Insurance & Commerce - Senate
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Bills discussed (8)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1290
· 3 mentions in agenda, chapter, transcript
Matched: “…ORM COMMERCIAL CODE. REGULAR AGENDA Number Sponsor Subtitle HB1290 L. Johnson TO MANDATE COVERAGE FOR MENTAL HEALTH WELLNESS E…”
|
TO MANDATE COVERAGE FOR MENTAL HEALTH WELLNESS EXAMINATIONS; AND TO ESTABLISH THE ARKANSAS SUPPORT OF … | L. Johnson | Died in House Committee at Sine Die adjournment. |
|
HB1917
Act 839
· 3 mentions in transcript, agenda, chapter
Matched: “to the table, please. Thank you members House Bill 1917 members. State Senator Barr Hester, District 33.”
|
TO AMEND THE ARKANSAS STUDENT-ATHLETE PUBLICITY RIGHTS ACT; AND TO AMEND THE LAW RELATED TO … | M. Shepherd | Notification that HB1917 is now Act 839 |
|
HB1055
· 2 mentions in chapter
Matched: “HB 1055 motion to run”
|
TO ESTABLISH COVERAGE DIAGNOSIS AND TREATMENT TO SLOW THE PROGRESSION OF ALZHEIMER'S DISEASE OR OTHER … | J. Mayberry | Died in Senate Committee at Sine Die adjournment. |
|
HB1746
Act 997
· 2 mentions in agenda, chapter
Matched: “…lint Penzo RE-REFERRED TO COMMITTEE Number Sponsor Subtitle HB1746 M. Brown TO AMEND THE UNIFORM COMMERCIAL CODE. REGULAR AGEN…”
|
TO AMEND THE UNIFORM COMMERCIAL CODE. | M. Brown | Notification that HB1746 is now Act 997 |
|
HB1853
Act 835
· 2 mentions in chapter, agenda
Matched: “HB1853 J. Moore TO AMEND THE LAW CONCERNING AGENCY RELATIONSHIP AN…”
|
TO AMEND THE LAW CONCERNING AGENCY RELATIONSHIP AND DUTIES RELATED TO REAL ESTATE LICENSES; AND … | J. Moore | Notification that HB1853 is now Act 835 |
|
HB1918
Act 810
· 2 mentions in agenda, chapter
Matched: “…Y- BASED SERVICES WITHIN RISK-BASED PROVIDER ORGANIZATIONS. HB1918 McAlindon TO AMEND THE LAW CONCERNING SPECIE OR LEGAL TENDE…”
|
TO AMEND THE LAW CONCERNING SPECIE OR LEGAL TENDER; TO AUTHORIZE THE USE OF A … | McAlindon | Notification that HB1918 is now Act 810 |
|
HB1942
Act 1023
· 2 mentions in chapter, agenda
Matched: “HB1942 L. Johnson TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR HOME-…”
|
TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR HOME- AND COMMUNITY-BASED SERVICES WITHIN RISK-BASED PROVIDER ORGANIZATIONS. | L. Johnson | Notification that HB1942 is now Act 1023 |
|
SB639
· 1 mention in agenda
Matched: “AGENDA (Revised 4/10/2025 @ 7:30 AM) Removed SB639 and Added HB1917 to Regular Agenda Senate Committee on Insu…”
|
TO CREATE THE ARKANSAS WIND ENERGY DEVELOPMENT ACT. | Caldwell | Died in House Committee at Sine Die adjournment. |
Machine transcript
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Speaker 4
19:36
Yeah, get me over there and I'll never leave. Senate Insurance and commerce come to order. We're going to start with House Bill
Senator Justin Boyd
Unverified
19:52
1290. Introduce yourself and your Thank you, Mr. Chair. State Senator Justin Boyd, what this bill does is it seeks to create parity between a mental health exam and a physical health exam, so, you know, if you're an insurance company and you pay for a physical health exam once a year. This would create parity
for a mental health exam as well.
Speaker 12
20:11
So members uh 1290 has been amended. If you see your green sheet with a physical impact that has been eliminated and there is no physical impact now. Was there any
Speaker 15
20:28
questions? You say that it's it's on. Page.
Speaker 17
20:32
Yeah, I'll just verified with EBD that Oh, OK.
Speaker 12
20:43
It's on page 4, line 15. Page 4 line 15. Now that
Senator Justin Boyd
Unverified
20:50
EBD fits under 21-5401. Go ahead, Senator Flowers. So
Speaker 22
20:56
what would the cost sharing be? For, for that for
Senator Stephanie Flowers
Unverified
21:07
that particular let me get uh
Senator Justin Boyd
Unverified
21:16
rather have a full answer than what the
Speaker 30
21:27
answer I'm gonna give you. OK Grant Wallace, director of Employee Benefits division Senators cost sharing would fall under your deductible, your copay, co-insurance,
Speaker 31
21:36
those items, so $25 office visit that's cost sharing your $500 deductible, that's cost sharing.
Senator Stephanie Flowers
Unverified
21:47
So for for mental health wellness examination, $25 they can expect to pay
Speaker 30
21:53
at oh, so what, what is, I'm sorry, I misunderstood your question. So this would fall under
Speaker 31
21:59
a normal kind of PCP, so it would fall under that $25 co-pay for the office visit.
Senator Stephanie Flowers
Unverified
22:07
Would it raise the premium at all? No,
Speaker 39
22:09
because we had this amendment done. There is no impact to premium.
Senator Stephanie Flowers
Unverified
22:18
And for just plain wellness. Uh, evaluation or physical examinations. Same thing, $25 copay.
So under our current plan design,
Speaker 31
22:32
you have a one annual visit for wellness that comes at a $0 copay, but yes, any normal doctor visit would have a $25 co-pay. So the The 0
Senator Stephanie Flowers
Unverified
22:44
that you talked about the one time.
If a person Uh, gets this mental health wellness exam. Is that what it's called? Yeah. First They have 0. No,
Speaker 44
23:03
this would fall outside of a physical wellness exam, right? Yes, ma'am. OK, I guess, I mean, do we have
Senator Stephanie Flowers
Unverified
23:10
a, I guess we have enough where would they go to get this mental health psych. Just I, I mean, like
Senator Justin Boyd
Unverified
23:22
Where do you go? Any willing provider that does a mental health well-being exam. I mean, so it doesn't have those? Uh Representative Johnson would not, OK, healthcare insurer, so a physician or a psychiatrist, a medical officer of the United States government, a psychologist or clinical psychiatric clinical psychologist, a nurse practitioner or clinical nurse specialist with a psychiatric primary care or mental health population focused license. So
those are the, um, those are the areas. And then also licensed clinical social worker, licensed marriage and family therapists, licensed professional counselor and physician assistants. So a list of a 8 of the providers who could do this. OK. And then For EBD. I wanted
Senator Stephanie Flowers
Unverified
24:13
to know Is there a cap on the amount that can be paid to the provider.
Speaker 30
24:26
For these services? No, they would build like any normal provider would bill. Obviously there are going to be provider agreements with
Speaker 31
24:32
or with our third party administrator who has health advantaged, so obviously there are network agreements and provider discounts and all those things that would go into it, but no, there would be no cap on number of visits or anything along those lines, but the and the
Senator Stephanie Flowers
Unverified
24:46
patient could end up actually having to pay. A little bit more depending upon what
Speaker 31
24:52
coverage levels. So if they're in their basic or classic, yes, they have
co-insurance, so they're that's when the 80/20 or the 9010 kick in with our premium plan, there is those co-insurances don't exist because that's the highest level you're paying a higher monthly premium for that particular plan, so you only have like the copays on that plan, OK, thank you. Is there any other questions, Senator McKee. So Senator
Speaker 58
25:15
Boyd, I appreciate you and I appreciate all the
Senator Matt McKee
Unverified
25:28
Are we, are we telling insurance companies that they
Senator Justin Boyd
Unverified
25:33
have to cover this? Yes, sir. That's exactly what it's an active mandate. So if you're you're covering a primary care wellness visit on the physical side. This is saying that if someone sees this list of providers A through H on page 3, begin at line 8 and going through, uh, line 17, uh, then yes, they're saying that once a year you need to cover a mental health wellness exam. Uh, just it creates parity
between a mental health exam and a physical health exam. Why do we have to tell them to cover this? That's a good question. Uh, you, you would
Speaker 7
26:18
hope that the market would have taken care of that, but By virtue of legislation they're being legislation that tells me that The market is not. So we, we've passed, I don't know how many mandated
Senator Matt McKee
Unverified
26:26
coverages out of this committee. Yes sir, we have, and this 1 may not cost
the state anything, but it does have a cost to business and it does have a cost to the people that we represent. And while I'm all in favor of people having good mental health and seeking care when they need it. I, I'm starting to get really weary of telling insurance companies what they, what they must cover.
