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. |
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Speaker 4
19:30
Senate Insurance and Commerce, come to order. We're going to start with House Bill 1290. Introduce yourself. Thank
Senator Justin Boyd
Unverified
19:47
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. 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 so
Speaker 12
20:06
members 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 is there
Speaker 17
20:27
I just verified with EBD that yeah it's it's on
Speaker 12
20:38
page 4 line 15 page 4 line 15 now that EBD
Senator Justin Boyd
Unverified
20:45
fits under 21-5 yeah one go ahead senator
Speaker 22
20:51
flowers so what would the cost sharing be for for
Senator Stephanie Flowers
Unverified
21:02
that or for that particular.
Senator Justin Boyd
Unverified
21:09
mind. I'd rather have a full
answer than what the answer I'm
Speaker 30
21:22
going to give you. Grant Wallace, Director of Employee Benefits Division. Senators, cost sharing would fall under your deductible, your
Speaker 31
21:31
co-pay, co-insurance, those items. So $25 office visit that's cost-sharing your $500 deductible
Senator Stephanie Flowers
Unverified
21:40
that's cost-sharing so for it for
mental health wellness examination $25 they can expect to pay
Speaker 30
21:47
oh so what what is I'm sorry I misunderstood your question so this would fall
Speaker 31
21:54
under a normal kind of PCP so it would fall under that $25 copay for
Senator Stephanie Flowers
Unverified
22:02
THE OFFICE VISIT. WOULD IT RAISE
Speaker 39
22:04
THE PREMIUM AT ALL? NO, BECAUSE WE HAD THIS AMENDMENT DONE
Senator Stephanie Flowers
Unverified
22:13
THERE IS NO IMPACT TO PREMIUM. AND FOR JUST PLAIN WELLNESS EVALUATION OR PHYSICAL
EXAMINATIONS, SAME THING, $25 COPAG?
Speaker 31
22:26
So under our current plan design, you have a one annual visit for wellness that comes at a $0 copay. But yes, any normal doctor visit would have a $25
Senator Stephanie Flowers
Unverified
22:39
copay. So the zero that you talked about, the one time, if a person
gets this mental health wellness exam. Is that what it's called? Yeah.
Speaker 44
22:56
First, they'd have zero? No, this would fall outside of a physical wellness exam, right? Yes, ma'am Okay, I guess I
Senator Stephanie Flowers
Unverified
23:05
mean do we have I guess we have enough where would they go to get this mental health psych? I mean like Where
Senator Justin Boyd
Unverified
23:21
do you go? Any willing provider that does a mental health well-being exam. I mean so
Do we have those? Representative Johnson would not. Okay, a health care insurer, so a physician or a psychiatrist, a medical officer of the United States government, a psychologist or clinical psychologist, a nurse practitioner or clinical nurse specialist with a psychiatric primary care or mental health population focused license. So those are the areas. And then also licensed clinical social worker, licensed marriage and family therapist, licensed professional counselor, and physician assistant.
So a list of A through H of the providers who
Senator Stephanie Flowers
Unverified
24:08
could do this. Okay. And then for EBD, I wanted to know, is there
a cap on the amount that can be paid to the
Speaker 30
24:21
provider for these services? No, they would bill like any normal provider would bill. Obviously, there are going
Speaker 31
24:27
to be provider agreements within or with our third-party administrator who is health advantage.
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
Senator Stephanie Flowers
Unverified
24:41
number of visits or anything along those lines. And the patient could
Speaker 31
24:47
end up actually having to pay a little bit more. Depending upon what coverage level. So if they're in their basic or classic, yes, they have co-insurance. So that's when the 80/20 or the 90/10 kick in. With our premium plan, 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 co-pays on that plan. Okay.
Speaker 58
25:10
Thank you. Is there any other questions, Senator McKee? So
Speaker 60
25:14
Senator Boyd, I appreciate you and I appreciate
Senator Matt McKee
Unverified
25:19
all the work you do on all this stuff. Are we telling insurance companies that they have to cover
Senator Justin Boyd
Unverified
25:28
this? Yes, sir. That's exactly what it is. It's an act of mandate. So if 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 three, beginning at line eight and going through line 17 then yes they're saying that once a year you need to cover a mental health wellness exam 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 hope that the market would have taken care of that but
Speaker 7
26:11
By virtue of there being legislation, that tells me that the market is not. So we've passed, I don't know how many mandated coverages
Senator Matt McKee
Unverified
26:21
out of this committee. Yes, sir, we have. And this one 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'm starting to get really weary of telling insurance companies what they must cover.
Senator Justin Boyd
Unverified
26:46
So I hear you. So when we're talking about that, there's two sides to the equation, right? And so one is what a service costs, and then the other is what's harder to document, but the costs that happen because we're not. Because if we have a 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 an easier-to-measure hard cost. There's a more difficult cost to society, but it actually has a cost, too. And I
Senator Matt McKee
Unverified
27:33
appreciate that. Wouldn't you agree, though, that we're just shifting costs? We're shifting who bears those costs? I agree. I think it's a valid point,
Senator Justin Boyd
Unverified
27:41
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.
