Insurance & Commerce- House

And then we'll see where we are so of vice chair Matix I'll turn it over to you. Once it is mine okay you are if you're ready you're recognized to present S. B. five one one thank you Mr chairman. Members so this bill is actually I'm in a way I caught cleanup language there's only three individuals operating the state right now the fall underneath this there's a five hundred dollar fee to be a part of someone that is selling or involved with the foreign a savings loan associations three and by the way form just means out of state in so those three individuals like said pay five hundred dollars they also resubmit all the information they already submitted under other applications so it strikes at language removes it it's of it's something that endorses supported by you know those in the field obviously but and also by the securities department so just removes redundancy good good cleanup bill. The less controversial last meeting. Thank you we appreciate that senator of any questions by the committee. Okay saying none is or anyone signed up I'm sorry represent fielding. Thank you Mr chairman of. I was looking at the bill I don't see a bill I mean it's just removing language likes it is. It's to put of it something that you know really isn't necessary there are to provide the information so yes when those easy things were just as striking code so. Get a thumbs up for my representative ray. Okay. Thank you for that reserve feeling any other questions by the committee. A reserve hours you're recognized. Okay we have a motion will take at the proper time anyway any other questions saying that anyone signed up to speak against the bill. Anyone to speak for the bill. Karen Tierney. Okay actually okay I say that she is saying she does not need to testify so. Hopefully I got close enough I I think you're I think so okay so saying no no no question we have a motion on would you like to go and make your motion represent flowers. Thank you Mr chairman in the fifth thank you for that with a motion do pass is there anything that the proper motion is there any discussion on the motion. Say no discussion on the motion We'll go ahead and move forward all in favor say aye. Any opposed no the ayes have it gradually see past your bill I think your representative flowers committee members and looking for smart run that on the floor so the best interest let me know thanks thank you senator. Okay. Reserve our is going to come to the table and run to bills now. Represent Lowery even have three on the docket which one you want to present first I know you just want to do to today I believe but yes and get by. Bills on here. Going to present to Two insurance department bills and let me call up the agenda here real quick so I can. Get the numbers. The ticket by H. B. twelve forty and I've asked for assistance from the insurance department and I'll I'll have Mr. What would you recommend would you introduce yourself for the record please. Thank you Mr chair I'm generator general counsel the Arkansas insurance department thank you reg allow you're recognized present your bill thank you Mr chair this is the purpose is to update Arkansas's statute for changes in credit for reinsurance regulatory standards of a lot of these changes many times come because there's maybe a shift in what the in A. I. see to does and in June of two thousand nineteen the in A. I. see adopted revisions to the credit for reinsurance model law and regulation incorporating provisions of the bilateral agreements between United States and the E. U. on prudential. Measures regarding insurance and reinsurance the update to the law as a new provision that can be utilized for credit for reinsurance by establishing standards for reciprocal jurisdictions at this point I'm just gonna go and turn it over to Mr brighter let him give you the the high points thank you. Thank you Mr this actually is is good for for insurance companies but not only that are Arkansas companies but all those that do business here. I've got are a deputy commissioner of finance here should there be any finer point questions I've never pretended to have a high level of understanding of finance but I do understand how this works what this does it okay permits companies states that have this companies that that have to use reinsurance will not have to put collateral up which is comes at an additional cost of those companies is prayer I'm sorry Mister chair I forgot to mention that we have an amendment that should be presented first and it is to add Senator Hendren. skews me Senator Pitsch as the lead sponsor in the Senate so that an amendment I believe is before you all all it is just changing co sponsors on the Senate side let's go ahead and address that I'm what we'll we'll move through this quickly would you like to make a motion to adopt that amendment do pass on the amendment okay during discussion on just on the amendment only. Okay with a proper motion do pass on the amendment only Ted co sponsor All in favor say aye in any opposed nay. Impasses okay thank you per se Mr Prater thank you so as I was saying the the a couple with at this law office this bill were enacted a company that relies on reinsurance could count what that reinsurance is worth basically for those losses as an asset and therefore not have to the collateral which would save it money that levels the playing field this is something you heard the president Lauer mention the this is something that as we as we have international markets this is something the that is been accepted in the