Senator Justin Boyd
Unverified
26:51
So I hear you. What the other side, so when we're talking about that, there's two sides to the equation, right? And so one is what a service cost and then the other is
what's harder to document, but the costs that happen because we're not, because if we have um man, woman, child, somebody who really needs this. They don't have the money to go have this exam that has a cost too, whether they wind up not working, whether they wind up committing suicide whether they wind up in some other. So I just encourage you, yes, there is a, a Easier to measure hard cost. There's a more difficult
Senator Matt McKee
Unverified
27:33
It costs to society, but it actually has a cost too. And I appreciate that. Wouldn't you agree though that we're just shifting costs, or shifting who bears those costs.
Senator Justin Boyd
Unverified
27:46
That I agree. I think it's a valid point and I appreciate this. I mean, this is the kind of debate we should be having on every single one of these bills. We should not just be rubber stamping a new mandate on insurance companies.
Thank you. Senator I'll get, I'll get you next, uh.
Speaker 70
28:05
If this intervention happens early and, and they are, they are helped in this. Is
Speaker 71
28:12
that not a societal and health care benefit. I believe it to be both. I
Senator Justin Boyd
Unverified
28:18
wouldn't be presenting this legislation if I didn't think it was the right thing to do. I want to be clear about that, but I respect Senator McKee's point that we have put a lot of mandates and at some point in time, even though it's a broken market, there's still a market, right?
And if we don't want to go to single payer system at some point we can't set all of the rules. The market has to determine some of them some. That said, I think this is a very reasonable, uh, rule. You can tell me if there are a bunch of people signed up to speak for or against it. I've not had anybody reach out and say, hey, we're concerned this is going to break the system or anything, uh, and I certainly have some other legislation pending where I have heard that this that it will break the system. This is not one of those. All right, thank you, Senator Murdoch.
Senator Reginald Murdock
Unverified
29:09
you, chair, thank you, and I, I concur with what you're saying. This just seems to be, if I'm reading it correctly, mental health has been something that has been overlooked many times in the wellness sector as it relates to medical diagnosis and we can add this to it at no cost to the to the constituent initially and even early detection, they can come from this that I just think this is more of a wraparound service where we're maybe.
Saving us money in the long term if we get an early diagnosis through examination and does not costing them any additional money, so Senator health care costs, I do agree with McKee, Senator McKee. I understand a lot of that, but some of these mandates that we've had to do, I would argue they shouldn't have been mandates that we have to do. It should be inclusive in the package of taking care of the people
Speaker 76
30:05
that the insurance is paying the premiums, in my
Senator Justin Boyd
Unverified
30:10
opinion. What we really want to do is have the market work on its own. There's a lot of government regulation. I agree in this case, this is g ing the market in the right direction. We are not mandating every last thing about mental health we're saying, hey, you're going to cover this physical health, mental health is important too. We need, we need that covered and the way I see it and so I think this is a reasonable, uh, bill, uh, but I also respect Senator McKee's point that we have put a lot of mandates on insurance and at
some point that comes with a cost. I'm personally OK with this, Senator Flowers.
Speaker 82
30:49
I hang on just a minute. You guys, you can come to the table. You don't have
Speaker 70
30:55
to stand up. All right. Yeah, I know, I don't like anybody behind me or all right. Go ahead, Senator Flowers. Thank you. Yeah I'm
Senator Stephanie Flowers
Unverified
31:05
wondering what You define what what it means to
have a mental health wellness examination. Includes without limitation. These things on page 3. Lines 20 through Uh 29 Referrals to on Going treatment mental health services and other supports as clinical clinically appropriate. We have the Medical marijuana statute.
And it lists certain Uh, diagnoses that a physician can prescribe. Medical marijuana for. One being post traumatic stress. Disorder. How, how would Could, would that be paid for? Under this bill. This is not
mandating ongoing treatment. This is mandating a
Senator Justin Boyd
Unverified
32:15
mental health wellness exam. So just like I go to the doctor once a year, I stand on the scale, my blood pressure's checked. I, uh, you know, they, they listen to my heart, they listen to my lungs. This is more of, we're going to look for those things presumptively if you had post-traumatic stress disorder, you'd already be in the system. You'd already be seeing somebody. we would already be working on. So that's, that's,
Senator Stephanie Flowers
Unverified
32:40
that's a good question. question, but that's the first application are presenting first
Senator Justin Boyd
Unverified
32:46
to the doctor. Yes, it's got a
Senator Stephanie Flowers
Unverified
32:49
behavioral health screening, right? And it also Say Referrals To ongoing treatment. Mental health services. And other supports that all referrals. So, so
Senator Justin Boyd
Unverified
33:06
if I'm the primary care physician or the nurse practitioner or the licensed clinical social worker, and I identify. This post-traumatic stress
disorder or whatever, then it's saying that, yes, so, uh, if I identify that, that could be a mental health wellness exam. It doesn't say ongoing treatment for post-traumatic stress disorder or attention deficit disorder or depression, anxiety, it, it's the initial, you know, just again, like if, if I'm going to the doctor once a year to be checked out, this gives me a list of providers I can go to to have my mental. Health. But it wouldn't cover the the
Senator Stephanie Flowers
Unverified
33:48
any prescription. are It might, it might cover
Senator Justin Boyd
Unverified
33:53
those, but that's outside the scope of this bill. I, I, how do you say
Senator Stephanie Flowers
Unverified
33:59
it might cover those, but it's outside the scope. It's outside the scope
Senator Justin Boyd
Unverified
34:04
of this bill, this bill is just saying we're going to cover a mental health wellness exam. That doesn't mean the insurance doesn't already cover all of those things as it is. Those things are either in the contract or they're in
Senator Stephanie Flowers
Unverified
34:18
legislation elsewhere. Have you talked to private insurers about What impact this bill would have on policies that I would, I think that's a good
Senator Justin Boyd
Unverified
34:35
question. I think the Typically when I file a bill or a bill is filed with my name on it, it's public. There are plenty of people watching and they have the ability to reach out to me
directly. They have the ability to come to committee. I've not heard from anyone at this moment in
time saying, I have a concern, Senator. The largest
Speaker 82
34:57
provider is across the table. I wanted There is no one here they have a position there is no one here to speak
Speaker 70
35:06
for or against the bill. I just wonder if they had a concern, you're welcome to stand up. OK, thank
Speaker 15
35:12
you. Uh, is there any other questions? I would like to hear from them
Senator Stephanie Flowers
Unverified
35:20
though on a question that I have close to Senator Boyd about Treatment. With the
policy Kind of a normal policy, you got normal, I don't know, I guess. I don't know how to phrase it, but the standard kind of policy, would it cover treatment? So all right, thank you. That's that's
Speaker 105
35:42
all I'm a prescription for medical marijuana.
Speaker 107
35:52
What diagnosis. for diagnosis. Prescription for diagnosis. What is that? the
Senator Stephanie Flowers
Unverified
35:59
exam. So, so if you needed
Senator Justin Boyd
Unverified
36:05
a prescription medication, then they're generally these plant, a health plan would typically
have prescription medications. I'm not here to, to debate medical marijuana, but in general medical marijuana is not an FDA approved drug. There are some derivatives of marijuana that
are FDA approved and very well might be, but what we refer to in this state is medical marijuana. is not a prescription drug, which is defined by the Food and Drug Administration, not by the state of Arkansas, kind of like Ivermectin is not an over the counter drug, though the state of Arkansas said it was, it's still the Food and Drug Administration says it's prescription. Again, not to
bring up that debate, but I don't know how else to uh. OK. Thank you. Uh,
Speaker 70
36:51
is there any other questions, seeing none, no
one speak for or against the bill, you want to close your bill?
Senator Justin Boyd
Unverified
37:02
McKee's expression of concern, but at the same token, sometimes the market needs to be nudged. We have a large insurer here who we've seen tacitly agree that they're not concerned about what this will do to costs, and so I would encourage good vote, so I'm going to make a motion to pass and encourage someone to give me a second and
Speaker 70
37:25
motion by Senator Boyd, seconded by Senator Johnson, any discussion saying none, all in favor say aye, all opposed like sign thank you Senator. You passed your bill. Senator Hester. You can, you can present from there. Do you want some other folks to come
Senator Bart Hester
Unverified
37:46
to the table, please. Thank you members House Bill 1917 members. State Senator Barr Hester, District 33.