Speaker 15
27:53
Thank you. Senator, I'll get you next. If this intervention happens early and they are
Speaker 70
28:03
helped in this, is that not a societal and health care benefit?
Speaker 71
28:07
I believe it to be both. I wouldn't be presenting this legislation if
Senator Justin Boyd
Unverified
28:13
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 a single-payer system, at some point, we can't set all of the rules. The market has to determine some of them somewhere. That said, I think this is a very reasonable 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. And I certainly have some other legislation pending where I have heard that it will break the system. This is not one of those.
Senator Reginald Murdock
Unverified
29:00
All right. Thank you, Senator Murdoch. Yeah, Chair, thank you. And 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 constituent initially, and even early detection that 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 it's not costing them any additional money. I mean, it costs, yeah, 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
Speaker 76
30:00
people that the insurance is paying the premiums, in my opinion. What we really
Senator Justin Boyd
Unverified
30:06
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 nudging the market in the right direction. We are not mandating every last thing about medical health. We're saying, hey, if you're going to cover this, physical health, mental health is important too. We need that covered. That's the way I see it. And so I think this is a reasonable bill, 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 okay with this.
Speaker 82
30:41
Senator Flowers. Hey, hang on just a minute. You guys, you can
Speaker 70
30:50
come to the table. You don't have to stand up. All right. Yeah, I don't like anybody behind
Senator Stephanie Flowers
Unverified
31:00
me. All right. Go ahead, Senator Flowers.
Thank you. I'm wondering what you define what it means to have a mental HEALTH WELLNESS EXAMINATION INCLUDES WITHOUT LIMITATION THESE THINGS ON PAGE 3 LINES
20 THROUGH 29 REFERRALS TO ONGOING TREATMENT MENTAL HEALTH SERVICES AND OTHER SUPPORTS clinically appropriate, we have the medical marijuana statute, and it lists certain diagnoses that a physician can prescribe medical marijuana for, one being post-traumatic stress disorder.
So how would, would that be paid for under this
Senator Justin Boyd
Unverified
32:07
bill? This is not mandating ongoing treatment. This is mandating a 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, you know, 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 it.
Senator Stephanie Flowers
Unverified
32:32
So that's a good question, but that's outside the... But if somebody's making first application or presenting
Senator Justin Boyd
Unverified
32:41
first to the doctor... Yes, it's got
Senator Stephanie Flowers
Unverified
32:44
a behavioral health screening. Right, and it also says referrals to ongoing treatment, mental health services, and other supports. Exactly. Is that all referrals?
Senator Justin Boyd
Unverified
33:01
So 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, 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's the initial, you know, just again, like 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 exam.
Senator Stephanie Flowers
Unverified
33:41
But it wouldn't cover any prescription or treatment. It might cover those,
Senator Justin Boyd
Unverified
33:48
but that's outside the scope of this bill. How do you say it
Senator Stephanie Flowers
Unverified
33:54
might cover those, but it's outside the scope? It's outside the scope of
Senator Justin Boyd
Unverified
33:59
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 legislation elsewhere.
Senator Stephanie Flowers
Unverified
34:17
Have you talked to private insurers about what impact this bill would have on policies that the Indians have? I think that's
Senator Justin Boyd
Unverified
34:30
a good question. I think 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.
Speaker 82
34:52
Senator, the largest provider is across the table. I wanted to know if they have a position on it. There is no
Speaker 70
35:01
one here to speak for or against the bill. So if they had a concern, you're welcome to stand
Speaker 15
35:07
up. Okay. Thank you. Is there any other questions? Seeing none. I would like
Senator Stephanie Flowers
Unverified
35:14
to hear from them, though, on a question that I have posed to Senator Boyd about treatment.
Would the policy, kind of a normal policy, if you've got normal, I don't know, I guess, I don't know how to phrase it, but the standard kind of policy, would it
Speaker 105
35:37
cover treatment? All right. Thank you. That's
Senator Stephanie Flowers
Unverified
35:40
all I'm going to allow for this. Would it cover a prescription for medical marijuana? Not medical
Speaker 107
35:47
marijuana. What? Not medical marijuana, but for other pre-diagnosis, prescription for diagnosis.
Senator Stephanie Flowers
Unverified
35:54
Prescription for diagnosis? What is that?
Senator Justin Boyd
Unverified
36:00
Anything that was discovered in the exam. So if you needed a prescription medication,
then there are generally these plans. A health plan would typically have prescription medications. I'm not here 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 as 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
Speaker 70
36:46
how else to. Okay. Thank you. Is there any other questions? Seeing none, no one speak for or against the bill. You want
Senator Justin Boyd
Unverified
36:57
I respect Senator 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 cost. And so I would encourage a good vote. So I'm going to make a motion to pass and encourage someone to give me a second. Motion by
Speaker 70
37:21
Senator Boyd, second by Senator Johnson. Any discussion? Say none. All in favor say aye.