U. but it's something that hopefully all states will adopt here in the United States it will put our companies add on a level playing field with companies that are able to take advantage of this kind of provision in the you it basically it sets up you know standards to provide a framework to support Arkansas domestic insurers that's one of the realest real selling points when they see to reinsure risks they will not have to come up with something to collateralized at risk there are some provisions in this if you look at the rather lengthy bill the talks about reciprocal jurisdictions etcetera those are they follow a model from any I. see and that's getting into your. Levelized the playing field for US companies and and the European companies if you have any questions I can that's high level if you have any questions they get down into the weeds on how this process works I would probably want Mr Anderson up here but with that I would certainly take a stab in any questions you might have. Thank you for testimony questions by the committee. You're recognized. Thank you Mr chair it just a simple question how does this bill effect. Self employed. Of entity self employed employees big self employed employees maybe it doesn't at all but I'm just curious of self image self funded insurance yes self funded well we we will have regulatory authority over self funded that that's kind of out of our regulatory framework so I don't think this would impact them thank you. Thank you any other questions by the committee. Seeing none as anyone else is anyone signed up to speak against the bill would anyone like to speak against this bill. Regularity have anyone left to speak for the bill no if there's ninety questions a. That the department can help with that that I'm fine it doesn't appear there are there is one housekeeping measure we need to clean up and I'll just defer to you represent Lowery staff told me that that the amendment adding the co sponsors acts on twelve forty three is that this oh I'm sorry you're absolutely right okay I wish I was seeing the wrong bill okay so sorry so why don't we expunge make a motion to expand K. of like a motion to expunge the vote by which the amendment previously passed it we we actually already have those Co sponsors in place correctly on this bill so my my mistake I appreciate do pass on the expungement the thank you so that is a proper motion to expunge The Amendment all in favor say aye. Any opposed no okay that passes okay thank you I'm just keeping you on your toes and you please don't have to an employee thank goodness he's here yes members I I'll close emotional appropriate to the opportunity to have Mister Breger here to to explain and I'll probably go back and watch the video and and really pour over the summary they've given me before I present on the house floor but I'd I'd make a do pass motion I appreciate a good vote okay we have a motion do pass on this bill any discussion it's a proper motion in the discussion on the motion. Okay saying none all in favor say aye time any opposed no. The I. seven graduation to pastor bill okay thank you and personally I would would you like to move forward now and go and present HB twelve forty three yes and I'll present the amendment to the correct bill or the correct amendment to the bill Amendment on twelve forty three would be to add recognize Senator Pitsch as lead sponsor in the Senate and keep better Senator Hendren also as a co sponsor do pass on the amendment does a proper motion on the amendment just add Senator Pitsch as the lead Senate sponsor or any discussion on that motion. Seeing none all in favor say aye. Impose no. As have a The Amendment was passed you are free to present your bill as amended okay Mr braiders gonna help with this as well this is the unfair policy cancellation bill Arkansas Code includes policy cancellation of property or casualty risk without proper notice as an unfair method of competition or unfair or deceptive act or practice that violates the trade practices act for property and casualty policies in effect more than sixty days there are two pathways that could potentially lead to cancellation being considered an unfair practice insurers can cancel for. There I'm back on insurers can cancel for a reason other than those listed in subdivision nine a or fail to give notice prescribed by nine B.. how referred policies in effect sixty days or less the department only considers policy cancellation to violate the trade practices act I will mention that it was brought to my attention right before the meeting that there is a tie vote within the bill that where it is I think something was labeled as C. and it was supposed to be B. or something like that it was just a man that if we pass this on the Senate in but this point I will go and turn it over to Mr brighter. Thank you Mr misprint thank you Mr and just to point out I've got that page in front of me on page eleven of the bill line thirty one there is a parenthetical capital B. that should be C. it's referred to the notice requirements we will take care of that is this moves on to the use of this committee thank you Sir this this bill is if there's an ambiguity right now and and we've got some concerns on market conduct folks brought this to me last summer as we were looking for a potential legislation that we needed for policies that are in effect for under sixty days at the. Thank you there there are some some companies out there in practice were not providing adequate notice a point that out for failure to pay premiums that's always