Speaker 70
37:56
Uh, we can get as detailed go ahead and let these other introduce you self and that way we don't have to do it later. Shane Broadway ASU system. I'm
Speaker 115
38:05
Brad Phelps. I'm counsel for the ASU system. All right, go ahead. I'm going to be brief and then
Senator Bart Hester
Unverified
38:12
let them add some comments. This, this is a we're, you know, call this year's NIL bill. We know that the NCAA has made a settlement with our institutions of a higher ed. This will allow our institutions to higher ed to be able to
Ultimately pay athletes athletes a revenue share based on that settlement. There's Probably a lot of details in there if you want to know, but that's the gist of the bill. It just allows the state of Arkansas to revenue share with our with our student athletes to keep us competitive, and I will pass it off to my colleagues now. add to that now. Uh, thanks, Senator Hester. I think you stated it
Speaker 114
38:52
very well. That's the primary purpose of the bill for a little bit of background. Get a little closer.
OK thing, but here we go. I might have broken this Shane Shane will pay for it. Earlier this week in a federal court in California a class action lawsuit was set for a settlement hearing that lawsuit is against the NCAA and several power conferences and as part of that lawsuit, um, institutions across the country will now have the ability to do
Revshare and so what is happening across intercollegiate athletics is that the name, image and likeness that we've all seen the last couple of years is going to change a bit. It'll be more. Done through Revshare and this legislation is designed, among other things, to implement that on a statewide basis so that we're in, you know, compliance with the settlement. We have the legal ability to do this, and that's essentially what it seeks to do. Senator Broadway, well, thank
Speaker 123
40:01
you, Mr. Chairman. I'll just add Coach Pittman. We had Coach Pittman and Coach Jones, both of our football coaches from Fayetteville and and they stayed here on Monday. They apologize. They couldn't be here today. Today's football practice day. Monday was an off day, or they would have been here, but to echo what and I first off, I want to thank Senator Hester for his leadership on this issue. This is the 3rd session in a row we've had to do something related to NIL and as Brad alluded to, it is changed since the initial bill and 2001 was just about the name and image and likeness for the third
party paying that paying a student to advertise their, you know, automobile business. Now you're going to transition because of continuous lawsuits into a revenue share that will flow through the university based on our conference shares that we received from being a part of a conference, SEC or Sunbelt. So you can see the changing dynamics, like it or not, have shifted in just 4 short years, hard to even imagine what we might be back here for next time
or the following time and so a lot of changes in collegiate athletics, we appreciate this legislature giving us the ability to keep up with that so we can remain competitive. All of your sister states obviously are in session right now considering the exact same type of legislation that we are so that we're all on. the same playing field and try to stay as competitive as we can. Senator Murdoch and
Senator Reginald Murdock
Unverified
41:27
then Senator Johnson. Thank you, Chair. So this legislation basically just gives you the authority, the
right to enter into these agreements with the Yeah, it's a great I guess agreements with the with the student athletes. It doesn't dictate how you're going to do it at each university, the University of Arkansas may do it a certain way. Arkansas State may do it a certain way in terms of The share and percentages. So which may be the next lawsuit if they, if it's not done in a similar fashion, you can look to see probably something coming from that because of
equality or whatever the case may be, whatever the lawyers come up with next, but, but this is just simply enabling you to do it right. It's
Speaker 114
42:16
not dictating correct, um, and I think you're right, Senator. No one knows where the next lawsuit will be where Complying with what's in front of us today. Thank you, Mr. Chairman.
Speaker 127
42:36
Gentlemen, I'm so tired of hearing about NIL. I can scream and I want to tell you, I think that
Senator Mark Johnson
Unverified
42:42
it's all is at the foot of the NCAA, which ought to be abolished or reconstituted or creating something new. It was clear that we were treating these athletes like chattel. And my cousin was the manager of the Razorback basketball team when they went to the Final Four in Charlotte, and he walked through mall withorliss Williamson. They passed a store that had an Arkansas number 34
jersey in the store window and he asked his, he said, I asked Corliss, does that bother you? He goes, it doesn't bother me. What bothers me is I don't have the 150 bucks to buy it. And it shows the inequity we're making money off these young people and an equitable thing could have come up where you'd get paid like a graduate assistant gets paid or some other nominal thing instead of a quarterback making over a million dollars a year in an offensive lineman, not being able to, you know, pay his
laundry bill. I mean, I was an offensive lineman, so you can tell I was prejudiced, but, but my point is, As much clout as all of you universities, and I'm talking about nationwide have. Can we not get Congress to move in and straighten this out. I mean, collectively. I know we can talk to our delegation and all this, but is there any effort to straighten this out because and, and I've got a question right at the end, specifically on it, but I wanted a global answer if I
Speaker 123
44:10
could get that first. So to your point, Senator Johnson, yes, we obviously have all talked to our delegation about it. That there needs to be some type of federal solution. There have been several hearings in the last few weeks with this new Congress. There was a hearing, I think, last Wednesday. I'm trying to forget I'm losing track of days, but there was a hearing last week, a bill filed yesterday and so there is a lot of discussion on Capitol Hill. I regularly sit in on briefings.
Brad does as well, uh, with updates on what's happening in Washington. So there does seem to be more movement, I think even With the president and Congress about trying to get their arms around this and trying to come up with one
Speaker 131
44:54
solution. So yes, there is a lot of discussion that makes
Senator Mark Johnson
Unverified
44:58
me feel a lot better now specifically on the bill. What we're changing here is, uh, with the, well, it seems to have been funded whether it's through, you know, Saracen doing something with their deal or Ola ask and the just general public
donating into a fund for this. This would allow you to do what I call the turn back, your TV if you go to a bowl game, that can, it lets the athletes actually share in that type of revenue, so that's the change,
Speaker 114
45:27
isn't it? Yeah, it's permissive. That's what this settlement is going to be doing. I do want to clarify, Senator, that those private opportunities that you reference, like say a student athlete has an arrangement with an auto dealership, those will still be allowed
going forward, but those will be handled pursuant to this clearing house which will evaluate those arrangements on a fair market value basis, so again that's it'll still be out there, but it's unrelated to Revsha. I have some philosophical
Senator Mark Johnson
Unverified
45:57
problems with saying that if you're in this, you have to go through this clearinghouse because we got here in the first place because, you know, I'm a free American citizen. I have a right to enter in to go
sell my services, uh, whether I'm a student athlete or not, and basically NCAIDs basically said you can't, and so they got their butt kicked big time, and that's why we're in this mess in the first place because they had prohibited that athlete from having a part-time job or doing something legitimate and instead we've just gone totally the wrong direction, but I appreciate that. I think it's a good bill. I think it's a temporary fix, a temporary thing, and I encourage you to please, please, we need
to do something to encourage Congress, and I don't think it's partisan. I think that we could get 50 states to say to Congress, Hey, please fix this equitably, so we're not here trying to compete with the Big 10 or the PAC 4 or however many of them are left out there or something. And to your
Speaker 123
47:01
point, I just remembered, Senator Johnson, that a number of the conferences and ADs on. Hill this week. And then some of us are going in a couple of weeks to reiterate some things as well, so that's
the solution long term solution, or else you're right it's got to be nationwide or it won't work. We'll continuously be
Speaker 15
47:21
in litigation. Yes, sir. Thank you both. Thank you, Mr. Chairman. Seeing no other questions, Senator Flowers. So
Senator Stephanie Flowers
Unverified
47:31
I'm trying to understand and I haven't read thoroughly this bill, but when you say Clearing house, would that be the conference? They're under
Speaker 114
47:40
the under the terms of the settlement that I referenced earlier that was being approved in California.