Aye. All opposed, like sign. Thank you, Senator. You passed your bill. Senator Hester, you can present from there. Do you want some other folks to come to the
Senator Bart Hester
Unverified
37:41
table? Yes, please. Anywhere. Thank you, members. House Bill 1917. 1917, members. State Senator Barr Hester, District 33. We can get as detailed... Go ahead and
Speaker 70
37:52
let these other... Okay. Introduce y'all's self, and that way we don't have to do it later.
Shane Broadway, ASU System. I'm Brad Phelps. I'm
Speaker 115
38:00
general counsel for the ASU system. All right. Go ahead. Thank you, members. I'm going
Senator Bart Hester
Unverified
38:07
to be brief and then let them add some comments. This is what we're calling this year's NIL bill. We know that the NCAA has made a settlement with our institutions of higher ed. This will allow our institutions of higher ed to be able to ultimately pay 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 that just allows the state of Arkansas to revenue share with our student-athletes to keep us competitive. And I will pass it off to my colleagues now. I want to add
Speaker 114
38:47
to that now. Thanks, Senator Hester. I think you stated it very well. That's the primary purpose of the bill. For a little bit of background. Get a little closer. I might have broken this. 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, institutions across the country will now have the ability to do rev share. 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 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 you,
Speaker 123
39:55
Mr. Chairman. I'll just add, Coach Pittman, we had Coach Pittman and Coach Jones, both of our football coaches from Fayetteville and A-State here on Monday. They apologized 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 first off, I want to thank Senator Hester for his leadership on this issue. This is the third session in a row we've had to do something related to NIL, and as Brad alluded to, it has changed since the initial bill in 2001. was just about the name, image, and likeness with a third party paying a student to advertise their 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 receive 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 four short years. It's hard to even imagine what we might be back here for next time or the following time. And so a lot of changes in intercollegiate 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 Reginald Murdock
Unverified
41:22
Senator Murdoch and then Senator Johnson. Thank you, Chair. So this legislation basically just gives
you the authority, the right, to enter into these agreements 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 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 this is just simply enabling you to do it, right? It's not
Speaker 114
42:11
dictating. Correct. And I think you're right, Senator. No one knows where the next lawsuit will be. We're complying with what's in front of us today.
Speaker 127
42:27
Thank you, Mr. Chairman. Gentlemen, I'm so tired of hearing about NIL. I can scream. And I want to tell
Senator Mark Johnson
Unverified
42:37
you, I think that this 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 a mall with Corliss Williamson.
They passed a store that had an Arkansas No. 34 jersey in the store window. And 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 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
and 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 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? And I've got a question right at the end specifically on it,
Speaker 123
44:05
if I could get that first. So to your point, Senator Johnson, yes, we've 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. with updates of 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 solution. So,
Speaker 131
44:49
yes, there is a lot of discussion. That makes me
Senator Mark Johnson
Unverified
44:53
feel a lot better. Now, specifically on the bill, what we're changing here is with the way it seems to have been funded, whether it's through, you know, Saracen doing something with their deal or Ocalon 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 money. If you go to a bowl game, that kind of, it lets the athletes actually share in that type of revenue. So
Speaker 114
45:22
that's the change, isn't it? And 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 automobile dealership, those will still be allowed going forward, but those will be handled pursuant to this clearinghouse,
which will evaluate those arrangements on a fair market value basis. So, again, that will still be out there, but it's unrelated to rev
Senator Mark Johnson
Unverified
45:52
share. I have some philosophical 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, whether I'm a student athlete or not. And basically, NCAAs 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, 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 Ten or the Pac-4 or however many of them are left out there. And to your
Speaker 123
46:56
point, I just remembered, Senator Johnson, that a number of the conferences and ADs are on Capitol Hill this week. And 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 in litigation. Yes, sir. Thank you both. Thank you, Mr. Chairman.
Speaker 15
47:20
Seeing no other questions, Senator Flowers. So I'm
Senator Stephanie Flowers
Unverified
47:26
trying to understand, and I haven't read thoroughly this bill, but when you say clearing house, would that
Speaker 114
47:35
be the conference? 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, I expect that many of those arrangements, if they're not approved, will probably lead to more disputes down the road. So Senator Johnson, Senator Murdoch, you mentioned other cases. I think that could happen. But
Senator Stephanie Flowers
Unverified
48:14
then I heard you say that the individual athlete, I think that's what I understood from what you said, an individual athlete could still contract privately?
Speaker 137
48:28
They could, but it would still have to go through the clearinghouse. Okay, so. They can't just go do it outside the institution or outside
Speaker 123
48:35
the NCAA settlement. Oh. It would still have 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
Speaker 114
48:49
the settlement. And what about $600? That's four arrangements
Senator Stephanie Flowers
Unverified
48:52
of $600 or more that have to be reported. But anything less than $600, the athlete can contract?