a reason to cancel with the proper shorter notice for for failure to pay premiums that's ever no matter how long policies been in effect this just clears up the ambiguity I think it puts the companies that we regulate on notice that it's clear all understand most are already doing it properly as the way the department sees it should be done this just clears up the ambiguity and it gives insured of more protection from a real fast cancellations this is critically important with reference to you get going the homeowner's policy perhaps you're purchasing a house. Underwriting maybe wasn't done as well as it should be and homeowner finds themselves without coverage or with the real short turnaround time we will go out to replace that coverage so this is to remedy that make sure that everybody's on the same page the ambiguity will be taken care of so I think it's well it's it's pro consumer I also think most of the industry already treats the consumer's fairly we're just clearing up one small ambiguity with that I'll take any questions. Thank you resent brown you're recognized. Thank you Mr so Mr Prater just does that mean that. Until a person's notified that they have they are that they are still actually covered. The notification requirements of any cancellation absolutely what this does is it treats those that have been in effect under sixty days the same as its reach those that have been in effect over sixty days that was my question okay my question is until they have been notified are they covered. Yes there statutory notification requirements yeah okay we'll perhaps she answered it not yet realized I mean it it and all of its work of acute policies going to cancel there are notice requirements. We're kind of over into one type and fixing the length of time for how long it takes that notice to occur but but yes there's always notice requirements thank you should never be a place for you think you have coverage and don't good thank you yes ma'am. Thank you have any other questions about the committee. Okay saying none is that we don't have anyone as they would like to speak against the bill. Soon anyone else like speak for the bill. Seeing none represent our would you like to close for your bill thank you members appreciate your support for this I think this is a a good bill to protect consumers thank representative brand your questions are right on on target that we want to make sure that everyone's covered that they if if there is a cancellation have adequate notice I I know that there are instances where sometimes that happens and there's not notice this clarifies that it would be a violation of a chip on fair trade practice and so consumers would have recourse in that case so I appreciate to do pass on this bill. So we have a motion do pass by rich allow it as a proper motion is there any discussion on the motion. Seeing none all in favor say aye opposed no and congratulates the pastor bill or to our thank you and members I'm going to pass so with the third bill is the one that I gave you a brief presentation on the other day relating to roofing deductibles the department is going to be back on Monday to help answer I know representative Allen had questions I think maybe representative Hodges did as well for the insurance department and will present that bill in full on Monday. Thank you. Thank you reserve our. Going to moving back to the top of the. Docket SP three oh nine is Senator Irvin said bill I do not see Senator. Thank you Mr Allen's going to represent Alan's gonna present this. Okay so would. Thank you You are recognized my stand there is an amendment to also yes yes you may proceed to. the amendment to the bill assist cleanup language which makes it consistent. So but that I move adoption okay so we have a motion on the amendment only for any discussion on the motion. Saying none all in favor say aye. The opposed no. Your member has passed you can proceed with presenting your bill as amended thank you. Ashu mill Senate bill three oh man today that I bring to you today it's on the last day of colorectal cancer awareness month. For those of you who may not know I am actually a state for Council survival and each one I have to journey to to Amanda for my treatment I just got back this past weekend and I know many of you all were on vacation eleven thousand allowing those again fighting for my life but I want to say with the Senate bill two O. nine this legislation will bring Arkansas online with American. Council so factors recommended guidelines the national standards for colorectal cancer following the screen in age from fifty to forty five it is sure the insurance we will cover it it will also save hundreds of lives across the state of Arkansas this is a bipartisan bill which bolster those staffers the language that has been agreed upon by all interested parties it we worked with insurers include Arkansas BlueCross BlueShield BlueShield to ensure that by lowering the age from fifty to forty five that the coal a must for you will continue to be covered with no call share share to the consumer. With their input this bill will provide that increased coverage at the age of forty five just like the exams are covered at the age of fifty. Regular colorectal cancer screening is one of the most powerful weapons for prevent colorectal cancer and with regular screen and most policies can be found and removed before they have the chance to turn it to counsel. Screening can also find colorectal cancer early when when is small and easier to treat so the sooner that you can find it the