Insurance & Commerce - Senate
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Bills discussed (16)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1150
Act 624
· 11 mentions in transcript, agenda, chapter
Matched: “doing the best you can do. Alright, we're gonna go to House Bill 1150. I”
|
TO PROHIBIT A PHARMACY BENEFITS MANAGER FROM OBTAINING CERTAIN PHARMACY PERMITS. | J. Moore | Notification that HB1150 is now Act 624 |
|
HB1572
Act 707
· 4 mentions in chapter, transcript, agenda
Matched: “HB1572 Ladyman TO CREATE A TECHNICAL FEASIBILITY STUDY ON NEW NUCL…”
|
TO CREATE A TECHNICAL FEASIBILITY STUDY ON NEW NUCLEAR ENERGY GENERATION; AND TO DECLARE AN … | Ladyman | Notification that HB1572 is now Act 707 |
|
SB621
· 4 mentions in agenda, chapter, transcript
Matched: “…GE FOR DELIVERY OF A NEWBORN IN A LICENSED BIRTHING CENTER. SB621 Irvin TO CLARIFY ENFORCEMENT PROVISIONS AGAINST A HEALTHCAR…”
|
TO CLARIFY ENFORCEMENT PROVISIONS AGAINST A HEALTHCARE INSURER; TO RETROACTIVELY APPLY TO A HEALTHCARE CONTRACT … | Irvin | Died in House at Sine Die adjournment. |
|
HB1735
Act 813
· 3 mentions in transcript, chapter
Matched: “…dle this for the committee. Representative Aves has a bill, House Bill 1735. I'm Senator Missy Irvin, District 24, um, again this um It…”
|
TO AMEND THE ARKANSAS UNDERGROUND FACILITIES DAMAGE PREVENTION ACT; AND TO REVISE MEMBERSHIP IN THE … | Eaves | Notification that HB1735 is now Act 813 |
|
HB1290
· 2 mentions in agenda, chapter
Matched: “…CERNING CRISIS STABILIZATION UNITS AND HEALTHCARE INSURERS. 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. |
|
HB1320
Act 626
· 2 mentions in chapter, agenda
Matched: “HB1320 Wooldridge TO AMEND THE LAW CONCERNING CRISIS STABILIZATION…”
|
TO AMEND THE LAW CONCERNING CRISIS STABILIZATION UNITS AND HEALTHCARE INSURERS. | Wooldridge | Notification that HB1320 is now Act 626 |
|
HB1847
Act 798
· 2 mentions in agenda, chapter
Matched: “…NEW NUCLEAR ENERGY GENERATION; AND TO DECLARE AN EMERGENCY. HB1847 McAlindon TO AUTHORIZE THE ARKANSAS RACING COMMISSION TO MA…”
|
TO AUTHORIZE THE ARKANSAS RACING COMMISSION TO MAINTAIN A STATEWIDE SELF-EXCLUSION LIST. | McAlindon | Notification that HB1847 is now Act 798 |
|
HB1850
Act 867
· 2 mentions in agenda, chapter
Matched: “…ING COMMISSION TO MAINTAIN A STATEWIDE SELF-EXCLUSION LIST. HB1850 L. Johnson TO AMEND THE LAW CONCERNING GROUND AMBULANCE SER…”
|
TO AMEND THE LAW CONCERNING GROUND AMBULANCE SERVICES; TO CLARIFY THE MINIMUM ALLOWABLE REIMBURSEMENT FOR … | L. Johnson | Notification that HB1850 is now Act 867 |
|
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 |
|
HB1863
Act 836
· 2 mentions in agenda, chapter
Matched: “…TE LICENSES; AND TO CLARIFY THE OBLIGATIONS OF DUAL AGENCY. HB1863 L. Johnson TO AMEND THE TRANSPORTATION BENEFIT MANAGER ACT;…”
|
TO AMEND THE TRANSPORTATION BENEFIT MANAGER ACT; AND TO DECLARE AN EMERGENCY. | L. Johnson | Notification that HB1863 is now Act 836 |
|
HB1942
Act 1023
· 2 mentions in agenda, chapter
Matched: “…PORTATION BENEFIT MANAGER ACT; AND TO DECLARE AN EMERGENCY. 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 |
|
HB1957
Act 847
· 2 mentions in agenda, chapter
Matched: “AGENDA (Revised 4/07/2025 @ 10:05 PM) Added HB1957 Senate Committee on Insurance and Commerce Tuesday, April 8…”
|
TO AMEND THE UNSOLICITED COMMERCIAL AND SEXUALLY EXPLICIT ELECTRONIC MAIL PREVENTION ACT TO INCLUDE UNSOLICITED … | S. Meeks | Notification that HB1957 is now Act 847 |
|
SB58
Act 52
· 2 mentions in transcript
Matched: “…ght now and many people in the room plus the hospitals with Senate Bill 58 that passed that will be opening pharmacies that will have…”
|
TO REMOVE THE PROHIBITION ON NONPROFIT, TAX EXEMPT, OR GOVERNMENTALLY-FUNDED HOSPITALS HOLDING A LICENSED PHARMACY … | J. Dismang | Notification that SB58 is now Act 52 |
|
SB592
· 2 mentions in agenda, chapter
Matched: “…LICIT TEXT MESSAGES. DEFERRED BILLS Number Sponsor Subtitle SB592 D. Wallace TO REQUIRE A FINANCIAL INSTITUTION TO RENEW CERT…”
|
TO REQUIRE A FINANCIAL INSTITUTION TO RENEW CERTAIN CERTIFICATES OF DEPOSIT AT THE HIGHEST INTEREST … | D. Wallace | Sine Die adjournment |
|
SB626
· 2 mentions in agenda, chapter
Matched: “…A TEMPORARY HOSPITAL FACILITY; AND TO DECLARE AN EMERGENCY. SB626 Irvin TO REQUIRE FAIR AND TRANSPARENT REIMBURSEMENT RATES;…”
|
TO REQUIRE FAIR AND TRANSPARENT REIMBURSEMENT RATES; TO ENSURE PARITY OF HEALTHCARE SERVICES; TO AMEND … | Irvin | Sine Die adjournment |
|
HB1826
Act 866
· 1 mention in chapter
Matched: “HB1826 Bentley TO MANDATE COVERAGE FOR DELIVERY OF A NEWBORN IN A…”
|
TO MANDATE COVERAGE FOR DELIVERY OF A NEWBORN IN A LICENSED BIRTHING CENTER. | Bentley | Notification that HB1826 is now Act 866 |
Machine transcript
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- October 2, 2026
Speaker 1
0:03
Yeah. Senate and Insurance and Commerce come to order. Please be seated or get where you can go. Take your conversations outside. All right, uh. Senator Irvin, Senate Bill 621.
Senator Missy Irvin
Unverified
0:34
Senator, Senator Missy Irvin, District 24. Good morning, Apton
Speaker 4
0:41
Metazotigan and Jason Hendren from Holly Smith. Hey, what about the
Speaker 6
0:51
Hendrick get you a microphone. I My apologies, Jason Hendre Hall Boo Smith.
Speaker 10
1:00
All right, you're recognized, Senator. Thank you.
Speaker 15
1:06
I'm going to turn it over and let them explain the bill.
Speaker 4
1:12
Thank you. Good morning. In 2023, um, the legislature passed a bill to allow for temporary hospital for ambulatory surgical centers to convert to temporary hospitals for the purposes of public health emergency excuse me, 2021, and two ASCs did that. The language of the bill was Quite clear, there is one health insurer that has argued that the language of that bill was not
clear enough to force them to provide these health care contracts to these ASCs that stood up and answered the call during these public health emergencies, and the insurance department, frankly this bill is to give the insurance department the tools they need to enforce the laws that you've already passed. The law we believe is clear enough, but this goes ahead and makes it clearer that insurance companies want a demand for a temporary hospital facility contract is made, shall provide that bill, and it makes it retroactive to again
recognize that the two ASCs in the state that did go through the effort of converting to temporary hospital facilities are getting the benefit of the bargain that you made with them. The governor's executive order cleared the pathway as well as Medicare and Medicaid to provide for these reimbursements in the Department of Health, excuse me, to provide for these reimbursements because there is no in the in the original bill that passed, the insurance companies have just refused to honor the
Speaker 17
2:33
law that you have passed. This bill makes it clear that they
Senator Missy Irvin
Unverified
2:39
have no choice. They have to honor the law you passed. So I, I just want to follow up to say at the time we had an executive order by Governor Hutchinson. We had Medicare and Medicaid and the federal government approved this program. We followed suit, passed legislation, which was my bill to say that when we need a temporary hospital, these ambulances are ambulatory surgery centers can become that. They went through all the hoops to figure that out, provide all the extra staffing and all the
extra requirements that was required in order to meet those standards that were put in place by the federal government, and this was in response to COVID when at the very beginning we had a tremendous need. I mean, you know, I, I think Samaritan's purse, they stood up a hospital under tents, you know, in New York, uh, because they were allowed to do this under the federal executive order and federal legislation. We passed legislation in this, in this general assembly uh with full
approval, um, uh, to do this and um basically, It was never, they never followed the law. So now we're coming back, clarifying the law so
that they will follow the law, and that's what the bill does, Senator Boyden. So I think I'm just
Senator Clarke Tucker
Unverified
3:57
going to restate what I heard and you can confirm. So, we have an insurance company, so there was an issue in the market. We responded with a law. And then the insurance company
failed to follow the law, and that's why we're here today. Senator
Speaker 4
4:24
McKee Thank you Mr. Chair, so this doesn't have a fiscal impact. On the state. It, it really shouldn't at all. It really goes and just makes clear from what the what
Speaker 17
4:30
the what this General Assembly already passed. It just adds a date within which the insurance company needs to act on that law that you already did pass, so that's only private insurance. Yes. OK, thank you.
