:06)

those same guardrails? Yes, sir. If

Insurance & Commerce (House) — April 2, 2025 (25:52)

that scan? Is it the insurance company that requires it, or who's requiring that they have the scan? And does this bill allow for EBD to have those same

Insurance & Commerce (House) — April 2, 2025 (26:01)

requirements? I'm going to speak to the medicine

Insurance & Commerce (House) — April 2, 2025 (25:28)

keep this from being overused? I'm going to speak

Insurance & Commerce (House) — April 2, 2025 (25:09)

and they prescribe the drug. That's not an appropriate, you know, mechanism to prescribe this medication. What are the guardrails that are in place? I know you've precluded step therapy in this. What are some of the other guardrails in place to

Insurance & Commerce (House) — April 2, 2025 (24:36)

I mean, I'm an emergency medicine physician. I feel very qualified to treat emergencies. I don't feel qualified at all to weigh in on whether somebody qualifies for one of these drugs or not, right? because that's not my area of expertise, yet because I have a medical license in Arkansas, I have a pretty broad scope of what I can do, right? Whether I'm really qualified or not, I can hang a shingle and start treating people for a whole variety of things, right? And so what's to keep me or other colleagues who maybe are intending to do good things, right? They're seeing a patient in their office, and they think, hey, this may be a drug that fits them,

Insurance & Commerce (House) — April 2, 2025 (23:54)

It's a very narrow group of people that would qualify for the more expensive therapies. And to be clear, it looks to me like this bill doesn't say anything about specific drugs, right? It just says any drugs approved for FDA approved treatment for Alzheimer's. It doesn't look to me like it characterizes mild versus other forms of Alzheimer's or dementia. It's just broadly just saying drugs, right? So not specific to this drug, or is that correct? Yes, sir, that's correct. And so, maybe this is more of a question for EBD, but I'm just curious about the process to make sure providers are following these narrow criteria and that we're not inadvertently opening this up for just anyone to prescribe these medications, right?

Insurance & Commerce (House) — April 2, 2025 (23:44)

and thank you for the testimony. I guess the question I have is around the guardrails, right? I mean, I think it's important to recognize that if I'm understanding you right,

Insurance & Commerce (House) — April 2, 2025 (0:33)

Dr. Morgan Sauer with Baptist Health and the Alzheimer's

Public Health Welfare & Labor Committee (Senate & House) — Feb. 10, 2020 (1:33:55)

we're fortunate that we found that this vitamin acetate this time is the product that's being randomly inserted into these chemicals that are being touted as e-liquid consumables, but who's to say the next time it's some other product because we have no real idea of knowing what any of these things are, or what's in any of them with regard to these open system products? That is correct.