easiest to treat S. B. three oh nine would drop the age from fifty to forty five align doctor stopped to the to treat the disease in its early stages according to the American cancer society which detected when detected early five year survival rates increased by ninety percent compared to forty percent of the council which is found out of state is that as with that spread throughout other parts of the body. It covid this bill will do. A couple things. As I mentioned earlier the issue of Arkansas Blue Cross blue shield specifically supports this legislation and we have from Blue Cross blue shield the bay of Max Greenwood in case you all need to hear from her they believe that early detection and critical supports more in a statement in the corresponding insurance coverage for the United States preventive services task force the American cancer society correct the council screening guidelines as outlined in this that legislation it close and this bill would do. Three things. It lowers the age from fifty to forty five for collectors screaming. Two includes correspondent language to ensure the screen with will be covered under insurance plan in the third thing that it will do will save lives and I have talked to largely from you M. S. if anyone have any technical questions about the screen. Thank you and we do have some questions by the committee Russia wants term you're recognized I love this bill I think it's going to save lives I think it'll save money I think it'll save time motion at the proper time. Thank you represent Lundstrum we will will hold that motion Russian Hodge's you're recognized. Thank you Mr chair to agree with the recognized by think of the great build appreciate Senator Irvin and yourself for for president this bill I know Task Chadwick bowl in the action but can't after he died he was forty three years of age when he with that when he when he died of a colon cancer and his wife accepted the award on his behalf alone going to stress the fact that that me in need to get tested younger than than fifty to prevent you know because if it's preventable this this up this disease but my question is do you have any data. Showing the young the youngest person ever died of colon cancer or do you have any information that that that that that that that that you have to come up with a with the up forty five age bracket. You're recognized if you would please introduce yourself for the record. So sorry doctor Johnson I a I. Medical in rectal surgeon and I kind of I'm the head of correct answer J. U. M. S. so yes to answer your question over the last thirty years the incidence of colorectal cancer as well as the more tidy the death rate has been declining and that is mainly due to screening as well as improvements and in treatment that being said over the same period of time the incidence of colorectal cancer in the younger patient groups so younger than fifty has been rising and that is A subject of a lot of study to figure out why we have seen that because typically will recognize as being cancer of the elderly publication in older than fifty and so based on that you know there's been a lot of push to to decrease the the screening age now talking about the youngest patients to die from colorectal cancer I mean we've seen patients as young as eighteen but some of that may be related to a genetic I've no money so that genetic syndromes that run in families and so you know one of them we call familial adenomatous polyposis or FAP where the at risk of developing colorectal cancer is up to a hundred percent by age forty and so in those patients we will if we know that they have that genetic abnormality will remove vehicle and **** if it if and when the at and get teenage years and then we have another one called Lynch syndrome where a the individuals who have these mutations I'd risk of develop and endometrial cancer ovarian cancer colon cancer and other kinds as in other parts of the of the body that in if I've answered your question thank you the died. Sorry no records were follow the diet play any role nine. You know and Act and. Technical questions about camp if you think your your doctor it died have any issues with the. Someone to it the individual development. I couldn't hear that died that their diet. Yeah okay yet so that there is there is some evidence that diet has something to do so in general diets that are high in red meats you know facts died that typically we say it is bad for your heart what is is associated with an increased risk of colorectal cancer and then diets that I hi and fiber you know Folate B. twelve and those kind of good things for your heart for example I also protective in terms of lowering the risk of colorectal cancer yes. Thank you doctor. Representative ray you are recognized. Thank you Mr chairman represent around create you bring this bill I'm in the data that was passed out of says that Arkansas's the fifth deadliest state. For colorectal cancer I'm just curious and do you have any numbers on how many other states have already adopted what you're proposing or or if are we. Behind other states in this in terms of the age that were screening. And you're good okay so that several states that And in the process of of passing bills like this This. On of the top of my head that this about eleven states that currently in various stages of this so we I kind of I the front and the you can check important thing is that the American cancer society actually came out with this recommendation for lowering the age in twenty eighteen however in in that room off making