There's going to be a third party clearing house set up related to the NCAA that's going to evaluate the kinds of agreements I was speaking about with Senator Johnson on this fair market value analysis to his point, expect that many of those arrangements, if they're not approved, you know, we'll probably lead to more disputes down the road, so Senator Johnson, Senator Murdoch, he mentioned other cases. I think that's
Senator Stephanie Flowers
Unverified
48:19
could happen. But then I heard you say that the individual athlete or I think that's what I understood from what you said, an individual athlete could still contract privately. They could, but it would still have to go
Speaker 137
48:33
through the clearinghouse. It's $600. They can't just go do it outside the institution or outside the NCAA settlement. It would still have
Speaker 123
48:40
to go through a process that we weren't part of the party in dictating. What's in the settlement, we're just having to implement the
Speaker 114
48:50
settlement. And what about $600? That's for arrangements
Senator Stephanie Flowers
Unverified
48:57
of $600 or more that have to be reported, but anything less than 600,
Speaker 114
49:03
the athlete can. Right. yes, they can they can contract with a third party if it's under $600. It does not have to be
Senator Stephanie Flowers
Unverified
49:12
reported to this clearing house. So if they have continuous ads or uses of their name, image and likeness. Just,
I mean, do you consider that? all of
Speaker 144
49:28
them together. Each one, yeah, somebody get around
Senator Stephanie Flowers
Unverified
49:31
this by going 595 uh and do it once a month, once a week.
If you don't have a contract that says the term, it's a
Speaker 147
49:45
great question, and it's a good hypothetical.
Speaker 114
49:52
I suppose, I suppose if somebody was creative enough, there will be somebody who's creative enough to do that, so we'll have to see, but the goal is if it's 600 or more, it has to be reported, so. And I think our understanding
Speaker 137
50:04
is 600 per year. Per contract contract is different. So then per year because
Senator Stephanie Flowers
Unverified
50:13
you can have 7 or 8 contracts. For her agreement you can have 7 or 8.
Again, we were not party to the settlement. But, and the universities get some of this money too if it's approved by the clearing house, or is that
Speaker 147
50:39
just for the athlete? Well, there's two separate things that we're talking about in the bill is the
Speaker 114
50:45
Revsha component, and of course that does include money for the universities. What's done privately with the student athlete and a private business under this clearing house is not something the university participates in.
Senator Stephanie Flowers
Unverified
50:58
And, and when you say rev sharing, That's no money from the state of Arkansas, it's, it's all about these vendors or these third parties that
are wanting to use the name image arrangements, ticket sales, game guarantees, private
Speaker 114
51:12
contributions. It all goes into a pot. OK, thank you. So you know other questions you guys are the only ones to speak
Speaker 15
51:22
for the bill, and I'm not going to let you, you want to close
your bill? I'm close. All right, uh, what's
Speaker 70
51:32
the will of the committee? Motion by Senator Johnson, second by Senator Flowers. Any discussion all in favor. Say aye. All oppose like sign. Thank you, Senator. Thank you,
Speaker 15
51:49
Mr. Chair. Uh, next, Senator Dees, it's uh 1746 1746.
Speaker 156
51:56
Thank you, members. State Senator Tyler Dees,
Speaker 157
52:00
District 35. You have an amendment to be passed out while that's coming out, if I may give a description, Mr. Chair. So this, this is passed out once and and you're making it better and yes sir. So
Senator Tyler Dees
Unverified
52:17
Senator Boyd, Senator Dodson made some great catches. Senator McKee as well to help us not undo some similar legislation or leave out. I think it was by mistake some clarity that related to UCC that
made sure that we, we are not really you look at some first I guess for the adoption of the amendment is really to make sure that Money does not include the CBDC, a
Speaker 157
52:43
central bank digital currency, so it would appreciate adoption of the motion to adopt by Senator McKee, seconded by
Speaker 70
52:49
Senator Boyd, all in favor. Say aye. All oppose like son. Thank you, Senator. We've heard this bill. Is there any questions? something. I had it
Speaker 156
53:06
I kind of want to see if you've been on the Senate floor, yes, yes, ma'am. I thought I had. what about Uh That send her flowers if it no, we voted on in this committee, and he's amended it. So you pulled it down,
Senator Tyler Dees
Unverified
53:39
yes, ma'am. I was made aware of some concerns that by accidentally leaving out some of the sections that potentially could be unclear or could undo some of the good things that we've done in other legislation, so we want to send it back, make sure that was added in for clarity to align
Senator Stephanie Flowers
Unverified
53:56
with what we're trying to do. So my question to you, since you, the title is to amend the Uniform Commercial Code is this truly
A uniform commercial code has been amended in other states
that have adopted the uniform commercial code. Yes this
Senator Tyler Dees
Unverified
54:15
same bill, yes ma'am, I would say very similar, if not
Senator Stephanie Flowers
Unverified
54:18
exactly the same. And, and they had what your amendment proposes in it, I suppose. OK. Because, OK, thank
Speaker 70
54:32
you, Mr. Chair. Motion at the proper time. See no other questions, motion by Senator Flowers, seconded by Senator Boyd motion as a as
amended all in favor say aye. All opposed like signing thank you, Senator. Next is a 1918. Representative, just introduce yourself to anybody you
Speaker 12
54:51
need to come to the table with. This is a fantasy DC a
Speaker 110
54:57
little heavier. Thank you for doing that. Representative Mindy McAlinden House District 10.
Representative Mindy McAlindon
Unverified
55:03
Yes, ma'am. Thank you. So the primary
objective of House Bill 8 1918 is to provide Arkansan with a secure and
Senator Missy Irvin
Unverified
55:15
efficient means to store and use precious metals as a form of payment. Uh, the bill does basically two things. The first thing it does is it authorizes the option for a state-run depository in the future. It does not mandate one. It does not create one, it just sets up the opportunity that if the state decides they can set one up. Texas has Established the 1st 1st state run gold depository back in 2015. It allows individuals, businesses, and even government entities to store gold and
silver there. Tennessee has adopted similar provisions and as I understand it, they are working on a depository. Louisiana, Oklahoma, and Florida are considering comparable legislations to this one, this session. Uh, the second thing that it does is gold and silver are already recognized as legal tender in Arkansas, but there is no mechanism to allow people to use it as legal tender. And so the next logical is a system that enables its practical use and by allowing a precious metals backed electronic transaction system, it allows for seamless
asset-backed exchanges for those who use who wish to use gold and silver, and basically what that all means is that if I have gold coins and I store them in the depository in Texas. Um, I will get a credit card from that depository, and then I can use that credit card at Walmart, um, Walmart, you know, digitally, they'll go get the gold. The goal will be transit will be exchanged into dollars and Walmart will be given dollars. So Walmart is not having to deal in gold. Walmart gets to deal in
dollars. I get to deal in gold if that's what I choose, and it's pretty seamless and so it just gives people an opportunity to do that. No one is required to do that. It doesn't cost anything for us to do that, uh, but it does position us as a leader and financial innovation, and it gives residents an alternative, stable and reliable means of conducting transactions however they choose. I worked closely with the treasurer's office to develop this bill and the responsibility for promulgating the rules on this will lie with the CFO. Happy to take any questions.
Senator Reginald Murdock
Unverified
57:17
Thank you so much. It's the treasurer's office here.
Speaker 182
57:27
I need to hear from them. Yes. So introduce yourself, who you're with and you're recognized.
Senator Reginald Murdock
Unverified
57:32
Michael Harry with the state treasurer. So From a consumer protection and just good. Um, regulatory oversight, just trying to make sure that this is good for us, for the state, for the consumers, and it's protecting us in the ways that
should protect us and give us advantage as it should. I'm asking you as from a guardrail
Michael Harry
Unverified
57:56
type position. Yes, Senator, um, So as the bill states, so any rules will be promulgated by the CFO if need be, but the Safeguards and things like that are already in place in the state in which the gold or silver is housed so um They will, the rules themselves
will interact with the other states' rules to make sure that those guardrails are in place. I mean it will act as as any other financial transaction that
Senator Reginald Murdock
Unverified
58:30
you have. So the the the the actual gold or silver or whatever, it's somewhere else. It'll be housed somewhere else, so it'd be subject to those state rules for their particular. Now the CFO here is going to make the rules as it relates to Arkansas the usage, the usage. Which has not happened, it's
gonna be happen later, so the devil is in the details, so we don't know what this is really going to be right now. This is enabling legislation to put something somewhere else and then for some future rules. My question to you is, why don't we have more detail of what this will be because now we will be kind of Approving a blank check to some degree. It would be permissive to some degree, I guess, you know, why don't we have more details? Well, I think,
Senator Missy Irvin
Unverified
59:20
honestly, and maybe you can answer it better than I can, but I think those details need to be worked out with the treasurer's office and how those transactions will be regulated, but I don't think that it's a blank check in terms of you just can't do anything that you want to do. It is,
Michael Harry
Unverified
59:36
it will be a regulated transaction and just like any other financial transaction, there'll be federal rules that that still apply it's no different than it would operate no differently than if you know, your bank was an out of state bank rather than an in-state bank. So this will come
Speaker 191
59:51
from through ALC before final approval. The rules will, yes,
Speaker 193
59:55
yes, thank you. So, I mean, this is Not
Speaker 70
59:59
established. It will have to create a money rail, a money rail is similar to a Visa, Mastercard, those those are major depositories with large assets. We don't have a banking system in the state of Arkansas that can create a money rail. This would be probably a
national bullion exchange and it is a currency in the United States and this is permissive if, if, and it is solid. Uh, and that's what I deal with. That's what I I grow something that, well, I, I, I, I, I grow a commodity that is real and this is real and this is allowing an exchange, monetary exchange that is not created yet, but maybe, maybe be coming, but uh
appreciate the bill. Is there any other questions? OK. I
Senator Stephanie Flowers
Unverified
1:01:01
don't have much gold, if any. I don't either or
any other precious metals, but I want to know, so the depository of they FDIC. In short. Yes, they're they're insured and
regulated. So if somebody deposits some
gold or precious metal in there, they make sure that it
is what It's purported to be, yes, yes, that's true.