Speaker 114
49:00
Yes, they can contract with a third party. If it's under $600, it does not
Senator Stephanie Flowers
Unverified
49:07
have to be reported to this clearinghouse. So if they have continuous ads or uses of their name, image, and likeness, I mean, do you consider
Speaker 144
49:23
that all of them together? each one yeah
Senator Stephanie Flowers
Unverified
49:26
so could somebody get around this by going 595 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
49:40
great question and it's a good hypothetical I
Speaker 114
49:43
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 is
Speaker 137
49:59
600 per year per contract per contract is different so
Senator Stephanie Flowers
Unverified
50:08
than per year because you can have seven or
Speaker 152
50:10
8 contracts. Per agreement. Per agreement. You can have
Senator Stephanie Flowers
Unverified
50:23
7 or 8 agreements. $5.99. Again, we were not part of the settlement. Okay. And the universities get some of this money too if it's approved by the clearinghouse? Or is
Speaker 147
50:34
that just for the athlete? Well, there's two separate things that we're talking about in the bill is the rev share
Speaker 114
50:40
component And of course that does include money for the universities
What's done privately with a student-athlete in a private business under this clearinghouse is not something the university participates
Senator Stephanie Flowers
Unverified
50:53
in And when you say rev sharing That's no money from the state of Arkansas. Correct. It's it's all about these Vendors
are these third parties that are wanting to use the name
Speaker 114
51:07
in the TV TV Arrangements ticket sales game guarantees private contributions. It's it all goes into a pot
Speaker 15
51:15
Okay, thank you See no questions you guys are the only ones to speak for the bill and I'm not going
Speaker 70
51:27
to let you you want to close your bill I'm closed. All right What's the will of the committee? motion by senator johnson second by senator flowers any discussion all in
Speaker 15
51:44
favor say aye all opposed like signed thank you senator next senator
Speaker 156
51:51
deez it's uh 1746 1746 thank you members state senator tyler deez district 35
Speaker 157
51:56
you have an amendment to be passed out? While that's coming out, if I may give a description, Mr. Chair. So this was passed out once and you're making it better? Yes, sir. So Senator
Senator Tyler Dees
Unverified
52:12
Boyd, Senator Dotson 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 um you really you look at me
first I guess for the doctrine of the amendment is really to make sure that money does not include the
Speaker 157
52:38
CBDC a central bank digital currency so it would appreciate adoption motion motion to adopt by Senator McKee
Speaker 70
52:44
second by Senator Boyd all in favor say aye aye all opposed like son Thanks, Senator. We've heard this bill. Is there any questions?
Speaker 156
53:05
Yes. Yes, ma'am. AND SENATOR FLOWERS IF IT -- NO, WE VOTED ON IT IN THIS COMMITTEE AND HE'S AMENDED IT.
Senator Tyler Dees
Unverified
53:34
YES. 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 WE'VE DONE IN OTHER LEGISLATIONS. We want to send it back, make sure that was added in for clarity to align
Senator Stephanie Flowers
Unverified
53:51
with what we're trying to do. So my question to you, since the title is to amend the Uniform Commercial Code, is this truly a
Uniform Commercial Code? Has it been amended in other states that have adopted the Uniform Commercial Code? Yes, ma'am. This same bill? Yes, ma'am. I
Senator Tyler Dees
Unverified
54:10
would say very similar, if not exactly the same.
Senator Stephanie Flowers
Unverified
54:13
And they had what your amendment proposes in it. Yes, ma'am. Okay.
Speaker 70
54:27
Because, okay. Thank you, Mr. Chair. Motion at the proper time. Seeing no other questions, motion by Senator Flowers, second by Senator Boyd. Motion as amended. All in favor say aye. Aye. All opposed, like signed. Thank you, Senator. Next is 1918.
Speaker 12
54:46
Representative, just introduce yourself. Is there anybody you need to come to the table
Speaker 110
54:52
with? This is anti-sticky D.C., a little heavier. Thank you. Representative Mindy McElinda, House
Representative Mindy McAlindon
Unverified
54:58
District 10. Yes, ma'am. You're recognized. Thank you.
So the primary objective of House Bill 1918 is to provide Arkansan with a secure and efficient means to
Senator Missy Irvin
Unverified
55:10
store and use precious metals as a form of payment. 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 first 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. 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 step 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 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, I will get a credit card from that depository. And then I can use that credit card at Walmart.
Walmart, you know, digitally, they'll go get the gold. The gold 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, but it does position us as a leader in 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 CFL. Happy to
Senator Reginald Murdock
Unverified
57:11
take any questions. Thank you so much. Is the treasurer's office here?
Speaker 182
57:22
Yes, sir. I need to hear from them. Yes, sir. Introduce yourself, who you're with,
Senator Reginald Murdock
Unverified
57:27
and you're recognized. Michael Harry with the state treasurer. FROM A CONSUMER PROTECTION AND JUST GOOD 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 GIVING US THE ADVANTAGES THAT SHOULD. I'M ASKING YOU AS FROM A GUARDRAIL TYPE POSITION.
Michael Harry
Unverified
57:49
Yes, Senator. 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, they will, the rules themselves will interact with the other state's rules to make sure that those guardrails are in place. I mean, it will act as any other financial transaction that you have.