recommendations is that U. S. preventive services task force that typically makes these recommendations and then C. M. as follows and everyone else followed suit the US preventive services came up with the a new recommendations are the new guidelines in October of twenty twenty so is still undergoing the public comment phase however I think the other part of this bill that it's important which has not been mentioned is the fact that you know when we talk about screening that different tests so the S. too based test and then days that opt what we call the optical test which a colonoscopy and flexible sigmoidoscopy and then we also have the radiology based as like that virtual colonoscopy so currently if a patient I always find individual that screening with this tool test and it's positive then they need a colonoscopy. Not when they've done that insurance doesn't they have cost sharing for the colonoscopy and the part of this bill that is important is that it's making for example if someone tests positive would that still be status and it to the colonoscopy that colonoscopy will be recognized as part of the screening process and not a diagnostic so that that way that still no cost sharing for the individual and I think that's that's very important a very important comment you mentioned that Arkansas is one of the deadliest date by when we look at across the board I did for biggest cancers that is colorectal cancer breast cancer lung cancer and prostate cancer Arkansas is at the bottom of the pack and okay in Austin some research that I'm doing now looking at the last fourteen years the the reason has that what we find is that is because we had a screening all right are people in this state because if you look at it most of it all the applications were dying from correct a wrecked all kinds at all I'm in the other three passes I presenting with later stages of the disease but when you when you come past stage for state you know there's no difference and so what it means is that we are not screened and I think this bill helps to remove barriers to screening and health so that we can screen more people and in a civilized. Thank you for that represent brown you had a question. Okay. Okay thank you represent Ferguson you're recognized yet you mention the color guard is what I call it the fecal test is that subject to a copayment deductible for the patient or is it considers screening is is considered screening so it is does this suppose bin no cost sharing and I guess had had diagnostic is that if it's positive what percentage to go owning you find selling cancer so if you take all comers you know the the initial studies that would done it was about sixty eight percent sensitive now if you take kind of a higher stages then it goes up to the eighties in terms of being able to find cancers so all the screening test I able to to find cancers Perhaps colonoscopy is probably the the best in the sense that you can actually prevent cancer by removing the polyps and then not counted on the diagnose and bacon also written policy can get biopsies but all this screening test in a way that fit tests Colo guard or the high sensitivity FOBT still test the all prevent cancer of the the date per day decrease mortality from cancer. Thank you any other questions by the committee. And I believe early on in the discussion represent Lundstrum did you have a motion that you wanted to make I'd like to move to pass. We have a motion do pass on the floor from representing most from represent the Lundstrum that is a proper motion is there any discussion on the motion. I would just like to briefly say is my part discussion about thank you for bringing this bill this is this is a great bill and I don't think anyone is going to oppose this and we appreciate your senate open for doing that so any other discussion. Seeing none we have a proper motion do pass all in favor say aye. Any opposed no. Graduation your bill is passed thank you Mr chairman and members. So Bentley's not so we're going to record that makes. Committee represent Bentley is not going to run her bill today so I believe represent eleven you're in you're in line if you're ready to go. The. Business. The script The. Yeah. After the. Representative eleven you are recognized to present HB eighteen oh four thank you Mr chair with permission the chair elected by John Vinson with Arkansas farms Association the table. Absolutely Mr Hansen you're welcome to join in. Be sure to. Representive eleven you are recognized to present. Thank you Mr chair member's house bill eighteen oh four is is an attempt to clean up and streamlined synchronize Some of the verbiage within the statute. Ording to ACT nine hundred of two thousand fifteen in regards to the definition of what a health plan is. I think it's important to note that when you're talking about this particular act this particular piece of legislation that we mentioned that the the act was challenged as part of the IBM licensure act of two thousand eighteen and was unanimously up hell with an eight oh decision by the United States Supreme Court in December two thousand twenty so I believe if United States Supreme Court support says an up hill that and then we as a station exams will. The bill defines what an Arkansas community pharmacy network is within adequacy to be consistent with the same terms of the federal network adequacy standards and what this also does is move the oversight of the audit laws regarding the the PBMs from the Arkansas state board of pharmacy unto the Arkansas insurance department to be consistent