Michael Harry
Unverified
1:01:32
That's, that's correct. Um, and they will live active values because you know, the markets fluctuate, so your, your, your value will fluctuate with the market itself, and they handle that, that, that fluctuation as well. How, how many How many states are doing this. That
Senator Stephanie Flowers
Unverified
1:01:50
I don't know. So I'm not exactly sure how many states I
Representative Mindy McAlindon
Unverified
1:01:56
know Texas and Tennessee are working on it. I know Florida has a bill currently going through their House and Senate to do this as well. Um,
Senator Missy Irvin
Unverified
1:02:02
and I, I researched that Louisiana and Oklahoma are also working on it. So there's several states that are working on. I'm not, I don't have the full breadth of it, but those are the ones that I saw. This is, this has a
Speaker 12
1:02:13
lot greater possibility than the spaceport. Yeah I just wonder how practical is this?
Senator Stephanie Flowers
Unverified
1:02:19
I mean, they say you transferred by like a credit card or something. So it's it's basically, you know, like a bank
Michael Harry
Unverified
1:02:27
account, you know, but instead of your your paycheck in that account, you put your your gold or silver in that account. It's like a debit card like a debit card, really
Senator Stephanie Flowers
Unverified
1:02:37
and that would the issue when you place it in
Michael Harry
Unverified
1:02:41
the depository. I mean it's already currency, it's already legal tender. This is just a mechanism for people to utilize the the money that
Senator Stephanie Flowers
Unverified
1:02:50
they have saved. And, and is it, is it limited just to the United States depositories or overseas, well,
Michael Harry
Unverified
1:02:58
the way that the way that I drafted the bill is just just within the
Speaker 15
1:03:02
United States. OK, thank you. Is there any other questions, uh, seeing none, uh, you want to close
Speaker 70
1:03:11
your bill? I am close for my bill. I asked for a good vote. All right, motion by Senator McKee, seconded by Senator Johnson, any discussion, uh, seeing none. in favor say aye, all opposed like and thank you, Representative, uh, do you want to do representative Moore's Bill. I'll give it a try.
I may not do him justice. Well, I've done that before. 1853. I've done that to my own bills.
Senator Missy Irvin
Unverified
1:03:40
Oh goodness. All right, Representative McAlinden, House District 10. This is House Bill 1853, and what it is doing is just clarifying what a dual agency is. It says the law requires that real estate agents have a duty of absolute fidelity to a client, um, but it clarifies that when you, when a client agrees to dual agency, that client has the right to waive the licensee obligation of
absolute fidelity. So just a clarification of you cannot be absolutely, you cannot have absolute fidelity to two people
Speaker 4
1:04:10
at the same time. Any questions that's in
Senator Stephanie Flowers
Unverified
1:04:15
the Bible. Uh, go ahead, Senator Flowers. I don't know if you can answer this because you're not the sponsor on it, but I'm surely notice is given of this dual agency to the client for and so I'm wondering if that notice is
given in writing, and so they have an opportunity to review it, take it to a lawyer if they
Senator Missy Irvin
Unverified
1:04:40
want to. Yes ma'am. As an agent, you have to, you have to give notice
Senator Stephanie Flowers
Unverified
1:04:44
and they have to sign that they have received notice, but they can take it for review with
Speaker 180
1:04:50
an attorney. Yes ma'am. You sure about that? I am a realtor. And and that's the practice practice, yes ma'am. OK,
Speaker 70
1:04:59
thank you. Thank you for helping, uh, representative Moore have been
nice to tell him that he didn't get here, but Is there any other questions saying none, you want to close. All right, what's the will of the committee? Motion by Senator McKee, seconded by Senator Boyd in a discussion all in favor say aye. All opposed like right. Thank you, Representative. Thank you, Chairman. Thank you, Representative Johnson. Where was he? There he is. That's a long ways down there, Lee, and I'm getting old. It's 1942.
Representative Lee Johnson
Unverified
1:05:36
Yes, sir, Mr. Chairman and Representative Lee Johnson, District 47. Members in 1942 is a is a bill that requires DHS to do write study on our direct service providers in the waiver care space. This is an agreed to bill. DHS had agreed to do the rate study. Some of the DD providers wanted to hold them to that agreement by putting it in statute. It also requires that if there is an increase in reimbursement that they rise the reimbursement to meet the recommendations of the rate review. If it's more than a 10%
increase, then they can phase it in over 2 years. I don't believe there's any opposition to the bill, and I'd be happy to
answer any questions. And does it require a Us contracting anyone or a specialist or a no, this is, well, it's whatever the normal
process is for DHS to do their rate reviews. They do them periodically so
Speaker 70
1:06:27
it's the normal process. Any other questions? Say none. Nobody signed up for for it to speak for or against the bill. You want to close, right, with the committee
motion by Senator Boyd, 2 by Senator Murdoch. Any discussion all in favor say aye. All opposed like sign. Thank you, Representative, Mr. Chairman. That's all on a regular agenda we have We have uh We have on
Speaker 15
1:06:57
a scheduled agenda, we yes, yes, sir. OK. I make a motion that we hear
how suspend the rules to hear House Bill 1055. What is it? I think it's 10:55.
Speaker 70
1:07:17
Uh, motion by Senator Murdoch, seconded by Senator McKee. Uh, can staff, can staff can staff run off 1055. And at least we know what it
Speaker 161
1:07:30
is before we vote to suspend the rule. We get it. OK
Unknown speaker
1:07:42
We'll see what it is. Why would you make promotion. I don't remember where I was in
Speaker 70
1:08:45
To hear it all in favor say aye. OK, I opposed like sign all
We're gonna recess for a few minutes and please don't leave. I don't. I to find my committee. No, this is, this is just a handout that they want to give you. Uh, we're recessed for a few minutes until we get a hard copy.
Speaker 15
1:14:07
All right. Everybody got a copy of 1055. Representative Mayberry. No, you set up here. Yes. Just introduce yourselves and you're recognized. OK, members, I'm state Representative Julie Mayberry, and thank you for the
Representative Julie Mayberry
Unverified
1:14:39
opportunity to at least let this information be heard on the Senate end. We did pass it in the House, and you'll hear how great this new medicine is. I'll let you introduce yourself, David Koch, director of
Speaker 28
1:14:52
government affairs for the Alzheimer's Association. OK. Um, as
Representative Julie Mayberry
Unverified
1:14:56
I somewhat mentioned Clint Penzo and I chair the Alzheimer's Disease and dementia advisory Committee that meets here at the Capitol almost quarterly. It's got stakeholders from all over the state, and we've spent a great amount of time talking about some new
medicine that is out on the market to help with Alzheimer's, and what I mean by that is it's not treating symptoms. It's actually treating Alzheimer's, which this is breakthrough medicine. And there's been nothing like it out there, and if you don't get anything out of what I'm trying to tell you. This is the most important thing right now if you have Medicaid, if you have Medicare, if you have veterans insurance,
this medicine is covered. If you have sin, if you have UnitedHealthcare, this medicine is covered. But if you are a state employee, Or you are a school employee. This medicine is not covered. And I think that's unfair. Our state employees deserve and our school employees deserve the
same access to this Alzheimer's medication. That's why this is so important to me, and you will hear from someone who has started this medicine and you'll see what a difference it's making. Um, David, I'll let you explain it and again we we did have some doctor, uh doctor testify with us on the House side, unfortunately, he could not be here and I was had two other doctors willing to come today, but things have Not turned in our favor, so but we'll let the Alzheimer's
Association explain a little bit more.