Senator Reginald Murdock
Unverified
58:23
So the actual gold or silver, whatever, is somewhere else. It'll be housed somewhere else. So it'll be subject to those states' rules for their particular. Yes. Now, the CFO here is going to make the rules as it relates to Arkansas. The usage. The usage. Yes. Which has not happened. It's going to happen later. Correct. So the devil is in the details. 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 will be permissive to some degree, I guess. You know, why don't we have more details? Well, I think, honestly, and maybe you can answer it better than I can.
Senator Missy Irvin
Unverified
59:15
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 will be a regulated transaction.
Michael Harry
Unverified
59:31
Just like any other financial transaction, there will be federal rules that still apply. It's no different than, it would operate no differently than if, you know, your bank was an
Speaker 191
59:45
out-of-state bank rather than an in-state bank. So this will come through ALC
Speaker 193
59:50
before final approval? Yes, the rules. Yes. Yes.
Speaker 70
59:54
Thank you. So, I mean, this is not established. It will have to create a money rail. A money rail is similar to a Visa, MasterCard. 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, and it is solid, and that's what I deal with. 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 may be coming. But I appreciate the bill. Is there any other questions? Okay. I
Senator Stephanie Flowers
Unverified
1:00:56
don't have much gold, if any. I don't
either, sir. silver or any other precious metals. But I want to know, so the depository, are they FDIC insured?
Yes, 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,
Michael Harry
Unverified
1:01:27
yes, that's true. That's correct. And they will live active values because, you know, the markets fluctuate. So your value will fluctuate with the market itself, and they handle that fluctuation as well. How
Senator Stephanie Flowers
Unverified
1:01:45
many states are doing this?
Representative Mindy McAlindon
Unverified
1:01:48
That I don't know. So I'm not exactly sure how many states. I know Texas and Tennessee are working on it. I know Florida has a bill currently going through
Senator Missy Irvin
Unverified
1:01:57
their House and Senate to do this as well. And I research that Louisiana and Oklahoma are also working on it. So there's several states that are working on it. I don't have the full breadth of it, but those are
Speaker 12
1:02:08
the ones that I saw. This has a lot greater possibility than a
Senator Stephanie Flowers
Unverified
1:02:14
spaceport. I just wonder how practical is this? I mean, they say you transfer by like a credit card or something.
Michael Harry
Unverified
1:02:20
So it's basically, you know, like a bank account, you know, but instead of your paycheck in that account, you put your gold or silver in that account. Like a debit card. Like a debit card,
Senator Stephanie Flowers
Unverified
1:02:32
really. And that would be issued when you place
Michael Harry
Unverified
1:02:36
it in the depository. Yep. I mean, it's already currency. It's already legal tender. This is just a mechanism for people to utilize
Senator Stephanie Flowers
Unverified
1:02:45
the money that they have saved. And is it limited just to the United States depositories?
Michael Harry
Unverified
1:02:50
Well, the way that I drafted the bill is just within the United States. Okay. Thank
Speaker 15
1:02:57
you. Thank you. Is there any other questions? Seeing none, you want to close for your bill? I
Speaker 70
1:03:06
am closed for my bill. I ask for a good vote. All right. Motion by Senator McKee, second by Senator Johnson. Any discussion? Seeing none, all in favor say aye. Aye. All opposed, like sign. Thank you, Representative. 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. Oh goodness.
Senator Missy Irvin
Unverified
1:03:35
All right Representative McElhinden House District 10 this is House Bill 1853 and what it is doing is just clarifying what dual agency is. It says the law requires that real estate agents have a duty of absolute fidelity to a client but it clarifies that when you when a client agrees to dual agency that client has the right to waive the licensee's obligation of absolute
fidelity. So just a clarification of you cannot be absolutely you cannot have absolute fidelity to two people
Speaker 4
1:04:05
at the same time. Any questions that's in
Senator Stephanie Flowers
Unverified
1:04:10
the Bible? 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 yes for and so I'm wondering if that notice is given in
writing yes ma'am and so they have an opportunity to review it
take it to a lawyer if they want to yes ma'am okay as an agent you
Senator Missy Irvin
Unverified
1:04:35
have to you have to give notice and they have to sign that
Senator Stephanie Flowers
Unverified
1:04:39
they have received notice but they can take it for review with yes ma'am
Speaker 180
1:04:45
an attorney yes ma'am you sure about that I am a realtor and that's the practice the practice yes
Speaker 70
1:04:54
ma'am okay thank you thank you for helping representative Moore it would have been nice to tell him that he
didn't get here but is there any other questions saying none you want to close I want to close. All right. What's the will of the committee? Motion by Senator McKee, second by Senator Boyd. Any discussion? All in favor, say aye. Aye. All opposed, likes aye. All right. Thank you, Representative. Thank you, Chairman. Thank you, committee. 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
1:05:32
Yes, sir, Mr. Chairman, Representative Lee Johnson, District 47. Members, 1942 is a bill that requires DHS to do a rate 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 two 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 us contracting anyone or a specialist? No. Well, it's whatever the normal process is for
DHS to do the rate reviews. They do them periodically, so it's the normal
Speaker 70
1:06:22
process. Any other questions? Seeing none, nobody signed up for it to speak for or against the bill. You want to close? I'm close for a bill. All right. What was will the committee? Motion to pass. Motion by Senator Boyd, second by Senator Murdoch.