with all the other laws regarding PBMs. it's important to note that the bill was reviewed and revised using information from legislative audit and also from the consultation input from the Arkansas insurance department. I also want to know that there was uh from the industry there was a request one singular change that was that was brought to us from the original draft and we gladly made that and met the request in may that amendment that amendment has been engrossed into the bill is before you today just wanna give you real quick some background information when ACT nine hundred of two thousand fifteen and the PBM license or active Arkansas two thousand eighteen when those laws were passed the purpose of that was to define deceptive trade practice practices by the PBMs it was to define prohibited practices to establish network adequacy and to improve transparency improve prescription drug pricing I think is is all of you think back to your districts in your constituents most especially that last piece hits home to all of us and that is the transparency in the prescription drug pricing that your constituents or have an affair out of their pocket for medications that they have no other choice but to take. The federal benchmark for community pharmacy network adequacy is set by federal by the federal government this is just codifying those industry standards into Arkansas law. again want to state that this is moving the audit bill of rights enforcement back underneath the Arkansas Insurance Department through consultation with them they're in agreement with that and we'll be happy to try to answer any questions. Thank you representive eleven and I know you kind of have a guest at the table would you like for him to introduce himself and and make yes absolutely. We were seated. Thank you master Matix and members of the committee my name is John Vinson I am a pharmacist in our cans and then head of the Arkansas pharmacists association thanks for having me here today. I would like to testify and in favor of the bill and tell you a little bit about how we got here there's been a lot of abusive practices of the PBM industry the pharmacy benefit manager industry in our profession over the last twenty years and the state has tried to address and done an excellent job of addressing some of those concerns over the last decade with an audit bill in two thousand eleven with the ACT nine hundred of twenty fifteen which are our state was up held at the US Supreme Court back in December we got a positive ruling eight zero on that and then the licensure active twenty eighteen and ACT nine ninety four of of two thousand nineteen and all four of those laws are excellent laws this bill doesn't introduce new legislation it sinks all four of those laws under common definitions to improve the enforceability of our insurance commissioner and their ability to enforce these laws are members of our profession met with representative Evans was Senator Jason Rapert with Senator Stubblefield some of the previous champions of these bills that we have passed with legislative audit and they brought to our attention some of the inconsistencies in those laws in a way to clean those up to make a more enforceable so with that we are testifying in favor of the clean up bill for better enforcement of our laws and I'd be happy to answer any questions thank you for your testimony questions by the committee. Rector Boyd you're recognized. Thank you Mr chair aside a question. Dr Vincent from a constituent. that just recently came to me so I'm just gonna read the question and let you respond how you will so. There there's concern in this email about self insured program sure okay and the concerned basically says the Blue Cross is telling them that this is going to go to a single rate system for pharmacist for pharmacy reimbursement across the state so that's kind of the first part of the question and so. Is there something in here that says there's got to be a single rate I guess is would would be an answer or you know something I want you to answer then the other thing is is is this really going to increase the costs on self insured plans or is this just going to help ensure their are back door mechanisms where money siphoned off the system and potentially help self insured plans just like your feedback on it thank you. You should question thank representative Boyd the answers your question is no there's nothing in the legislation that requires the state to go to a single payment mechanism for pharmacies like I said earlier these laws have been in place over the last ten years and we haven't gone to a single payment system in the fully insured marketer in the plans we could clearly regulate even prior to the US Supreme Court ruling eight zero so it will not do that at all the second part is is it does regulate the vendors are the middle man and and if employers always have the opportunity to shop the market and get a better deal and get a better middle manner or even even better than that to contract directly with the providers to cut out the fifteen dollars per prescription like we saw in the limited exam of the PBMs by the insurance department recently and they're audit of the PBMs were they were continuing to DO clawbacks behind the curtain to and impose spread pricing on employers in our citizens and our taxpayers and to not have a transparent payment mechanism that's easy to understand in fact Chief Justice Roberts the U. S. Supreme Court called the processing system Byzantine meaning it's it on purpose impossible to understand