Speaker 36
4:44
Is any other questions? We have one to speak for the bill I think it's Jason. Do
Speaker 5
4:54
you want to speak for the bill, Mr. Chairman, I'll defer to Mr. No one else speak for or against the bill, you want to close your bill? Thank you. I'm close. I make
Senator Missy Irvin
Unverified
5:09
a motion to pass. Motion by Senator Ervin.
Chair
Unverified
5:18
Second by Senator Boyd any discussion all in favor say aye. All opposed like sign. Thank you, Senator. You've passed your
Senator Missy Irvin
Unverified
5:26
bill. Thank you. 626 is in the process of
Chair
Unverified
5:29
being amended. All right, thank you, Senator. We're going to go to or House Bill 1572. Yeah
Senator Matt McKee
Unverified
5:59
So 1572. You ready? You're ready now. Matt McKee State Senate District 6 members this bill is basically just the first step in moving forward understanding that our energy needs are changing and we need to be developing on all fronts the small modular nuclear
reactor technologies developing around the world. While we probably don't want to be a first adopter. We do want to be early adopters, and so this bill just puts in place a study that will help us make those first steps.
Speaker 47
6:41
I'd be happy to take. questions All right, Senator Boyden. Thank you, Senator McKee.
Senator Clarke Tucker
Unverified
6:49
I just, again, have to ask my in Fort Smith. There's nothing
in here that's says Fort Smith should be a priority location over anywhere else in the state
for storage or disposal. No, there's nothing in this bill that talks of that, and nothing that encourages us studying specifically Fort Smith or anywhere else in the state. This
Senator Matt McKee
Unverified
7:10
bill is designed to help us determine what are the
Chair
Unverified
7:17
best locations. Thank you. Is there any other questions? Seeing none, uh, have no one to speak for
Dawood Rassam
Unverified
7:23
or against the bill, you want to close the bill, members, I'm closed. I appreciate the opportunity to present. I appreciate a good vote and I'd make a motion for
Chair
Unverified
7:32
DuP pass. The motion by Senator McKee, second by Senator Johnson in discussion all in favor say aye.
Speaker 53
7:38
All opposed like sign thank you, Senator. Past 1572 here or something. Jack, you just got yours passed. All right. Uh, does
Chair
Unverified
7:59
anybody have Any of the members have anything
else to run for House members. I can do something. 1735. Just introduce yourself and you're recognized to do the best you can do. Uh, I will, so
Senator Missy Irvin
Unverified
8:37
I basically just try to go through and
if they didn't have a Senate sponsor, I tried to put my name on this just so that I could handle this for the committee. Representative Aves has a bill, House Bill 1735. I'm Senator Missy Irvin, District 24, um, again this um It amends the Arkansas Underground Facilities Damage Prevention Act revised the membership in the one call center under this so that um Making sure that they operators
of underground facilities do become members of this one call center, um, and then you'll see on line 33 to 36, there is, um, warnings and fines if they if an operator fails to become a member of the one call center, um, And basically that's what the bill does is it just makes sure that there is membership from the one called to the one on one call center, and that the
commission is defined as a public service commission. Is there
Chair
Unverified
9:49
any questions, seeing none, no one's signed up to speak for or against
Speaker 36
9:53
the bill. Anybody want to speak for against this bill, seeing none, you want to close the bill? I'm closed. I make a motion to pass motion by Senator Ervin,
Chair
Unverified
10:02
seconded by Senator Johnson in your discussion, saying not all in favor. Say aye. I opposed like sign. Thank you, Senator, for
Speaker 64
10:09
doing the best you can do. Alright, we're gonna go to House Bill 1150. I
Chair
Unverified
10:25
We have multiple folks to speak for or against this bill. Introduce yourself, Senator,
and you're recognized. Thank you, Mr. Chairman Kim Hammer, state senator of
Senator Kim Hammer
Unverified
10:41
District 16. Mr. Chairman, may I If I could have a couple of people come sit to present what I've instructed our presenters that will be, I'm going to read a short 2 minute statement, and then I've asked them to keep their comments condensed to about 5 minutes around that and then we'll leave the majority of time for questions from the members and testimony. I know there's a lot of people who speak for and a few to speak against. And
Chair
Unverified
11:05
so whoever come to the table with you, this is their time and and they can help
you close also, but no testimony from them. between you bring them to the table if you want. All right, if I
Senator Kim Hammer
Unverified
11:17
can get those that I asked to come help present, and I'll let them introduce him, so. John Vincent and the president of the association. Mr. Chairman, we have a handout I'd like to ask that it be presented to the members, please. It's already been handed out. Thank you.
Whoever's coming to the table, get up there. John Vincent, leave the rumor or is he in the room? I'll get in here. I'll go ahead and
Speaker 78
12:02
begin with my opening comments. OK. Go ahead. Would you like her to introduce
Speaker 79
12:06
herself. Thank you for the opportunity to be here today. My name is Brittney Sanders. I'm co-owner of the pharmacy at Wellington and serve as the current
Chair
Unverified
12:13
president of the Arkansas Pharmacists Association. Thank you
Senator Kim Hammer
Unverified
12:19
and you recognized, Senator. Thank you. House Bill 1150 is a simple bill. It stops anti-competitive acts of monopolies who have raised prescription drug prices and stripping access from Arkansans. It simply says you can't be a PBM that both sets the price for themselves and their competitive competition and takes the price as a pharmacy. It ends those anti-competitive acts. It is consistent with the FTC reports,
the House Oversight report, Wall Street Journal, and New York Times investigations, for example, the FTC report showed 70% of every dollar spent on cancer therapy and specialty drugs are being filled by 3 PBM owned pharmacies. That number is 225 billion, by the way, being filled at 3 pharmacies owned by PBMs, CVS, Optum, and Express Scripts. That's not competition. That's actually a monopoly. I want to talk to you about why House Bill
150 matters so much to Arkansans patients and communities right now pharmacy benefit managers or PBMs or streaming patients to out of state mail order pharmacies that they own are affiliated with these pharmacies often have no relationship with the patient. Or prescribing doctor it's not personal care, it's just a business model. The FTC January 2025 report also showed how PBMs are inflating prices by writing prescriptions through their own pharmacies sometimes by charging 1000%, for example, a cancer
patient was charged $19,000 through a PBM-owned mail order, while the same prescription would have cost $100 at the local pharmacy, reining in these monopolies could dramatically lower costs, not only for patients, but also for providers or employers and health care plans across Arkansas. House Bill 1150 changes that. It gives patients the option to fill prescriptions at the local community pharmacy or even at their local hospital pharmacy or have it mailed or mailed by a pharmacy at their choosing places where the
pharmacists actually knows him. This bill has been refined through collaboration with input from patients, hospitals, and chain pharmacies. It's been amended multiple times to ensure it addresses real world access. Concerns and the Arkansas Board of Pharmacy retains the authority to issue special use permits where needed. The bill is thoughtful in its implementation. It allows PBM affiliated pharmacies to keep filling prescriptions for rare or limited distribution drug when needed, and it doesn't go into effect until January 1st,
2026, giving plenty of time for doctors and patients to prepare and make sure there are no disruption in care. House Bill 1150 also has support of Arkansas Attorney general as a veteran. He sees firsthand how monopolistic PBM practices disrupt access to care, forcing him and his family to switch pharmacies repeatedly and pressuring them into mail order options at a press conference in January, he voiced his support, and affirmed his confidence in defending this bill, and at its core 150 is about restoring choice, improving access, ensuring affordability and
trusting the local care that so many Arkansans depend on, and Mr. Chairman, before I yield to Mike to John Vincent, who will introduce himself. We will also address the multiple emails and the last few days as far as inserting information regarding how this would affect the military. There have been questions about having already given to the pharmacists the $10 dispensing fee through Rule 28 and also there's been an influx of emails and lobbying regarding the mental health and
how this would affect mental health patients as well, and we'll address all that in our comments. Mr. Chairman, yield to John Vincent with the chair's permission after he introduces himself. Introduce
Speaker 83
16:00
yourself and your. Thank you, Mr. Chairman,
John Vinson
Unverified
16:03
members of the committee, my name is John Vinson. I'm the CEO of the Arkansas Pharmacists Association. We did introduce this bill to Senator Hammer's point first week of session, held a press
conference, had a number of speakers there at that meeting. Some of those people are in the room today. They're signed up to speak. They can provide details greater than I can, but just wanted to address some of the points that Senator Hammer shared the first and of course we've heard this in the house and there have been testimony about loss of jobs, and I just wanted to say that we're empathetic to that. We would support anybody. that might be impacted, but just to remind the committee members that this bill being a simple
bill of removing the conflict of interest that would give the PBMs and pharmacies of choice of which one they would prefer to be if they were to choose to be a PBM and not a pharmacy or vice versa, then there would be an opportunity to provide services in the absence. We've also had 65 net loss of pharmacies with hundreds of losses of jobs. dreams that have been shattered because of the anti-competitive acts of PBMs. Some of those
pharmacy owners and former pharmacy owners are in the room. One of them in the room today show a pharmacy last week in Pine Bluff. There are also from a pharmacist's perspective on indeed and LinkedIn more than 100 openings right now and many people in the room plus the hospitals with Senate Bill 58 that passed that will be opening pharmacies that will have opportunities for pharmacists, pharmacy technicians and current employees by any pharmacies that might be impacted by changes
that occur in the market. One of the pharmacies that has an affiliation with a PBM Genoa, which is a mental health pharmacy and And 11 communities in Arkansas, mostly in urban areas, but there is one in in Hope and one in Texarkana and Pine Bluff and some underserved areas, there are some pharmacists in the room that work for other mental health facilities in Arkansas that provide similar care without those conflicts, and they have testimony and information that can talk about
um how this can be done without that conflict of interest. I'm confident if those are affected, that there would be the ability to either backfill those or to support those pharmacists to open their own and provide those services or to use our existing network of both closed-door pharmacies as well as traditional retail and hybrid pharmacies to provide mental health services for patients. I would point out that for Genoa there was a case in a few years ago in Arkansas where Genoa,
there was a complaint filed where patients were allowed to use their clinics as a pickup station, but only if those prescriptions were filled. By Genoa Pharmacies, and they did sign that consent and settled that back in 2018, but that would be an example from our perspective of what would be considered steering because it was only if you were part of the vertically integrated pharmacy that's own and affiliated with the clinics. We think fair competition, open access is better for Arkansans.