Any discussion? All in favor, say aye. Aye. All opposed, like sign. Thank you, Representative Johnson. Thank you, Mr. Chairman. That's all on a regular
Speaker 15
1:06:52
agenda. We have on a scheduled agenda. Yes, sir. Okay. I MAKE A MOTION THAT WE HEAR HOUSE BILL -- SUSPEND THE RULES TO HEAR HOUSE BILL 1055.
WHAT DO YOU THINK? I THINK IT'S
Speaker 70
1:07:12
1055. MOTION BY SENATOR MURDOCK, SECOND BY SENATOR MCKEY. CAN STAFF -- CAN STAFF -- CAN STAFF RUN OFF 1055? and at least can we know what it
Speaker 161
1:07:25
is before we vote to suspend the room we'll see what it is
Unknown speaker
1:07:40
why don't you make the motion I don't have to memorize it Thank you.
Speaker 70
1:08:24
To hear it, all in favor say aye. Okay, all opposed, like sign, all right,
Speaker 232
1:08:46
we're going to hear 1055 whenever we get a copy.
Speaker 70
1:09:24
NEW SPEAKER: WE'RE GOING TO RECESS FOR A FEW MINUTES AND PLEASE DON'T LEAVE -- I DON'T -- I HATE TO FIND MY COMMITTEE. NO, THIS IS JUST A HANDOUT THAT THEY WANT TO GIVE YOU. WE'RE RECESSED FOR A FEW MINUTES UNTIL WE GET A HARD COPY.
Unknown speaker
1:09:54
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
Thank you.
Speaker 15
1:13:54
All right, everybody got a copy of 1055. Representative Mayberry? No, you're set up here. Yes. Just introduce yourselves and you're recognized.
Representative Julie Mayberry
Unverified
1:14:30
Okay, members, I'm State Representative Julie Mayberry, and thank you for the 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
Speaker 28
1:14:47
of Government Affairs for the Alzheimer's Association. Okay. As
Representative Julie Mayberry
Unverified
1:14:51
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 Centene,
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 David, I'll let you explain it and again, we we did have some doctor 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 Thank you
Speaker 243
1:16:39
for the opportunity to present today. Hospital 1055 really is simply about access to FDA-approved treatments for Alzheimer's disease.
David Cook
Unverified
1:16:48
Alzheimer's was first discovered by Dr. Waldis 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 other forms of dementia. In 2023, 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 an Alzheimer's diagnosis would qualify. In order to qualify for treatments, you have to catch the disease in its very 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 you will hear testimony from one of our retired teachers who, again, has had great success 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 seventh leading cause of death, according to the CDC. And what we do know is one in nine Americans age 65 and older is currently living with Alzheimer's.
And the research is clear, one in three seniors will die with Alzheimer's or another form of dementia. Increasingly, Alzheimer's is, you know, in the past, we've discussed Alzheimer's in the concept of aging adults. We've made it about 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 64 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.
Speaker 15
1:19:18
Just come up and introduce yourself and you're recognized.
Speaker 248
1:19:38
I really appreciate y'all sticking around.
I know you don't have very much to do or haven't been working very hard this week, but
Speaker 249
1:19:45
I do appreciate you sticking around to
Speaker 247
1:19:48
hear this. It's still early in the day. And with the handouts you had, if you want it dumbed down, I'm your guy. I
Speaker 248
1:19:55
will take care of that for you. And Senator Flowers, just hang in there because 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? Name is Steve Daniels. I never dreamed
Senator Matt McKee
Unverified
1:20:09
I'd be up here speaking to senators.
I can promise you that, but I'll do the best I can. I retired after 38 years of teaching. I coached football, and I was an assistant principal. I was an athletic director all within 30 miles of the state capital, Conway and North Little Rock. I retired in 2018. I'm 67 years old, and six years after I retired, I was diagnosed with Alzheimer's. At that time, I didn't know much about it, and to be honest with you, I couldn't even pronounce it.
I still can't. I was having some headaches. I knew that my aunt had it. I don't know how many of you have had relatives or know people that have suffered from this disease. 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 had had 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, did everything look good as far as that part went? But there was 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. 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 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 I sit in there with chemotherapy patients, and I get this infusion. The last, and I'm there three or four hours, and they check mainly, it takes about an hour for the infusion. Then in about two or three hours, we 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 lasts for 18 months. Then they check you again, and then if the dementia starts to increase, then they stop the drug.
And 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. But there's a small window of people like myself, thank goodness, it does help. He did send me to Barnes Hospital in St. Louis. I went there for a PET scan, and that was kind of the determining factor that showed that I did have Alzheimer's, and that's what started.