to drive up prices so this bill will not drive up prices it will just provide enforcement are our existing laws and I believe it actually will drive down prices in as an example I had a kannst member of our share an example to members where the PBM continues to pay its own pharmacies that it owns in this case a hundred and thirty more dollars than the pharmacy in a rural part of our state and Brooklyn Arkansas and they forced the patient to use CVS for a self insured employer at a rate of a hundred and thirty more dollars for that prescription that they couldn't get. At the pharmacy in their community because they paid that pharmacy eighty dollars below cost their job is to drive our pharmacies out of business and raise prices and they they are fair but these laws make them more fair and protect consumers and in my opinion lower cost. Thank you any other questions by the committee. Okay. We will hold that motion at the proper time at this stage would have some people signed up Can you. I believe we do have someone signed up to speak against the bill Mr hall I believe you're signed up if you like to come to the table. Mr hall if you would introduce yourself for the record and you may proceed with your testimony. Thank you very much Mr chairman and good morning my name's Kenny hold on the executive vice president of the state chamber of commerce in associated industries of Arkansas we represent over twelve hundred businesses of all shapes and sizes and every county in the state and includes every local chamber in the state other than some of the smallest and just about all of the business associations many of which you're all familiar with this is a difficult testimony against one of our best friends and it's nice to have been we've had a very nice working relationship with John Vincent over the years this is the issue that we have a PO since the very beginning. Is an issue that has always gotten me yelled at. And so every time I see it filed my heart sinks because not everybody wants to rush appear and the talk about this so I'm the sacrificial lamb today if you will but there's a very serious issue here and I know with a representative Boyd already touched on is the cost issue and and this issue this is the big businesses this is the one that is going to touch the self insured companies all over the state which according to the I found an old map representative Lundstrum we had a one year bills two or four years ago just about almost fifty one percent of the businesses in this state have more than five hundred employees so if you're looking at one point two to one point three million employees we're talking about probably a half a million or more than a half a million employees that stand to be impacted by a bill like this if it changes the way this the self insured companies are able to operate their pharmacy benefit plans I am not prepared to be an expert on any of the technicalities of this issue I am not here speaking on behalf of PBMs I'm here speaking on behalf of the large corporations in this state many of which have contacted us and said that they had review this bill and found significant problems and concerns. Thank you represent flowers you're recognized for a question. Thank you Mr and thank you for being here today I I do appreciate the concern about the impact to businesses in this equation and. But when I hear the the The concern about cost in this. I'm wondering how. And I know you said you don't prepare to answer technical questions but you're you're telling us that there is an your you know consistently against this measure because of cost being a concern we know that in the last year the Supreme Court made a ruling that would basically bring all self insured companies in line to To comply with the existing state law anyway so if what. This bill would do is to codify Supreme Court the Supreme Court ruling. How is this going to be a cost that would be incurred anyway and as a matter of fact so that's one question but as a matter of fact. He wouldn't something like this really save businesses money so that everyone is playing by the same rules and we can avoid litigation. I cannot address the Supreme Court decision or its impact on this legislation what I do know is that like I said before we've had major companies look at this before we chose to come speak against it of we have a weekly call with our executive committee we talked about it Friday I had responses from multiple once before by yesterday that they had had their experts of whoever it is look at it and and said they had concerns I know some of the other concerns besides cost have to deal with the the privacy of information interfering with private contracts and and those sort of things but. From what I've seen and I'm excited for probably twelve years we've oppose this issue. It looks like there's an ugly battle between the pharmacies and the PBMs and the business side of it are getting caught up in that battle because unfortunately the PBMs are saving us money. And so what we have to stop and think when you're trying to fix one problem are you making another one and again I'm I'm I'm not technically able to go into the details of that but that's that's in a nutshell on the on the lowest level comment I can make is is how this is all kind of broken down we have been consistently told by employers that their plans are say they believe they're saving the money and I cannot answer why and I don't distrust John at all or representive eleven I as just the kind of way this issue is always gone there's been two sides