CVS also back to the point about closing some of our larger chains including including CVS have actually closed pharmacies. I know one in your district has closed in the news, they do plan to close another 270 stores and 900 over the last 3 years, um. We think that competition without these conflicts of interest that attempt to take pharmacy services out of our local communities and shift them to more expensive mail order pharmacies owned by the big 3 as well as other PBM owned
pharmacies out of state, drive up prices, take away access and take away good patient care. There was a comment about our veterans will not be able to receive their prescriptions through mail order, uh, pharmacies owned by Express Scripts, which is an exclusive relationship within the Tricare benefit and what I would say to that is that the Attorney General of Arkansas is supportive, and he is a veteran that our military bases and VA would be unaffected by this bill and would be options for
patients to pick up and fill prescriptions. Kroger and Walgreens and Harps are in-network, and the bill would incentivize them to grow and and open up more access for our nation's finest that have served our country, and would be supportive of that. In the worst case scenario that the PBM remained a bad actor or the US Department of Defense did not take action and listened to the citizens of Arkansas and to the Attorney General of Arkansas, if they continue to restrict that to a single meld or pharmacy, I'm confident with the
amendments that were made that are state board of pharmacy would be able to provide limited use permits to provide access to that service if it were to happen. And finally, have been a lot of, I think what I would characterize as fake news about the specialty pharmacies won't exist or won't be available. We have a robust network of over 25 pharmacies in the state of Arkansas that are happy to and willing to serve our patients with cancer, our
patients with complex diseases, many of whom are duly accredited or single accredited through national accreditation bodies. Many of them are in the room today, and that doesn't just include Independent pharmacies that includes Walmart, that includes Walgreens. That includes UAS, Children's Hospital, and new pharmacies that will open up to provide the services, but the reality is the reason specialty drugs are not accessible or being filled in Arkansas is because of the monopolistic practices that are driving 70%
of every dollar in this country spent on expensive complex drugs to treat cancer. They are complicating care, not uncom they should be uncomplicating it. And it should be about patient care, but instead it's about and from our perspective, what we've read in the Federal Trade Commission reports and what our members have experienced is that they're in a monopoly practice driving up prices and steering to pharmacies that are owned by 3 companies, according to FTC report. With that, I'd be happy to take any questions. Thank you, members of the committee.
Chair
Unverified
22:29
OK She anything else to say for questions? Yeah. Thank you
Speaker 88
22:38
for asking, Mr. Chairman. The bill sponsors
John Vinson
Unverified
22:41
reminded me I do have two other things. One is a handout that I passed out. We continue to get questions that we passed the law in 2015 that that makes it illegal for PBMs to own pharmacies and pay themselves more than local pharmacies, and yes, while that law has been in
place for 10 years, that law's been challenged to the US Supreme Court in Arkansas was victorious 8 to 0, solidify. States' rights, by the way, I've also heard that it's not the place of the state to do this. This should be the federal government, and I just wholeheartedly disagree with that. The Attorney General said, we have the right to do this. Our Constitution supports stopping monopolies and protecting Arkansans, and we decide who has a license in our state, not the federal government. I have data that I've put together with the help
of my friend Greg Raybold, who's in the room today, an attorney from Georgia that represents 76. pharmacies in Arkansas in the US postal workers we talked earlier at this committee about US postal workers overcharging the government through the rebate manipulation and the $44 million settlement. Data from Dumas, Arkansas on a pharmacy that closed, that opened on the first day electricity came to Dumas in July 4th, 1917, when the lights came on, the pharmacy opened,
and through the monopolistic practices of in this case, Express Scripts overpaying itself, locking out local pharmacies from being able to fill specialty drugs and then marking up the price to themselves by thousands and thousands of that pharmacy and One other pharmacy all consolidated and shut its doors at the end of the year, so the lots are out in Duma, Arkansas for Meter Pharmacy because of these practices, and we did open up a website and encouraged
patients, pharmacists, family members who would be supportive of ending these conflicts of interest, and I do have 8000 plus signatures, and these are actually patients who know why they support the bill. They support access at their local pharmacy. And if you were to call or email any of this, they've not been misled by the millions of dollars that have appeared to have come into our state to confuse people. I got home at 11:30 last night. This legislature was up here late. I
turned on one shining moment. I wanted to see what happened in the game. And the first thing that popped up was I'm from Leachville, Arkansas. Please vote against 1150 because I don't want to lose my pharmacy in Leachville, Arkansas, of course, if, if that patient's using that pharmacy is a local pharmacy that's independently owned, and I know that many legislators, there was testimony on the other end that legislators have got hundreds of emails and calls, and when they call the patient back, they don't have any recollection of
being opposed or even understand what the bill does, so With that, I appreciate everybody who listens to what I have to say and take any
Speaker 36
25:47
more questions. I'll never do that again. Thank you. uh any questions? All right,
go ahead, Senator Boyd. Uh, John or Brittany, John Vincent
Senator Clarke Tucker
Unverified
26:00
or Britnie Sanders. I just have a question for you or Senator Hammer. So there's been discussion of specialty, and this is just we
need to, we need to understand this. I think before we vote on this bill, because there's all these issues around surrounding specialty. So my question to you is, specialty drug really a clinical term? Or is it really just a term that has been used batted around to drive patients and dollars in a specific direction. Can one of y'all give us a clear answer on that. Thank you, Senator Boyd. It
Speaker 79
26:34
is not a clearly defined term. It's determined by each PBM what they consider a
specialty medication and there are pharmacies across the state who are situated to and dispense these every single day and can provide access to patients locally through care in their home. communities. And they can be mailed if it's if it's not accessible. There are pharmacies in the state that mail or hand deliver prescriptions to all corners of the state.
John Vinson
Unverified
27:04
some of the drugs are complex from a laboratory follow up prior authorizations and coordination of care. Dr. McGee
shared with us on the other end that he had a patient that was forced to a mail order special specialty pharmacy and they weren't able to get a phone call answered. They weren't able to fill it, and she lost her eyesight and local pharmacies, they know their patients, they know their doctors, and they coordinate
those complex cases, and that doesn't happen. So would you classify warfarin is a specialty drug or Uh, regular insulin is a specialty drug. I mean, how do we get, I mean, what makes a
drug One drug more special than the other.