Speaker 243
1:16:44
Thank you for the opportunity to present today. House Bill 1055 really is simply about access
David Cook
Unverified
1:16:50
to FDA approved treatments for Alzheimer's disease. Alzheimer's was first discovered by Dr. Was Alzheimer's in 1906 up until 2023, physicians were really handicapped on how they could treat this disease. Most of the drugs on the market now are behavior modification drugs, and those are drugs that simply help ease some of the symptoms associated with
Alzheimer's and other forms of dementia. In 2023, the the FDA approved the first treatment that actually is treating the underlying biology associated with Alzheimer's disease. These first generation treatments are targeting one of the proteins that is a hallmark of Alzheimer's disease called amyloid plaque, and for that reason, these treatments are very specific. Not everyone with a an Alzheimer's diagnosis would qualify in order to qualify for treatments, um, you have to be
catch the disease in its early stages, and also there has to be a confirmation of the presence of amyloid before a patient can be enrolled in the treatment. It is an infusion-based drug, so we, you will hear testimony from one of our retired teachers who again has had great success on this on this drug, and I do apologize that our physicians are not here to answer more of the technical questions, but what I will say is that what we know is Alzheimer's is not just
a public health crisis, it's an economic crisis that touches nearly every corner of our state. It's a 7 leading cause of death, according to the CDC and what we do know is 1 in 9 Americans age 65 and older is currently living with Alzheimer's and the research is clear 1 in 3 seniors will die with Alzheimer's or or another form of dementia. Increasingly, Alzheimer's is um, you know, in the past we we've discussed Alzheimer's in the
concept of aging adults. We've made it about older older adults. We can't afford to wait until someone is in the aging space to have these conversations. What we are seeing is people younger and younger are getting diagnosed with the disease, according to the Mayo Clinic, 110 out of every 100,000 adults aged 30 to 4 are at risk for developing younger onset Alzheimer's disease. What I would like to do is yield some of my time to coach
Daniels, who can come and share his story and his experiences. She come up and introduce yourself and you're
Speaker 15
1:19:23
recognized. Push that OK, Push that but OK. OK. I really appreciate y'all sticking around.
Speaker 248
1:19:43
I know, I know you don't have very much to do
or haven't been working very hard this week, but I do appreciate
Speaker 249
1:19:50
you sticking around to early in the day,
Speaker 247
1:19:53
But uh and with the handouts you had, if you want it dumbed down, I'm your guy. I will take care of that for you, and Senator
Speaker 248
1:20:00
Flowers, just hang in there because I'm I'm the one that's fixing to simplify all of this for you because I don't understand it either, sir, would you introduce yourself? My name is Steve Daniels. Um, um, I never dreamed I'd be up here speaking to senators. I can
Senator Matt McKee
Unverified
1:20:19
promise you that, but I'll do the best I can. I retired after 38 years of teaching. I coached football all within, and I was a assistant principal. I was an athletic director all within 30 miles of the state capital, Conway and North Little Rock, um, I retired in 2018. I'm 67 years old. in 6 years after I retired, I was diagnosed with Alzheimer's. Um, at that time, I didn't know much about it, and to be honest with you, I couldn't even
pronounce it. Still can't I was having some headaches. I knew that my, my aunt had it, my, I don't know how many of you have had relatives or know people that have suffered from this disease and but You know, I found out that there's a lot of people that have and will probably all of us will be touched with it at some point in our lives either directly or indirectly. I didn't know much about it. I was having some headaches. I went to my
primary care physician. I had played football and things like that growing up and just from life in general has some concussions and was having some headaches. I went there to see him. He ordered an MRI. I went to have the MRI done and went back to see him. He said that everything looked good. as far as that part went, but there were some things that were happening there from the MRI that he wanted me to go see a neurologist, so I did, and that's when I heard the term amyloid plaque. I had no idea what that was either, but it was
from what he told me was a hallmark for Alzheimer's disease, so he did a cognitive test for me. Which was giving me some words to remember and things like that. I was having some trouble a little bit remembering things from time to time after, after he did the test, I went back later. He did a blood test. He did some physical therapy, some occupational therapy, more cognitive tests, things like that, and he was pretty sure he thought that I had Alzheimer's
or some degree of mild cognitive impairment. He wanted to do more tests and He told me about a new drug that was out called Lakembi. I'd never heard of it and Had no reason to even pay attention if I had heard of it, but this drug, he was so excited about it because there's never been anything that treats this disease. There are some things you'll see on TV commercials that talk about symptomatic things where you'll see a lady that acts out in a store or
something, you know, and there's some pills that you can take for that that helps, but it doesn't do anything with it, with the disease itself. This is an infusion therapy. I go to the hospital every other Monday and uh, sit in there with chemo chemotherapy patients, and I get this infusion last I'm there 3 or 4 hours, and they check mainly takes about an hour for the infusion, then in about 2 or 3 hours just check for side effects, and after that, then I'm off for a week and then I go
back the next month. This lasts for about, I get this will last for 18 months. Then they check you again and then if the dementia starts to increase. Then they stopped the drug. Then there's only certain people that qualify for this. He was very excited for me because I was mildly impaired and The ones that have no amyloid plaque or anything, they're fine. He doesn't worry about it. If you're at a stage where the dementia has progressed enough,
the drug will not help you at that point either. Uh, but there's a small window of people like myself, thank goodness it does help and He did send me to Barnes Hospital in St. Louis. I went there for a PET scan, and that was the kind of determining factor that showed that I did have Alzheimer's and that's what started. I had my first infusion in October, and I've had some, they test you for MRIs. I checked there's there's some
side effects to it. I've experienced none. They really monitor you closely. I asked my primary care physician. I asked my cardiologist. I have no heart problems, but I go to one and also check with my pharmacist if you were me, would you get into this to begin with because I had some reservations about it, I'll be honest with you, and all three of them said without a doubt there's nothing else out there. I know what the disease is going to do. I've seen people suffer from it. The, it's just, it's progressive. It's a death
sentence. I know that, and what it does to you mentally is it's horrible. I got on the internet, which was the wrong thing to do. I know that my wife told me not to get on there, but I did. Once I found out about it, and this is just me, I typed in on the internet. I typed in worst diseases to live with. The answers were said to be subjective and depending on factors such as severity, impact on quality of life and availability, excuse me, of. treatment. And it said the number one worst disease to live
with at the top of this list was Alzheimer's, and it's all going to, it's going to impact us all in some way or another. Um Like I said, I've had no side effects with this. I was asked if I could return to work today, and I honestly can say mentally I would have no problem going back to my job. I physically I may have some problems. Don't step as fast as I used to could, but mentally I would have no problem returning back. I've had great success with this drug. I
think more clearly now than I did when I first started. um I know in my heart that at some point in time that This disease is going to progress. That's just the way it is. It's not a cure, but I've got a wonderful wife. I have two awesome children and 2 beautiful grandchildren. I don't know how much longer I have. But I do know that
When this disease is going to rob me, but this drug and this therapy that I'm undergoing will extend my life dramatically for years where I'll still know their names and I'll still know their faces for years to come. And Your support of this bill and I had health advantage, Blue Cross Blue Shield, the whole time I was teaching school through the state of Arkansas. It's, it's been a wonderful insurance
force, and I was really kind of surprised that it wasn't covered under this, but that's For me not to discuss because I'm not an insurance person, and I'm not a doctor, as you can tell, but I do know this, that your support of this bill, it will, it will be a life changer, not just for people like myself that are suffering from this disease. But from the families that are going to have to bear the burden. Of this that's been placed on
them, um, I want to thank, I know I'm going to wrap this up for you because I think I've said enough, but I, I want to thank Representative Mayberry and Mr. Cook, and each one of you for giving us the opportunity to speak because I know, I know you crammed us in here, and I really, really appreciate y'all for doing that. And I, I said all last week when we were down the hall, all of you have got an awesome responsibility. And may God bless you. Thank you.
Senator Stephanie Flowers
Unverified
1:28:01
Senator Flowers. To own first thank Representative Mayberry for bringing this bill. And Mr. Cook for his efforts with the Alzheimer's. Organization and for you
coach, um, for presenting your testimony to us, um, wanted to know. So you, you've been taking these treatments for a while. We had Blue Cross Blue Shield Blue Cross Blue Shield in the
Senator Stephanie Flowers
Unverified
1:28:34
were talking about that mental health
wellness evaluation and so I asked them about uh Post-traumatic stress disorder in medical marijuana, uh being uh a uh therapy or whatever you want to call it, um, to address that. That's one of the listed things,
and they said that wasn't covered as a treatment but they
had other Um medications or uh Therapies to that they do cover and so and you mentioned you had Blue Cross Blue
Speaker 248
1:29:22
Shield. Yes, ma'am. I had advantage Blue Cross Blue Shield what
Senator Stephanie Flowers
Unverified
1:29:28
if any medication or treatment or therapy did that insurance cover.