of this issue for twelve years follow up please Mr you're recognized so Apple things you just said I don't think are consistent with you coming here today and. Presenting a position representing you know so many businesses who have a stake in this these are businesses that have engaged in a relationship with PBMs you yourself said that they are saving these companies money. And so we can't dismiss. The fact that that relationship and entering into a contract to somehow puts them in the in the middle as if it's sort of arbitrary and this fight between pharmacies and PBMs is something they don't really have anything to do with theirs they are in the middle and you know and I'm asking you this question because. Going back to the Supreme Court decision. This figures. Very centrally into this bill and into this issue and I don't think you can. Come here with all due respect and glaze over at that point that's exactly the point that there have been issues about how we deal with the conflicts including pharmacies. being impacted because they're being paid below the actual cost of the medication and then. not been paid at all for the service I mean that's been it issue as to whether or not the self insured companies have to it here to the law that has been in place since twenty fifteen so if this particular bill. Really is clean up language because it's bringing those self insured companies into compliance based upon a Supreme Court ruling. I just I don't understand how you can say to us don't vote for this bill because it would hurt companies. That now have to adhere to the law of the land there is no place else to go president flowers I'm sorry did you just so my question so my question is I understand that you do you you're saying you don't have a technical understanding what you're telling us it will cost money how would it cost money when they have to comply with the law of the land. As I said before I'm not Sensually again I don't know for sure some misunderstanding about what the case was all about Justin represented board may know more about it I think I don't is it check out what is the actual legal issue that they're deciding and if I know the Supreme Court they're deciding the issue on the most narrow issue they can find to make a ruling out so I don't know if this is a codification bill or not I'm just telling you that the biggest companies in this state have concerns about this bill thank you. Thank you represent fielding you're recognized for a question. Thank you Mr chairman I'm I'm trying to. Confuse. And the. Timer. Position. In if this bill. Here is to help. Small business. I've had two pharmacies in my town go out of business in the last year in the head. So if the chamber going to pick and choose who they have they don't have because I'm not concerned about Walgreens CVS Walmart they can take care of themselves. What a why is the time of fighting against. This bill that's going to help mom and pop. We're not against mom and pop representative fielding we represent the companies as I said before that have probably a half a million to three quarters of a million employees in this state all of which are covered by self insured health plan that according to what I'm being told that will be negatively impacted by this bill. For the same. Take that position. Yeah thank you for that thank you represent Boyd you're recognized for a question. Yes. Strong I just wanted to clarify I mean. What I understood you to say is that PBMs are saving you money and I and I'm confident that someone has told you that but I just when you look at the whole system and you hear the kickback schemes are you really confident that PBMs are setting you might. I am confident in the people that are running the big businesses that tell us they have problems with this probably went too deep into the details that's just kind of been the twelve years ago when the very first PVM bills filed that's what we were being told how it's evolved with the bills that have been passed I cannot address our committee chairman would have been here today but like representive Allen and I is a cancer survivor and having check ups or something today and I couldn't get in here so I I had to do the best I could he he would he would benefit excellent witness and I'm sorry I don't have been here for you Thank you represent Clowney you're recognized for a question. Thank you Mr hall campus I just under the answer to this maybe I should is the pharmacists association a member of the state chamber. They are now okay thank you. Thank you representative of any other questions by the committee. Okay saying none would any we have anyone else to speak for the bill. Okay no one else the sun the. But of anyone else signed up to speak against present anyone in the audience who would like to speak against the bill. There's not representative eleven would you like to close for your bill. Thank you Mr thank committee members those questions answer for like a clarification and it's worth thank the Arkansas insurance department is in support of this issue work work through the technicalities with the farms association believe this is a good bill for our constituents I believe it's a good bill for our business owners and with that I move a motion to pass. We have a motion do pass by representative eleven which is a proper motion is there any discussion on the motion. Okay saying none all in favor say aye. Any opposed no. Congratulations your bill is passed the Committee. Committee appears we worked very efficiently today and I'll take credit for that and