Speaker 79
27:49
I've not seen a clearly defined set of terms that classify one drug as more special than the other. Certainly warfarin requires special handling in terms of it's counted in a separate location and handled differently than maybe lisinopril or atenolol would be insulin, regular insulin is stored in the refrigerator, so requires special handling again over maybe an antibiotic that sits on the shelf, so there are
many reasons something could be considered specialty. Sometimes it's on a cost basis. Sometimes it's on a storage. basis or a handling
basis, so just, just to clarify, and I'll I'll be done asking
Senator Clarke Tucker
Unverified
28:25
you questions on this, but I just think it's important both of you have doctoral degrees in pharmacy. How much of that was training or education was on storage handling and counseling for medications. The degree is based on
Speaker 79
28:44
dispensing medications. It's based on helping determine the right therapy for a patient, given a disease state, disease progress, and how to safely deliver that. Care to the patient. I would just say no other health care
John Vinson
Unverified
28:57
professional on earth has more training, as you described in pharmacists do. Yeah, so, so at the end of
Senator Clarke Tucker
Unverified
29:04
the day, a specialty drug is not something that pharmacy and literally just Of pharmacy in Little
Rock couldn't read the product information, figure out if it
had what it needed to store and store it. So like, um, any other, you know, any other medication, like, it's got to be stored at a certain temperature. These are the, the, the message that needs to be delivered. This is when it needs to come out of the refrigerator. This is, if it ever needs to go back. I mean, our pharmacists licensed in Arkansas in your opinion, equipped to handle that. Yes,
Speaker 79
29:37
in my opinion, pharmacists licensed in Arkansas are equipped to handle that, and we do handle that. Every single day. Thank you.
Speaker 36
29:47
There any other questions? Seeing none,
Chair
Unverified
29:51
uh, thank you for your presentation. Members without objection, uh, we have many people to speak on these bills. We have, I have two sheets. I have 84 and 4 against on the first sheet and 94 and 1 against. Without objections, I'm going to give both sides 20
minutes, 20 minutes, 4, 20 minutes against they can use that time as a I have a 2 by Senator Boyd. All in favor. Say aye. All right, we're going to get 20 minutes total on your on your deal. This does not include questions that if if committee members ask questions, that's not in your time, but whenever you speak, the total will be 20 minutes.
Dawood Rassam
Unverified
30:51
I'm going to begin. Uh, with Apparently these
Speaker 1
30:58
are doctors because you can't read their writing. Uh, Dar
Speaker 70
31:02
Darwood Ransom or something like that. I'll let you clear that up. It, it's fine right there because that's
Speaker 1
31:24
Just a minute. Uh OK, you're recognized.
Daud Rasan
Unverified
31:30
Good morning, Mr. Chairman, members of the committee. My name is Daud Rasan. I'm a pharmacist at the Centers for Youth and Families. It's a nonprofit organization that deals with mental health for adults and children, as well as primary care, counseling, and therapy. I'm in front of you to urge you to vote yes on HB 1150. As you can tell, this is my
Dawood Rassam
Unverified
31:54
first time talking in public. I'm, I'm going to tell you if you take up too much time,
Daud Rasan
Unverified
32:00
you're going to ruin everybody else's testimony. Go ahead. I'll do my best. Psychiatric relapse rate after
Speaker 110
32:06
the first episode is 30% within the first year and 80% within 5 years. Number 2 reason of that is lack of adherence to treatment. PBMs have engaged in predatory practices to steer patients to their own pharmacies in the name of saving taxpayer dollars and specialty medications require specialty
handling. Well, I am here to prove these stories wrong. Two examples. I'll do my best. One of the most important vacations in psychiatry and mental health are called long acting injectables. These are very expensive injectables that we dispense on a daily basis in a mental health. Um, one of them is a shot that's given every 3 months and that shot costs $10,000. I ran a report over the past quarter and the pharmacy have lost 2% on that. We dispense over 20
prescriptions, and we as a pharmacy paid out of pocket more than $4000 to make these patients or to keep them out of the hospital and keep them compliant. The PBS that forces the pharmacy to stop dispensing these medications and eventually transferred to their own mail order pharmacy or a big store they own. I've got a second example. There are 2 medications to treat TD tardive dyskinesia. It's a movement disorder characterized by involuntary repetitive
movements after often affecting the face, tongue, and lips that can develop as a side effect for long term use of certain medications, particularly antipsychotics. They're considered specialty medications due to their cost and complexity of monitoring side effects and educating patients. I export the idea to be credentialed to dispense these medications only to find out that even if I go through that process we're going to lose hundreds of dollars per prescription to dispense these prescriptions.
PBMs have used this tactic for so long and so often that at any point they can determine a drug being specialty to steer our patients to their own pharmacies. Mental health is complicated. Providers have to coordinate on so many levels to achieve the desired outcome, worrying about where and how to get the right medication should not be complicated. The population we serve is one of the most fragile and susceptible to relapse you can ever find. I'm here in front of
you first and foremost representing our patients and also our wonderful pharmacists behind me. This bill will ensure that we continue caring for this population that patients will receive their meds right after they're prescribed by their provider, not weeks later. And in fact this bill will save taxpayer dollars and will ensure patients not ending up back in the hospital or waiting for their meds to be mailed. And with that, I conclude my statement.
Chair
Unverified
35:05
All right, thank you. The rest of y'all have 16 minutes and 25 seconds. Uh, any questions? Hold on. Anybody have any questions? Saying none, thank you. So next we have 2 from Dean's Pharmacy, if those two will come to the table. killed our time, sir. All right, thank
Speaker 1
35:29
you. This is all 4, OK? Just so everybody knows, these
Speaker 63
35:36
are the fours, uh, Loretta Mosing. So I mean
Speaker 1
35:45
you wrote in here for, is that correct? Absolutely. All right. Uh, just introduce yourself and your're recognized and you have 16 minutes and 25 seconds use however much of it you want. Thank
Speaker 53
35:58
you. Good morning and thank you for having me. My name is
Loretta Bosing
Unverified
36:03
Loretta Bosing and I am the
founder of Unite for Safe Medications. Today I've brought with me 3
Speaker 117
36:10
children. It's the first time they've come to a hearing, because this impacts all of us, especially families like mine. This is my son Wesley. He's a transplant survivor who relies on medications every 12 hours. His life. So precious to me. But for the pharmacy benefit managers, his life is nothing more than a tool they call, that they use to distort drug prices in their favor and for shareholders' profits. My son
was 8 years old when I first became an advocate and uncovered the suffering of many as I've watched him grow older over the past few years I've also watched pharmacy benefit managers only grow stronger. Despite massive bipartisan support on these issues at the federal level changes isn't happening fast enough to save the lives of those suffering. As I look ahead for my son without breaking up these monopolies, the future of pharmacy and medication access and affordability as quickly diminishing.
I've never imagined that I'd have to be fighting like this, but PBMs left us no choice. They forced us to accept life saving medication shipped and flimsy bags sitting in scorching hot mailboxes and freezing trucks, damaging the very drugs meant to keep my son alive, exposing medications two times, 2 to 2 times room temperature in a mailboxes and trucks that quickly reach 140 degrees. No mother whatever get by with it, but it's OK for a PBM to force others to do. it.
That's what makes a specialty drug a specialty drug. The delays, interruptions in treatment often go without any repercussions, and there's no real counseling. That was a different fact. There was much less than what we had at local pharmacies in a relationship with doctors was just not there. The way they risk lives, the way the distort drug prices as the FTC report has stated that they also, as they're forcing patients like my son to these pharmacies, they're reimbursing themselves over 10 times more. I saw it for myself
early on. So peoples are profiting from monopolist to control they're hurting patients and providers alike and patients like my son. This isn't a partisan issue, has massive bipartisan support across our nation. This is a human issue and legislators across the country and so many patients right now are watching Arkansas in hopes that someone will finally lead the way to saving patients like my son. Thank you.
Speaker 36
38:41
Thank you. Any questions? Senator Johnson. Thank you, Mr.
Senator Mark Johnson
Unverified
38:48
Chairman. Ms. Mosing, um, your son was a young man that the mail order left the drugs on the front porch. They weren't refrigerated and because of spoilage or whatever, he had a reaction, a serious reaction to that. Is that and he must have read my op ed on this, but do you, is that true? That was a sun that was that was my son, yes, and it's not just the
Speaker 117
39:12
sitting on the porch, but also the hot trucks that are not protected. So
Senator Mark Johnson
Unverified
39:17
and Before when you were able to access your local pharmacy, you didn't have that problem. Is that correct? Never.
Speaker 117
39:22
It was never a problem at the local pharmacy, and I can't now I do everything I can to use their local pharmacy and they'll deliver in a temperature controlled uh truck or vehicle at a scheduled time. OK, great,
Senator Mark Johnson
Unverified
39:34
thank you for your answer. Thank you, Mr. Chair. Any other questions, saying none. Thank you for your testimony. Uh
Chair
Unverified
39:46
We have 13 minutes and 57 seconds left, Dylan Jones. All
Speaker 1
39:54
right. Christian Riddle. Say my time. Thank you, thank you. Harp's
Speaker 131
40:02
Foods, Robert Accord. But also, sir. Cathy and Blake Goodman.
Speaker 1
40:21
All right, we're going to the next page which has 8 4s. Uh Lee Stice. OK. All right. Thank you. I have no idea.