For Alzheimer's. Mr. Cook has a response.
David Cook
Unverified
1:29:42
Yeah, I'm, um, they, they will cover the cost of behavior modification drugs typically when someone receives an Alzheimer's diagnosis, you know, initially the first drug that people were put on is a drug called Aricept that's supposed to help with with memory. My dad does not have Alzheimer's. He has a behavioral frontal temporal dementia, so he wouldn't qualify for these treatments, but he's on like an Aricept drug, so they are covering the cost specifically for some of these behavior
modification drugs. on the state employee benefit plan, but what has not been covered is these treatments and they are unique therapies. They again are not just controlling behaviors. They are also, they're reducing the buildup of amyloid plaque in the brain, and they're they're these first generation treatments are monoclonal antibody treatments and the role of that is to again slow the progression of the disease and target that protein amyloid that builds up in the
As Coach Daniels mentioned, there is risk associated with with taking this treatment. That's why the association is really confident in the FDA guidance the appropriate use recommendations and also the clinical protocols that are in place to monitor a patient while they're taking the treatment, and again, Alzheimer's is not diagnosed with a single test. Doctors take a variety of tests. They'll do a cognitive assessment. They'll do brain imaging.
the association hopes one day we'll be able to rely on a on a blood test to confirm some of this, this biology associated with the disease, but these again are treating some of that underlying biology, not just the behaviors that are associated with, so it's a very specific patient in the early stages it has confirmed presence of amyloid, and that's why our fiscal impacts our assessment and EBDs are quite a part because we, we think based on our risk assessment. At the most there'll be 2020
state employees that would qualify for this treatment. It's not as simple as switching. It must be an expensive treatment then. Yes, ma'am, I think we've seen that in other disease
Speaker 258
1:31:54
spaces as well. It is an expensive treatment. It's the first generation treatment, but I
Senator Stephanie Flowers
Unverified
1:32:00
would argue cancer treatments are also expensive, right? Well, I'm just saying the
resistance though that you get from um having this treatment. qualified or undercoverage for
uh you wanted it for state employees
and um basically state employees, is that correct? Correct, yes, in this legislation employees and
we have, OK, and so I had another question about Um the coach mentioned that There are certain risks involved and we, I remember that we've
had legislation that became law where we allow for patients or Arkansans
to participate in clinical Programs that I guess having really been um they've been FDA backed but not Such that they can offer a specific result or a certain result without risk, correct,
Speaker 259
1:33:17
but this actually has been approved by the
Senator Stephanie Flowers
Unverified
1:33:21
FDA. The others haven't that we've been passing legislation on, is that what you're this
Speaker 260
1:33:26
particular drug has been right, but I'm,
Senator Stephanie Flowers
Unverified
1:33:29
I'm just trying to think back about the uh the bills that I've seen that we allow people
they had to have permission from the legislature, I suppose, because we had had these bills in front of us that allowed them to participate in these programs, so I don't know
whether they were FDA approved or not.
But if this is FDA approved, it seemed more likely that the legislature would support
Uh, individuals for this. Therapy and so how, how, I guess. The big to do EBD that you is that
EBD can they come to the table?
Speaker 261
1:34:29
Just introduce yourself again you recognize. Grant
Senator Stephanie Flowers
Unverified
1:34:36
Wallace employee benefits division. So basically I want to know what's the position of EBD, how, how, what's the fiscal impact in your, your opinion about this. So Senator, thank you
Speaker 44
1:34:48
for the question. I will say, and these are
Speaker 31
1:34:52
the hardest decisions that I have to deal with as director. This bill does have a 2 to $4
million fiscal impact, and we do have a lot of concerns around the way this bill is currently drafted. Like what? So, uh, First off, the concern really is giving the power to control and set our planned benefit design over to the FDA. On page 2 lines 14 through 15, it says, and I quote, According to the standards of guidance established by the United States Food and Drug Administration. This bill is mandating that
coverage of any and everything that the FDA approves, we automatically have to prove. Which essentially subverts the process that the legislature has diligently designed around the review and approval of medications on our formulary right now we have to go to the EBD oversight committees advisory commissions, then we have to go to the state board of Finance, and then we come to ALC and the EBD Oversight Committee. This bill would subvert that entire process, take that power away from you all to review and
set the formulary and depends strictly on whatever the FDA approved, whatever the FDA. approved, we automatically have to do so there would no longer be that review and approval process, and this does expand not just to Alzheimer's but any dementia related medication, so I'll pause there. There are other concerns, but that is the greatest concern with
Senator Stephanie Flowers
Unverified
1:36:25
the bill. One other question I have then, has this therapy specific
therapy or medication I don't formulary, whatever you want to call it. Has it been? Presented or
gone through. Your board or whatever you,
Speaker 44
1:36:44
right, both of these drugs that are currently approved, have gone through our approval process.
Speaker 31
1:36:51
We have our clinical consultant it is EBRX, which is housed in a relationship with UAMS. They're the ones that help come alongside us and review,
and they have recommended not approving these drugs just to the clinical risks that are associated with them and the cost of the medication.
Senator Stephanie Flowers
Unverified
1:37:13
Without any kind of restrictions. They don't, they don't write well for certain people after certain
Speaker 44
1:37:20
test, right, even looking at the FDA label and going off of
Speaker 31
1:37:24
the guidance that is set out. There's still too many risks, and it is not in their opinion, worth the price and the outcomes are not there to prove
Speaker 264
1:37:35
utilization of the drug. And are there
Senator Stephanie Flowers
Unverified
1:37:40
any last this would be my last one because what I'm thinking about, I'm Thinking back to uh other legislation that we've had. Where Well, and maybe it's been something that
I've seen on television where people are solicited to be uh in a, um, some kind of But.
I, I hate to call it a Like a test or something, like some like a guinea pig,
Speaker 262
1:38:16
I guess like the clinical trials, that's the word. This would not our plan does not prevent anybody from participating in
Speaker 31
1:38:23
a clinical trial in those setups, the trial covers all the costs that are related to the medical care during that time period and the health plans and this this is broad all would not cover any of those costs. The trial
themselves covers the cost of the care while that patient participates in it.
Senator Reginald Murdock
Unverified
1:38:46
Senator Murdoch. Thank you, chair. So, um, this, I guess this brings just some questions into it and now Representative Mayberry is so it would be so important for me if you're doctors were here because after um Hearing from EBD and the processes that we have put in place legislatively for checks and balances on things such as
that are very complicated and I'm very sensitive to coach and what you're doing and wish you all pray all the best for you and your family and all families that suffer, but obviously we have to make decisions here and so we need expert. Analysis and I know everybody on that side of the table brings some sort of extra, but it don't bring. What that doctor would tell me about because I want to know about alternatives now. I mean, if this is something that has
not passed your review, um, Has it not so would it not pass in your review. Is there plan B's or alternatives. Talk to me about what is available for a situation such as this.
Speaker 31
1:39:58
Right, there is, there is a drug class that is available now it addresses symptoms and behaviors, so it is different than what is being proposed here, but we do have medications. What about
Senator Reginald Murdock
Unverified
1:40:13
something that parallels with this is doing in terms because this is a what's the word you use? It starts with an I, I think, and this
Speaker 31
1:40:26
in true amyloid plaque, is that the IV infusion, so they're only 2 drugs that behave and work with the amyloid plaque or do the or in our administered via an IV infusion. There are no other drugs in like on the market right now that do what these particular drugs are doing so.
Speaker 44
1:40:44
EBD, so we don't have an alternative for this, not for this particular drug.