I had my first infusion in October, and they test you for MRIs. I checked. 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 I 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. 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 going to impact us all in some way or another. 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. 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. I know in my heart that at some point in time that this disease is going to progress. It's just the way it is. It's not a cure. But I've got a wonderful wife. I have two awesome children and two 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 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 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. I want to thank, I know I'm going to wrap this up for you, because I think I've said enough,
But I want to thank Representative Mayberry and Mr. Cook and each one of you for giving us the opportunity to speak because I know you crammed us in here. And I really, really appreciate you all for doing that. And I said last week when we were down the hall, all of you have got an awesome responsibility. And may God bless you. Thank you. Senator Flowers.
Senator Stephanie Flowers
Unverified
1:28:00
So I want to first thank Representative Mayberry for bringing this bill, and Mr. Cook for his efforts with the
Alzheimer's organization, and for you, Coach, for presenting your testimony to us. I wanted to know, so you've been taking these treatments for a while. We had Blue Cross
Speaker 14
1:28:24
Blue Shield in the room earlier when we were
Senator Stephanie Flowers
Unverified
1:28:29
talking about that mental health wellness evaluation.
And so I asked them about post-traumatic stress disorder and medical marijuana being a therapy or whatever you want to call it to address that. that's one of the listed things, and they said that wasn't covered as
a treatment, but they had other
medications or therapies to that they do cover and so and you mentioned you had Blue Cross Blue Shield. Yes,
Speaker 248
1:29:17
may I had health advantage blue cross blue shield I
Senator Stephanie Flowers
Unverified
1:29:23
wonder what teacher what if any medication or treatment or therapy did that
insurance cover for Alzheimer's mr. cook has a response
David Cook
Unverified
1:29:37
yeah they will cover the cost of behavior modification
drugs typically when someone receives an Alzheimer's diagnosis you know So initially the first drug that people were put on is a drug called Aricept that's supposed to help 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 even 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 reducing the buildup of amyloid plaque in the brain. And 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 brain. As Coach Daniels mentioned, there is risk associated 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 blood test to confirm some of This biology is associated with the disease. But these, again, are treating some of that underlying biology, not just the behaviors that are associated with it.
So it's a very specific patient in the early stages that has confirmed presence of amyloid. And that's why our fiscal impacts, our assessment, and EBDs are quite a part because we think based on our risk assessment, at the most there would be 20 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 spaces as well. It is an expensive treatment. It's a first
Speaker 258
1:31:51
generation treatment, but I would argue cancer
Senator Stephanie Flowers
Unverified
1:31:55
treatments are also expensive. Right. Well, I'm just
saying the resistance, though, that you get from having this
treatment qualified or under coverage for you wanted for the state
employees and basically state employees is that correct? Correct, yes.
Okay and so I had another question about 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 haven't really been they've been FDA-backed, but not such that they can offer a specific result or a certain result without risk.
Speaker 259
1:33:12
Correct, but this actually has been approved by
Senator Stephanie Flowers
Unverified
1:33:16
the FDA. The others haven't, that we've been passing legislation on? Well, I'm
Speaker 260
1:33:21
talking this particular drug has been...
Senator Stephanie Flowers
Unverified
1:33:24
Right, but I'm just trying to think back about the bills that I've seen that we allowed
people, they had to have permission from the legislature, I suppose, because we 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 individuals for this therapy. And so how, I guess, the big to-do,
EBD, is that EBD, can they come to the table?
Speaker 261
1:34:19
Just introduce yourself again and you're recognized.
Senator Stephanie Flowers
Unverified
1:34:31
Grant Wallace, Employee Benefits Division. So basically I want to know what's the position of EBD, what's the fiscal impact in your opinion about this? So Senator,
Speaker 44
1:34:43
thank you for the question. I will say,
Speaker 31
1:34:47
and these are 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, first off, the concern really is giving the power to control and set our plan 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 depend 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 Alzheimer's, but any dementia-related medication. So I'll pause there. There are other concerns, but that is
Senator Stephanie Flowers
Unverified
1:36:20
the greatest concern with 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
Speaker 44
1:36:39
you... Right. Both of these drugs that are currently approved have gone through our approval
Speaker 31
1:36:46
process. 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 risk that are associated with them and the cost of the medications.
Senator Stephanie Flowers
Unverified
1:37:08
Without any kind of restrictions? They don't write well for certain people after certain tests? Right.
Speaker 44
1:37:15
Even looking at the FDA label and going off of the
Speaker 31
1:37:19
guidance that is set out, there are still too many risks, and it is not, in their opinion, worth the price and the outcomes are not there to prove utilization of the drug.