Speaker 126
40:41
Lane stone, Lane. Chapel Pharmacy. All right. All right. Uh
Speaker 70
40:56
Tim Finley. Greg Reynold or Ronald, OK, all right. If you
Speaker 5
41:14
would just introduce yourself. I'm sure I destroyed that. Thank you, Mr.
Speaker 137
41:18
Chairman Greg Reibold with American Pharmacy Cooperative on the general counsel and vice president of healthcare policy,
and we represent our member independent pharmacies in Arkansas. We have just over 80 independent pharmacies in the state, so Arkansas is a critical state for our independent pharmacy members. It's a critical state for independent pharmacy across the country. I would go so far as to say that today Arkansas is the center of the pharmacy universe because you guys are on the on the verge of pushing forward a solution that will be comprehensive and it will be complete for years, for all the senators in this room, I know
you've been hearing from your community pharmacists for years and years and years. About PBM practices. For so long those practices were anecdotal, right? Pharmacists are behind the counter every day. They see patients getting steered. They know things are wrong, but it's anecdotal, but we're at a point now where we have data to tell the tale. Folks have looked under the rocks and the dirt is there. The FTC has looked, and the FTC found in between 2017
and 2022 $7.3 billion that pharmacy benefit manager have steered into their channels and overcharged over the national average drug acquisition cost. Mississippi recently completed an audit looking at a particular PBM administering benefits for the state, and they found 75,000 claims that the PBM paid itself, its pharmacies. More than their competitor pharmacies more than independent pharmacies. And so just to be really clear what's happening here is the largest companies on Earth.
Money more than some nations are targeting the sickest patients in this country, sickest patients in this state, and they're steering those patients into their channels against their will, and they're not just taking away their choice. They're not just fragmenting their care, but they're marking these medications up thousands and thousands of, and they've done it for years under the age-old sort of claim that hey, our PBM affiliated pharmacies save money, but they don't, and that's what the data tells all of you should have a one pager on there and it looks at a plan
and it looks at an Arkansas pharmacy that was open for 100 years old that recently closed. This pharmacy survived World War II. This pharmacy survived the Great Depression, but it didn't survive anti-competitive PBM practices, and what you'll see is for the most commonly prescribed generics more often than not, the PBM mail order pharmacy is more expensive than the Independent. In this particular plan, after two fills, 2 fills. Arkansas patients have to use the PBMO mail order pharmacy
where they pay more money, then you get to the specialty medications and the independent pharmacies in the state can't even fill one under that plan. They go to the PBM owned pharmacy, and it's marked up thousands and thousands of dollars. Now here's what's important. States have tried to tackle this issue. States all over the country have tried to rein in steering, try to institute parity payments, any willing provider, and they have all failed, and they have failed because of the size of these companies and the
insidious relationship between the PBM and their mail order pharmacies are rotten to the core. And that's why those those measures have failed. This cuts to the quick, and that's why they don't like it, because this, this cuts that rot out and it forces them to choose. You can be a PBM or you can be a pharmacy, but you can't be both. And to the extent that they say this is going to force them to close stores in Arkansas. This pill gives them a choice. PBM or pharmacy. It gives them a
choice, and it's a choice that they don't give patience. They don't give cancer patients. They don't give multiple sclerosis patients, and it's a choice they don't give pharmacies that have been forced to close their doors because of these practices, and so we are strongly in support of this legislation, grateful for the work of Arkansas and this body and ask for a favorable consideration. Thank you. questions Senator Irvin. Thank you.
Senator Missy Irvin
Unverified
45:29
Thank you for your testimony, and I apologize for not coming in. I've been running
bills in other committees, um, so I just have a quick question for
you. I mean, so we have, and I was a co-sponsor on the pharmacy Benefit Manager's licensing Act. I, we started that
journey and I worked really hard, stayed up late in the House of Representatives helping to whip votes to get it passed for Representative Michelle. gray. Um, we've talked about this and
we have acted not just then but like multiple, multiple, multiple, multiple times now, and I think at the time when we have been told this is what will fix it. This bill will fix it. I, you know how many times I've been told that. Over and over and over again, the problem is we cannot fix what they will not fix at the federal level, and I'm, I'm, I'm getting worn out, to be just frank with you. It's it's, it's,
it's you're wearing us out in a, in a sense because we have bent over backwards a time and time and time again to accommodate and help, and, and we, and we have done that and we have had policy policy after policy, but, but my question and my concern is coming from a veteran, OK? And, and I, I understand we have independent pharmacies, and that's great, and we have independent pharmacists and they are a very important person in
our community. They're not the only solely most trusted medical professional, and I'm hearing that and quite frankly that's a little offensive to me. My husband's a physician, a medical doctor. He prescribes all these patients, and he prescribes all this medicine and um And you know, and, and there's, there's some, there's some talk from pharmacists right now. That's really offensive towards our medical doctors, and that's unfortunate and that's not part
of my question to you. I'm just letting you know there's a team here and and my husband prescribes a ton of uh medication that helps, you know, patience, but also helps us independent pharmacies in our community too. So it's a team effort. There's, there's not just one person out there that's, you know, the end all be all to the patients out here, so I just, I just want to caution as we're we're talking about
these issues, but this is particularly a question um as it relates to a veteran who texted me. He's a
former state representative, um, and he's opposed to this bill, and he said that US military retirees get our meds at the VA airbase, and from Tricare's mail order pharmacy called Express Scripts. The military VA and Express Grop would fall under this law adversely. Since all three have pharmacies and pharmacy benefit managers. This bill, uh, he believes should exclude VA military services and US government sponsored Tricare designated
pharmacies. He says, please, I get a biological shot every 4 weeks to keep me alive through Express Scripts. It cost, the cost is $4000. I pay $38. Every few years, the US negotiates a contract for a national military. retiree pharmacy. The VA has both local pharmacies and mail order as well. I am not sure how the US Civil Service retiree pharmacy operates, but I do know the US has PBMs that negotiate contracts with local chains,
i.e. Walmart, as well as use a national mail service for both remote veterans and civil service retirees, and he's asking to pull this bill down and exempt the VA Tricare and military retiree programs. What is your response? So I would say a couple
Speaker 137
49:32
things. First of all, acknowledge that Arkansas has absolutely led the nation, and you all have worked really hard to rein
Speaker 150
49:38
in these practices and appreciate some of the frustration. I think ultimately this solution is comprehensive and that it cuts off one of the two heads, right?
They're going to have to choose. They can't keep feeding and steering into that, into that mouth and with regard to your comment as to physicians, you know, completely agree, and we found throughout the country typically independent pharmacists and physicians. Work really, really well together to try to rein these practices in. I know, you know, obviously oncology practices are also really exposed to a lot of these PBM practices with regard to the Tricare question in particular, you know, off the cuff my thinking would be absolutely wouldn't impact any of the military pharmacies
themselves, right? They're not subject to state licensure as a rule, and so it wouldn't impact that in that regard. There are a number of mail order options that are not necessarily PBM affiliated as well. And for for years and years and years and years and years, retail pharmacies have cared for Tricare patients and done a good job, I would say a wonderful job, and there are some that still care for them and oftentimes a loss just because they're near a base and they care about that patient population, so the options I would say are absolutely there
and we also have found significant, I'd be happy to email you some examples, but we have found significant overcharges for those very specialty medications that you're talking about within the. Care program, thousands of above the national average drug acquisition cost when you take away the PBM affiliated specialty. We believe you're going to see those prices come down to the rates that they're non-affiliated pharmacies are being paid for those same services, and I have one
Senator Missy Irvin
Unverified
51:16
more question. Um, you know that it is against the law in the state
of Arkansas for a PBM affiliate pharmacy to pay themselves more than an independent pharmacy, correct? That is, that is state law. You, you do also acknowledge that we have had numerous, uh, Um, I would say reviews of claims submitted in our insurance company, our insurance department has done,
I think, a very thorough job at looking at that and correcting it and enforcing the law. Would you agree with that?
Speaker 137
51:56
I would, yeah, I mean, I don't, I'm not in Arkansas every day, but I think Arkansas
Speaker 150
52:00
has done, you know, has led the nation in terms of passing important legislation
Senator Missy Irvin
Unverified
52:04
and enforcing important legislation. OK, so if we have this law
on the books. That makes this illegal to do this. That gives an edge to the pharmacy. The
PBM owned pharmacy over the independence, and we've taken care of that issue. What then is the need for this bill? I think, I think the
problem persists, right, and these things can be
Speaker 138
52:27
complicated, but if you look at the one pager, you'll
Speaker 150
52:29
see for the commonly prescribed generics and again, we took the 15 most commonly prescribed generics amongst the most commonly prescribed generics in the country. These are the drugs that are being prescribed every day, you know, high cholesterol, um, high blood pressure, things like that. These are the drugs that pharmacies are are dispensing. hundreds and hundreds and hundreds of times a day, and what you'll see there is a mail order pharmacy compared to an Arkansas independent that was recently forced to close its
doors. In fact, 12 out of those 15 more expensive at the mail order pharmacy where the patients are required to go after 2 fills. Now that data is based on a federal, a federal health care plan,
Speaker 137
53:09
you know, federal employee health plan is the largest self-funded employer in the nation. These are really big companies with really
Speaker 150
53:15
sophisticated counsel. Really suffocate attorneys, and they've proven willing to push the envelope and have really aggressive interpretations, but, but, but we know based on that data and that data is coming
from the PBM data itself, we know that in fact in Arkansas today, There are mail order pharmacies that are being reimbursed better than independent pharmacies, and they're also completely excluded out of that specialty market. Have you turned those over? To the insurance department. I
Senator Missy Irvin
Unverified
53:39
have not. Why not? I would say I would say two reasons.