Speaker 31
1:40:50
And but what this bill is doing is expanding that, so it would be It would be an expansion and a mandate covering something that we do not currently cover right now with subverting the process that is in place. So the question becomes, do we
Senator Reginald Murdock
Unverified
1:41:08
need to. Legislatively do this so that those possibly 20, I think you
said other members of this class, if you will, will have an opportunity if necessary to take advantage of what coach is describing and so that's, I would argue that that's our question. Go ahead. I would
Speaker 31
1:41:30
argue that you don't need to pass a bill to do this. There is a review process in place that currently and regularly reviews medications like. this. We do it all the time. Earlier this week we had our formulary review before the EBD oversight subcommittee of JBC,
and they look at and we have that process in place that exists. This medicine was the the quinby was reviewed last year about May. Again, the clinical evidence was not there to support adding it to the formulary. The other medication, and forgive me, I'm not, I'm going to butcher the name, but the Cainta was reviewed in November. Again, that didn't have the clinical data that would support adding it onto the formulary. We regularly review these bills every 6 months to a year, so we're coming up on time to look at
this, that there's new data out there, there's new evidence that shows improved clinical outcomes, then that's a different discussion. But right now we don't, there is no need to pass a bill that does what this bill is doing. We don't need to subvert that process
Speaker 268
1:42:36
and automatically defect to whatever the FDA approves. Sorry, chair.
Senator Reginald Murdock
Unverified
1:42:42
I do understand about that. I do have concerns about that automatic.
Approval of whatever that's a big broad statement and I do have concerns about that, um, but I guess I'm trying to micro this down to this situation, and I don't know that I can. I don't know how to micro to this this because every life is important and so And I know I mean business and and and and so. Um What say, do you have a response to what he
said? I do. I want David Cook to kind of answer
Representative Julie Mayberry
Unverified
1:43:20
some things, but I do want to point out that's why it
was important for me to give you all this clinical stuff. This is one of the doctors that was planning on being here today. Unfortunately she is ill this morning and could not be here. You, she is a UAMS doctor, and they are seeing dramatic differences in their patients. They're currently using this, and they have advocated publicly many times. in that committee, the Alzheimer's Disease and Dementia Advisory Committee many times
saying there should be access to this medication, so
Senator Reginald Murdock
Unverified
1:43:53
not to cut you off, but to try to expedite this. So why, why have we not done it and why is it not happening? What what Mr. Chair, I actually have the director. I have the director of
Speaker 44
1:44:02
EBRX here with me. May I bring him to the table to answer some of those questions, and can I let David Cook explain
Representative Julie Mayberry
Unverified
1:44:08
a little bit of the language that's there because we've gone back and forth with the National Alzheimer's Association to to, to work on this language, and he can explain why it was written the way it was. I think that's the crux of us from a legislative standpoint, we want
Senator Reginald Murdock
Unverified
1:44:22
to make a decision and we need information because we don't want it just being. Not, not approved for some not good whatever reasoning, but I don't know what's the, what's the reasoning? Introduce introduce yourself and who you're
Speaker 261
1:44:34
with and you're recognized. Thank you, Mr. Chair. My name is Trey Gardner. I'm the director
Trey Gardner
Unverified
1:44:40
of the evidence-based prescription drug program. We're a service unit of the UMS College of Pharmacy. We serve as a clinical consultant to EBD.
Speaker 276
1:44:56
through the review process, yeah, and, and just to kind of let you know our review process, OK? We, um, we, we're evidence-based, OK? Um, which means that we have a group that looks at all the clinical studies that come out. We look at the trials, um, our pharmacy and therapeutics committee is made up of physicians and pharmacists from not only UAMS but from around the state. We have physicians that are multiple board certified, um, and so all of this has been reviewed by that committee. The
concerned with these medications is when you look at the trials that were used for approval, they did not meet what is called the minimum clinical difference compared to placebo, and that means in the trial, the patients and their caregivers did not detect a minimum clinical difference between the patients that were on these medications and on placebo. So that was not proven. Now there were some stat stat istic al measures that of
course the FDA used for their approval, but for clinically important difference, the bar was not met. The main concern with these medications for our clinical committee is the risk, and Senator Johnson, please excuse me, I don't, you don't like people to read, but I've got some study that I just want to share, um. All right, for Lakembi, um, 1 in 9 patients will experience brain swelling, 1 in 10 will experience brain bleeding,
cerebral hemorrhage, um, for the newest drug, Casula, it's even worse. It's 1 in 3. just to compare that to a an oncology medication, there's a monoclonal antibody oncology medication. The number one side effect is neutropenia, which can be easily treated with other medications that shows up in 1 in 50. So 1 in 31 in 91 in 10 versus 1 in 50. So the side effects, the brain bleeds, there, there's one patient in the study that after 3 doses passed away and when
they did her autopsy, she had 51 microhemorrhages in her brain. There are concerns on these drugs. Now Lakembi was approved by the FDA under accelerated approval, which means they continue to study it. And we monitor those studies and as Director Wallace said, we actually are coming up for a review on Lakembi in May. So we will be looking at it again, hoping that there's new evidence out there. We want a treatment for Alzheimer's. Everybody wants a cure for Alzheimer's. I watched my grandfather die of
Alzheimer's. One of my core childhood memories is standing in his kitchen and him yelling at my dad to get out of the kitchen cause he didn't know who he was. So I'm very sensitive to the emotional and the the the the hard facts of Alzheimer's, but we as a body and our recommendations to EBD have to be based on the evidence, and that that's the reason for our recommendation, but we are still monitoring the medication. Thank you so much for that explanation. Is there any other questions saying none. want to
Senator Stephanie Flowers
Unverified
1:47:59
OK. So coach, are you footing the bill for this? Medicare Medicare is covering
Speaker 280
1:48:08
80% of it. OK, so Medicare does recognize this. I'm glad for
Senator Stephanie Flowers
Unverified
1:48:11
you for that. The rest of it
and I just want to wish you well. Thank you. Thank you, Mr.
Speaker 15
1:48:20
Chair. All right, no other questions, you want to close your bill? Well, I, I would
Representative Julie Mayberry
Unverified
1:48:27
like to respond if, if possible, and I would
love David to respond. Members,
Medicaid, Medicare. Veterans They get this medicine. Our state employees. And our state, our school employees do not. If it was so risky, Medicaid wouldn't cover it. veterans, they wouldn't give it out.
I'm sorry you also didn't get to hear another lovely lady who would have been speaking today as well, but I do understand that I've asked for way more than anything today, um. I would Appreciate support. All
Speaker 5
1:49:18
right, due to lack of quorum, I can't accept a motion. Senate Insurance and Commerce is adjourn. I appreciate it.
Agenda
RE-REFERRED TO COMMITTEE
Call To Order
HB1746 M. Brown TO AMEND THE UNIFORM COMMERCIAL CODE.
REGULAR AGENDA
HB1290 L. Johnson TO MANDATE COVERAGE FOR MENTAL HEALTH WELLNESS EXAMINATIONS; AND TO ESTABLISH THE ARKANSAS SUPPORT OF MENTAL HEALTH WELLNESS EXAMINATIONS ACT.
HB1853 J. Moore TO AMEND THE LAW CONCERNING AGENCY RELATIONSHIP AND DUTIES RELATED TO REAL ESTATE LICENSES; AND TO CLARIFY THE OBLIGATIONS OF DUAL AGENCY.
HB1942 L. Johnson TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR HOME- AND COMMUNITY- BASED SERVICES WITHIN RISK-BASED PROVIDER ORGANIZATIONS.
HB1918 McAlindon TO AMEND THE LAW CONCERNING SPECIE OR LEGAL TENDER; TO AUTHORIZE THE USE OF A BULLION DEPOSITORY; AND TO ALLOW FOR A PRECIOUS METALS-BACKED ELECTRONIC SYSTEM.
HB1917 M. Shepherd TO AMEND THE ARKANSAS STUDENT-ATHLETE PUBLICITY RIGHTS ACT; AND
TO AMEND THE LAW RELATED TO ATHLETIC PROGRAM FUNDING.
HB 1055 motion to run
HB1055 - TO ESTABLISH COVERAGE DIAGNOSIS AND TREATMENT TO SLOW THE PROGRESSION OF ALZHEIMER'S DISEASE OR OTHER DEMENTIA-RELATED DISEASE UNDER THE STATE AND PUBLIC SCHOOL LIFE AND HEALTH INSURANCE PROGRAM.
Adjourn
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — INSURANCE & COMMERCE - SENATE, Apr 10, 2025 | Agenda | 1 | Official source ↗ |
Speakers
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Senator Justin Boyd
Unverified
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Senator Stephanie Flowers
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Senator Matt McKee
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Senator Reginald Murdock
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Senator Bart Hester
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Senator Mark Johnson
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Senator Tyler Dees
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Representative Mindy McAlindon
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Senator Missy Irvin
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Michael Harry
Unverified
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Representative Lee Johnson
Unverified
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Representative Julie Mayberry
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David Cook
Unverified
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Trey Gardner
Unverified
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