Senator Stephanie Flowers
Unverified
1:37:35
will be my last one, because what I'm thinking about, I'm thinking back to 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 in a, some kind of but I hate to call it a like a test or something like some like
Speaker 262
1:38:10
a guinea pig I guess. Right like the clinical trials. This would not like our plan does not prevent
Speaker 31
1:38:18
anybody from participating in 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 is broad, all would not cover any of those costs. The trial themselves covers the cost of the care while that patient participates in
Senator Reginald Murdock
Unverified
1:38:41
it. Senator Murdoch. Thank you, Chair. So this, I guess, this brings just some questions
into it. And now, Representative Mayberry, it would be so important for me if your doctors we're here because after 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 expert, 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, has it not? So, with it not passing your review, is there plan Bs or alternatives?
Talk to me about what is available for a situation
Speaker 31
1:39:53
such as this. Right. 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 something that parallels what this is
Senator Reginald Murdock
Unverified
1:40:07
doing in terms, because this is a, what's the word you use? It starts with an I, I think. Is this an intruder?
Speaker 31
1:40:18
Amyloid plaque? Is that what it is? Yeah, well, the IV infusion. So there are only two drugs that behave and work with the amyloid plaque and are administered via an IV infusion. There are no other drugs on the market right now that do what
Speaker 44
1:40:36
these particular drugs are doing. So EBD, so we don't have an alternative for this. Not for this particular
Speaker 31
1:40:45
drug. But what this bill is doing is expanding that.
So 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
Senator Reginald Murdock
Unverified
1:41:03
becomes, do we 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.
Speaker 31
1:41:22
And so that's, I guess that's our question. Go ahead. I would 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 we have that process in place that exists. This medicine, the Lequimby 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 going to butcher the name, but the Casenta 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 six months to a year, so we're coming up on time to look at this. If there's new data out there, if there's new evidence that shows improved clinical outcomes, then that's a different discussion. But right now, there is no need to pass a bill that does what this bill is doing.
We don't need to subvert that process and automatically defect
Speaker 268
1:42:31
to whatever the FDA approves. Sorry, Chair. I do
Senator Reginald Murdock
Unverified
1:42:37
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. 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 so, what say,
do you have a response to what he said? I
Representative Julie Mayberry
Unverified
1:43:13
do. I want David Cook to kind of answer 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. 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 not to cut you off, but to
Senator Reginald Murdock
Unverified
1:43:48
try to expedite this. So why have we not done it? Why is it not happening? Mr. Chair, I actually have the director of EBRX here with me. May
Speaker 44
1:43:57
I bring him to the table to answer some of those questions? And can I let David
Representative Julie Mayberry
Unverified
1:44:03
Cook explain a little bit of the language that's there? Because we've gone back and forth with the National
Alzheimer's Association to work on this language, and he can explain why it was written the way it was.
Senator Reginald Murdock
Unverified
1:44:14
I think that's the crux of us from a legislative standpoint. We
want to make a decision and we need information because we don't want it just being not approved for some not good whatever reasoning. I don't know. What's the reasoning? Introduce yourself and
Speaker 261
1:44:29
who you're with and you're recognized. Thank you, Mr. Chair. My name is
Trey Gardner
Unverified
1:44:35
Trey Gardner. I'm the director of the evidence-based prescription drug program. We're a service unit of the UAMS College of Pharmacy.
Speaker 276
1:44:44
We serve as a clinical consultant to
Speaker 276
1:44:51
of let you know our review process, okay? We're evidence-based, okay? Which means that we have a group that looks at all the clinical studies that come out. We look at the trials. 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.
And so all of this has been reviewed by that committee. The concern 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 statistical measures that, of course, 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 know you don't like people to read, but I've got some study data I just want to share. For Lakembi, one in nine patients will experience brain swelling. One in ten will experience brain bleeding, cerebral hemorrhage.
For the newest drug, Kisunla, it's even worse. It's one in three. Just to compare that to 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 3, 1 in 9, 1 in 10 versus 1 in 50. So the side effects, the brain bleeds. There's one patient in the study that after three 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 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 because he didn't know who he was. So I'm very sensitive to the emotional and the hard facts of Alzheimer's. But we as a body and our recommendations to EBD have to be based on the evidence. That's the reason for our recommendation, but we are still monitoring the medications. Thank you so much for that explanation. Yes, sir. Is
Speaker 5
1:47:51
there any other questions? Seeing none. Okay.
Senator Stephanie Flowers
Unverified
1:47:58
So, Coach, are you footing the bill for this? Medicare is
Speaker 280
1:48:03
covering 80% of it. Okay, so Medicare does recognize this. Yes, ma'am. I'm
Senator Stephanie Flowers
Unverified
1:48:06
glad for you for that. The rest
of it. And I just want to wish you well. thank you thank
Speaker 15
1:48:15
you mr chair all right uh seeing no other questions you want to close your bill well
Representative Julie Mayberry
Unverified
1:48:22
i i would like to respond if if possible and i would love david to respond for your bill
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. OUR 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. I WOULD APPRECIATE SUPPORT. All right, due to
Speaker 5
1:49:13
lack of quorum, I can accept a motion. Senate Insurance and Commerce is adjourned.
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
Unverified
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Michael Harry
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Representative Lee Johnson
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Representative Julie Mayberry
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David Cook
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Trey Gardner
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