Speaker 137
53:46
First of all, we just pulled this data really, really recently and so would look forward to would look forward to sharing that information with not just this committee but with the commissioner's office as well. Well, again,
Senator Missy Irvin
Unverified
53:59
It's fully in our intention to for everybody to follow the law that's already been passed, and I'm, I'm confident that
while supported that law, voted for that law, but we need to let that law work. And so I, I appreciate your answers. Yeah, thank you
Senator Clarke Tucker
Unverified
54:19
for your questions. Senator Boyden. Thank you, Mr. Chair. So in states, I'm up here. So instead, does the state or the federal government have the ability to license pharmacies or
Speaker 161
54:30
licensed PBMs. Who, who does the licensing. So states
Speaker 137
54:35
enjoy broad authority when it comes to licensing, you know, federal government does not typically get involved in any way, shape, or form in licensing health care providers. That's considered well within the domain of of states, and
Speaker 157
54:46
I appreciate the question because again what this bill looks to do
is speak to Liener. OK, so sometimes Would you, would you
Senator Clarke Tucker
Unverified
54:54
agree with this, that sometimes the federal government gets states to do things by incentivizing them
with dollars to do certain things, so they take our money, they go circulate around in DC and then they say if you'll do what we want you to do, we'll give it back to you. Would you agree that that happens? I would agree that happens. OK, so on the same token, could a state then not have an area where it has control and where there are federal plans that don't want to follow the state's rule, could the states then might come up with a mechanism by where they use state power to get what they wanted the federal government to do. Would you agree that maybe since we
control licensing, this is a way we could tell the federal government to
support the state of Arkansas. Absolutely.
Senator Reginald Murdock
Unverified
55:44
Senator Murdoch. Uh, thank you, chair, and I
think Senator Boyd did a good job of, of maybe uh Answering some of the quandary that I have because as Senator Irvin mentioned, She, like I, I like her, have been in this fight for a while.
One Saturday morning many years ago, my local farmers, independent pharmacists, I got a call from Mr. Dean Watts on a Saturday morning, related to these gangs that the PBMs have played for many years, and she mentioned Representative Michelle, former Representative Michelle Gray and many of us others including Sydney Irving, we started this fight long ago and we continue this fight. But it has become exhaustive because What she said is true. We've been told many times this is it,
this will get it, this will fix it, and we'll stand in the gap, we'll stand in there and we'll fight against a strong lobby that PBMs have. Obviously at the federal level it's extremely, extremely huge and even at the state level we have been presented with uh pressures if you will, from their lobby, but we withstood that and every time we've tried to come up with legislation to make sure That we protect the consumers, the businesses, and specifically
our end user which are our constituents from being gouged in many ways now. And then, so what we did as part of this process, we brought AID into this and and they became our watchdogs, if you will, we, we gave them the authority and the power to hate. Let's get this, and so what I would say to my independent pharmacist over the years because it seemed like every session we've had more of this and I think Represent Senator Boyd just kind
of answered what happened federally when they do some workarounds to come back at us in a different way. Because of their capacity if you will, but. What, what, what we're trying to do is make sure we capture finally, but now we have to have the help. Of The pharmacy reporting, they can't get weary and their well doing in terms of reporting these issues to the department
so that we can have the proper enforcement because law is on the books that supports what we're already talking about. And while we're still here dealing with some of the things we've seen this sheet before. We've seen this before and now that we're back again because the argument really hasn't changed. It's just the game seems to evolve evolve differently. So again, I think Senator Boyd kinda mentioned what's happening on the work around and maybe
this deals we deal with licensure. This can help us, but we're really truly trying to solve something, and we do need and send the Irvin asks, why not report? We need you to make sure. We need the members to make sure that you report these. Um, infractions to the department who we've given authority to referee to make sure they properly enforce the law so that we can get better and we don't suffer from this because This should not come back again
Speaker 137
59:09
as we're seeing. Yeah, I appreciate the comment and, and you know, understand, right, sometimes it's like what's the expression fatigue makes cowards of men and women, right? And you know, sometimes it's it's attrition and so certainly there are periods where even pharmacists will will lull in filing complaints and the desire, right? I mean you guys have been in the trenches. You guys have led year over year with a lot of these issues, right? And and what we found is certain aspects that are effective, certain aspects they evolve and
they're not, right? And and I would hope that there's some degree of frustration from that perspective too, right, that you continue to say, hey, stop doing this, and they continue to do it. And again it's complex regulatory legal stuff when you're when you're legislating PBM's insurers, but what this does is, and I got two boys and Lord knows they don't listen to me a lot, right? Sometimes you have to take the ball away. And that's what this does. This legislation takes the ball away. You've tried to stop it. You've tried to stop it, and you've tried to stop it again, and the
games continue. The patients get steered. The patients gets gets overcharged. The patients lose choice. Independent pharmacies continue to close. They continue to feed the mouth, right, two headed beasts here and they're continuing to feed those prescriptions to their affiliated pharmacies and mark those up. And what this does within the state's authority. What this does is it takes the all the way, and it takes away your Senator Irvin. So to that
Speaker 173
1:00:32
point, it takes the ball away. That's concerning to me.
Senator Missy Irvin
Unverified
1:00:43
We're using government to deny Business to operate. We're using the government to say we're getting rid of your competition. That, that you said it takes the ball away. It takes it takes the ball away. It says that we're denying a permit to be approved for you, but not for you. You're picking winners and losers in this bill. You're denying you're using the government. In an anti-competitive way to
pick winners and losers, because if, if I'm an independent physician, and I don't like that federally qualified health centers get an enhanced reimbursement rate, they compete unfairly. They're putting me out of business. I have to close my independent clinic because I just can't make it anymore because they're getting federal subsidies, they're getting an enhanced rate that they're getting paid, they're going after all the private insurance, they get more money from Medicare and
Medicaid, then I get because they qualify for it because they have this federal designation. They're putting, you know, me out of business as an independent physician and clinician. I didn't,
I didn't bring a bill that says we're not going to approve the licenses of FQHCs. Anymore And so I mean,
do you understand that that like, that, that's what I feel like this bill is doing. I mean, I don't, what if the shoe was on the other foot for all
the independent pharmacists in this room. What if this bill said you don't get a pharmacy permit. How would you feel? I mean, I, I, I'm, I really do want somebody to answer that question. I'm trying to be as real and honest as possible. I don't, I am a I am a I am a conservative woman. I, I, I, I believe that government is here for good policy, but when you start using government to shut
down and close out your competition, uh, and by denying permits and licenses, that gets a little weird for me, especially when it comes to health care. So and I'll
Speaker 161
1:03:00
be brief here, but what I would say is we're talking about 3 of the biggest companies on Earth
Speaker 150
1:03:06
that are, I mean. That are effectively monopolies that are themselves depriving patients of their choice of pharmacy and then steering those into their channels and massively marking up. So what we're talking about is taking
away their ability to monopolize and act anti-competitively, and I would just close with this, right, the Arkansas Constitution monopolies are contrary to the genius of the state, and what this bill is looking to do is end those monopolistic anti-competitive. Are they defined as a monopoly by
Senator Missy Irvin
Unverified
1:03:33
the federal government. Who who's defining them as
a monopoly, you, or is there, do you have an official document that says they're monopoly. We can
Speaker 138
1:03:43
certainly provide you with some FTC documents where they have actually been, has it been ruled
Speaker 137
1:03:50
As a monopoly or is that your opinion? These would be in reports as a result of an FTC 6B study and happy to
Senator Missy Irvin
Unverified
1:03:57
provide those with it to you. But do we have
any actual legal documentation, legal documentation that says that they are monopoly and that they have to divest because I'm familiar with that and we've we've
seen that at the federal level. So the answer to that would be no. I think there's there's a lot of concern that I
Speaker 161
1:04:14
wouldn't say the answer is that they're not monopolies, but I can't point you to.
Senator Missy Irvin
Unverified
1:04:23
A legal court case where they so that is your opinion that they're monopolies. OK, Senator, I don't, I
Speaker 64
1:04:29
like the exchange. I don't want you anybody speaking over the other, so just for the future, are we done with this? All right,
Chair
Unverified
1:04:37
thank you. We're going to move on. Thank you, Mr. Chairman. OK, next is Adam Head. You have
9 minutes and 52 seconds just introduce yourself and
Adam Head
Unverified
1:05:00
you're recognized. Thank you, Mr. Chair. Members of the committee, yes, my name's Adam Head. I'm the president and CEO of Carti. We're a nonprofit cancer organization, but I am speaking really on behalf of all Arkansans facing cancer in this state. I'm here today because ultimately we believe that this bill actually uncomplicates.
A cancer journey and actually protects the integrity of the cancer journey for patients facing cancer. A term that we very often use in health care as coordination of care and this actually speaks to Senator Ervin, something you mentioned earlier in reference to your husband. We actually do believe that it's a team that's required to be able to take care of patients on a care journey. Often you'll have a physician in the mix who'll have nurses
coordinating with pharmacists to navigate some of the most complex things that a patient can face here in Arkansas specifically. What we've seen over time is Some of the patients that are told you have cancer, may be walking through our doors, and they've never seen a doctor before. And may have an insurance plan that's directing them to an out of state PBM and they've never utilized that, so they didn't even know it and now all of a sudden you have cancer. And
You're trying to navigate this. And you'd like to be able to use a local pharmacy as part of your, your clinical team here locally, either a retail pharmacy or an in-house pharmacy, which many health care facilities like us have those, and then you can't do it. And you're dealing with a 14 syllable drug that you're unfamiliar with and you're scared to death. And so ultimately we believe that this helps to uncomplicate that part of the journey.
Senator Missy Irvin
Unverified
1:06:58
So I'm happy to answer any questions I can. Senator Irvin Thank you for being here. I've enjoyed working with you guys on so much.
We've passed legislation this session as it relates to specialty drugs. Can you just go through those for me, uh, on behalf of
Cartai, I believe, and, uh, Highlands Oncology. I've actually got Maggie Smith that's here with me,
Adam Head
Unverified
1:07:19
so it's if it's OK, I'd like to be able to bring her up with me. Yeah, I just want to,
Senator Missy Irvin
Unverified
1:07:25
I just want to understand, you know, we, we
have worked really hard to accommodate. Uh, car tie in Highlands Oncology with legislation this session already, so I just need to understand, you know, what those bills. You know, well, recap that. So hang on
Speaker 186
1:07:46
just a minute. Uh, now, what is she going to do? I was just bringing
Adam Head
Unverified
1:07:52
her up to answer some of the specific questions on those other bills
just to answer the as it relates to
Speaker 188
1:08:03
yourself. I'm Maggie Smith. I'm director of
Speaker 188
1:08:09
OK. The other, the other bill that dealt with specialty pharmacy that I believe you're referring to is HB 1531, and that one dealt with drug manufacturers limiting the distribution of certain drugs to certain pharmacies,
Speaker 176
1:08:21
so it was not related to PBMs. So that's why, that's why these two are different. OK, thank you.
Speaker 5
1:08:31
All right. Any other questions? Seeing none you dismissed. Thank you. Thank you.
Speaker 70
1:08:38
Next, uh, We have brandy. Can't change, chain, what is it? You have 7 minutes and 52
Speaker 5
1:08:50
seconds. You're, you introduce yourself and you're recognized.
Speaker 70
1:08:55
Hello, thank you for, thank you for being
Brandy Chain
Unverified
1:08:58
here today. Thank you for allowing me to speak. My
name is Brandy Chain. I am with Pharmacists United for Truth and Transparency, and I am the owner of an independent pharmacy in Weatherford, Texas, where we've proudly served our community since 1892. Although I'm not from Arkansas, I felt compelled to be here today to support my colleagues and to witness what I truly believe is history in the making. House Bill 1150 is more than just state legislation. It's a national statement. It says. that Arkansas is ready to stand up against the unchecked power of monopolistic practices that are threatening the very
foundation of our health care system. These monopolies or pharmacy benefit managers, insurance companies, and pharmacy chains are all owned by the same corporate entities have made it nearly impossible for small pharmacies like mine and like these guys to survive. More importantly, they've stripped patients of the ability to choose where and how they receive care. House Bill 1150 gives us hope. It represents the first real pushback that says we will not allow billion dollar corporations to dictate what's
best for our communities. It prioritizes patient access, restores fairness to the market and recognizes the essential role of local community pharmacies. I drove from Texas to be here, not just to support my friends in Arkansas, but to speak for the thousands of pharmacy owners across the other 49 states who are watching this moment closely. While you may not hear their voices. in this room, I assure you they are watching. They are listening, and they are hopeful, and they will be cheering if this bill becomes law.
Arkansas has the opportunity to be the first state in the nation to take a stand and stop monopolistic vertical integration and pharmacy to be the leader that others will follow to protect patient care, preserve real competition, and safeguard the future of independent community pharmacies. I'm honored to witness this moment, and I applaud you for your courage and leadership. Thank you. Thank you.
Chair
Unverified
1:10:58
Is, is there any questions? Seeing none, we have 2 more.
Speaker 1
1:11:07
2 more to speak for the bill, Jason Finke. All right. Introduce yourself. You have 5
Speaker 53
1:11:19
minutes and 53 seconds. All right, I'll be brief. My
Jason Finley
Unverified
1:11:23
name is Jason Finley. I'm the director of pharmacy for Birchree Communities and which is a nonprofit corporation, much like Centers for Youth and Family, uh, and so we serve 380 severely mentally ill patients across the state and many of those patients
coming from the state hospital and so I know that there is the worry of deserts for facilities and patients in mental mentally ill facilities, and so I wanted to let You know that there are pharmacies ready and active to grow and serve these patients in those facilities and not only able to do that, but actually have been hindered by mail order pharmacies trying to come in and take away business and even Predatory practices toward my own patients, and I'll give a brief example. I have a patient
with severe mental illness, been in a facility for many years that got a call from Humana and Not really sure she couldn't tell me what she answered, but a week later, 90 days' worth of medicine came, and she already had medicine filled, and she's under a guardianship legally and so I would not make any changes without her guardian, but yet the Guardian didn't know anything about this, and, and so the other side of it is, is if I tried to fill medications two weeks after another pharmacy
did, the PBM would tell me it's too soon to refill. However, the PB him didn't do that, they were able to refill and override that and so the other thing from a specialty standpoint is I have about 115 clozapine patients that historically we've always drawn labs and reported those and had to do specialty type circumstances, ensuring that safety with that medication happens and and so we want to continue to be able to do that if anything would be a specialty
medicine, that one would be specialty, but yet no specialty, you know, it's not considered a specialty medicine because it's A very cheap medicine, much less not been generic for many, many years, and no longer plus there's an extensive amount of lab work that has to be done and so it, I've never had an issue with that being considered a special medication, even though there's a lot of special circumstances other than price. It has to make that especially medication, and so I have many other things to do with that, but I just want to let you know
the room shows that the infrastructure to serve these patients, not only re but in these facilities and mental health centers and things is there and the pharmacists are eager to do so and at that I'll stop my time. Thank you, Senator Ervin. Thank you.
Senator Missy Irvin
Unverified
1:13:58
I appreciate your testimony. I really appreciate what y'all do for your patience, um, the, um, but I understand that
the community mental health centers are affected by this bill and asked for an amendment
to be exempted out of the bill, so were you aware of that? I have
Jason Finley
Unverified
1:14:16
not been involved in those. My CEO is actually the vice president of the Council for Behavioral Health, and I was told today that they want to remain neutral as far as this bill from my perspective. And so I have not been involved in those talks, and I'm not aware of where the council stands personally as a pharmacist.
Senator Missy Irvin
Unverified
1:14:37
OK, well, I, I have concern if this affects community mental health centers,
not being able to function or get their permits, that would, that would be a major problem for me because I feel like pharmacies are important as component as a commit inside those community mental. Health centers, and I'll say that somebody else might be able to speak to
Jason Finley
Unverified
1:15:00
that other than you, Birch Street Community approached me in 2011, they used a retail pharmacy. For their pharmacy services. And through that opportunity, I was able to open that pharmacy for that mental health center and uh
and it's fully independent and they're able to serve that patient better than they were able to be served before and so I can't speak for anyone else. I can only speak for my own experience, but, uh, it's been a very good opportunity both for myself as a professional, but also for that mental health center to have its own pharmacy and like I said, there are a few other pharmacies throughout the state as well that are able to do that. Uh, mental health centers that have their own pharmacy like that. Senator Murdoch. Thank you, chair. Uh, the
Senator Reginald Murdock
Unverified
1:15:45
neutrality that you mentioned that you said they expressed they wanted to be on this bill. That concerns me when anybody is neutral on this because of the way I perceive this to be in the senator Irvin is bringing out some things that I, I, I need to hear answers to
in terms of consideration for um those concerns. Why would they be neutral on this. I cannot speak to that, sir. I
Jason Finley
Unverified
1:16:15
got a text message today, not to use any of their Uh, not to use their name for or against the bill to keep it neutral. And so I simply give you that information. I have no uh further information regarding that and I'm not involved in those committee meetings or any of their meetings. So
Senator Reginald Murdock
Unverified
1:16:32
then as you come forward to speak for this bill from your perspective, can you see why? Anyone in this
equation and and this of what we're doing here dispensing costs, um, Fair dealing, those, these are the things that we're trying to deal with as legislators, you know, I'm not trying to choose what business does better than the other business. I'm trying to make sure that my constituents are not unduly harmed by Practices that have been explained, shown, data revealed
to me over the years with legislation such as this. So uh But so whenever someone is neutral or an entity becomes neutral, that's concerning, but explain to me how you for it and do you, do you understand neutrality in this, or is it clear for you? That this is a problem and this needs to pass to
take care, help take care of a problem. I I am here to simply state that
Jason Finley
Unverified
1:17:47
as a pharmacist that has always been an independent pharmacy. Opportunity is not always been there for independent pharmacy, uh, when I started this pharmacy in 2011, the opportunity was great at that time. However, over the years as Bill's chased this, we talked about this earlier as bills were made through the assembly, uh, that opportunity did change over time and so that neutrality, uh, I can't speak for them personally. I can only speak that I'm for it
as a pharmacist myself, but I must also say that my family owned an independent pharmacy in Benton, Arkansas and sold that in 23 and my dad is here retired, uh, and, and we're here not because we didn't love taking care of our patients and wanted to see that business succeed, but we're here because the market changed in such a way that we could no longer sustain that business, and, and so I can only speak for my personal
testimony and as As far as neutrality, I, I simply can't. I, I would not have a good answer. I'll go ahead and tell you. And I'm for it personally and I'm here as a mental health pharmacist for a mental health center and and I'm speaking from my personal viewpoint. For the bill. Thank you. Thank you. Senator
Senator Missy Irvin
Unverified
1:19:13
Irvin, are y'all, is birch tree designated as a community mental health center. Do y'all meet that criteria, or
are you an independent business. No, no, no.
Jason Finley
Unverified
1:19:23
So our pharmacy is owned by the community mental Health Center 5035013C nonprofit corporation and, and it is not an independent business. I do not own it whatsoever. It's owned by the corporation governed by a board of directors, no single entity owns that. Pharmacy and so I'm a just an employee as director of pharmacy for that mental health center. OK, but it, but, OK, so you're,
Senator Missy Irvin
Unverified
1:19:51
is that a federal designation? I believe
Speaker 204
1:19:55
so. I, nonprofit. I'm not an expert on that, by all means I've tried to learn and educate myself, but my expertise ends there I was just
Senator Missy Irvin
Unverified
1:20:05
trying to get it straight. Thank
Dawood Rassam
Unverified
1:20:11
you. See no other questions. Thank you, sir, for your testimony. We have one more lake Torres
Speaker 215
1:20:21
Westside Pharmacy. You have 3 minutes and 20 seconds. I'm gonna stop watch out. Like to pharmacy. Uh, first off, thank you for having me today. Uh, if you want to call this is not my first time in this legislative fund. Uh, 2 years
Speaker 217
1:20:43
ago I testified before ALC thanks, sorry about that. West Pharmacy. This is not my first time before this committee, um,
I testified before ALC almost 2 years ago, the community pharmacy was dying by 1000 slashes, and here we sent today's Point. Rehashing the same thing over and over again. I hadn't tested in preparing but to the time and try to keep it short. Tricare, Captain Brian Damon Torrance, United States Marine Corps FN fighter pilot just got back from 2 tours in Japan and
squadrons now in Panama. I have empathy for those who have served our military and are currently serving. 90 and they will lose access while partially insurance is not the whole truth. They were still be able to get prescriptions filled at military bases along with local and community pharmacies and keeps being an independent pharmacy issue. This is a community pharmacy access issue. Kroger, Walmart, Walgreens, Harps, Amos will maintain access for veterans.
West Side Pharmacy is initiating contract with Express Scripts and We've gotten pending response after pending response. We're reviewing network. We will find a way where my brother who was sacrificing his life for this country and everybody in this room will stay and maintain access and care. The second thing that keeps getting caught up is we don't want to pick winners and losers. Well, we decided that in the federal government decided that when they answer to Medicare
Part D, and then they allowed vertical integration with consolidation where insurance companies were allowed to buy pharmacies and buy PBMs and the reverse triangle presented, so now my companion, not only is mine competing in the marketplace. They are setting my prices, and then we forced myself to publish my acquisition costs in a model called. Act for the entire world, so they now have my price files. How do you compete against that
and Sarah Erman, to your point, I empathize with you, and if there was another private or public commitment that's not FQNC, and they were sending your reimbursement directly as well as paying. I will stand with you in this, and I know that you worn out. I'm worn out, but this is $1 trillion industry that we were fighting here. This is not some mom and pop. against each other. They don't answer to the US conference. They're sure as heck not answering to our AIT and my
professional opinion, fighting for my patients, to give you a real example and I'm gonna chase rabbit here for 1 2nd. On Monday, yesterday I had my team how many times a patient was forced to go to mail order CVS 5 patients, 5 patients false access. Then lost Walgreens, they lost Walmart. They lost Harps, they lost all of them. So we're going. Part 36 with all of that ends. Thank you for good. Any questions?
Speaker 64
1:23:59
Thank you, sir. We're gonna switch over to the against. And
Speaker 70
1:24:10
uh Just as a reminder against total 20 minutes questions do not count. Uh, Randy Zook. Just introduce yourself and
Speaker 221
1:24:30
you're recognized. Thank you. Thank you, Mr. Chairman. Randy Zook with the Arkansas State Chamber of Commerce, um. Thank you for the opportunity to comment on the bill as an organization, we remain opposed to the bill as it's written now. In our view, HB 1150 is simply a bill that says a pharmacy benefit manager who owns a pharmacy must decide to be a PBM or a pharmacist in Arkansas because it can't be both. When did, when did the
government's job extend to such arbitrary demands on our markets. This bill is a direct assault on innovation or business models and consumer choice. The practice of a business purchasing part of its supply chain or vertical integration is common and often used by large organizations such as Exxon. Tyson's, McDonald's, Apple, you name it. If you remove the term pharmacy benefit manager from this bill, I would imagine that
none of you would touch it because of its clear government overreach. Let's consider the obvious intent of the bill or recognize it, which is to eliminate competition from the market. And just an aside on the much um quoted comment about the 100 year old pharmacy in Douma. had to close regrettably. I'm familiar with that business. Meadows Pharmacy. I grew up in Desha County. I also remember Vickers, Chevrolet and Dumas. I
remember Peterson Ford and Demas, all of which have gone away for one simple reason. When I graduated high school in McGee, there were 26,000 people living in Deshay County. Today there are barely 10,000. The world has changed dramatically for those businesses. Since 2018, lawmakers, you, your cohort, your colleagues have placed regulations on the PBM industry to prevent predatory
practices such as paying an affiliate pharmacy more than other pharmacies, from steering patients to affiliate pharmacies, including mail order pharmacies and from paying below the national average drug acquisition cost. According to the last audit by the Arkansas Insurance Department, the PBMs were complying. They are obeying all of these laws if they are not, they need to be brought to court
and brought to account for it. If a PBM behaves in the egregious manner described by proponents of the bill, AID has full authority to assess penalties and even suspend or cancel a license. AID can N PBM at any time to ensure compliance with all of these laws. This bill is a punitive measure to remove competition from the market, plain and simple. It is not about patient
protection or lower costs. Hundreds of thousands of Arkansans through free market competition, choose to fulfill their prescriptions at a pharmacy owned by PBM today. Perhaps they like the convenience of mail order or picking up while shopping at a favorite retailer. Maybe they choose a PBM owned brick and mortar location because of service or convenience. Who knows? But the choice is the
consumers and these pharmacies, these companies made good faith business investments in our state with the expectation that it would be allowed to compete in our economy. This bill would unjustly force them to divest, which would put over 600 hardworking Arkansans on the market or out of a job with the strict regulations I recounted, AID has the authority to throw out bad actors, so get
with it, do it. If you can find and convict them. So unless the state wants to get in the business of picking winners and losers in our economy, we see no reason to pass this. Just a few months ago, independent pharmacists were advocating for a dispensing fee rule because they claimed Arkansas's network was inadequate to support our market. Today, the same group is advocating to force 40 plus pharmacies out of business. To me, that says what the bill is
really about, which is using the government to ensure market share. All businesses should be concerned when a bill like this comes along. because it's a slippery slope that can jeopardize us all. If the pharmacists are successful, get ready for the next group to show up trying to do the same thing. I'll conclude by reiterating that the bill is a classic example of unwarranted government overreach meant to eliminate competition in a free
market, or at least sort of free market economy. Thank you. Happy to take any questions. Thank
Senator Mark Johnson
Unverified
1:29:45
you, Senator Johnson. Thank you, Mr. Chairman. Mr. Zook, sometimes we're on the
same side and sometimes we're on opposite sides, and I value both of those times. But this is probably the strongest I have disagreed with you in my life. Uh, are you familiar with Article 2 Section 19 of the Arkansas Constitution. No, I'm not. Let me read it to you. It says perpetuities and
monopolies are contrary to the genius of a republic and shall not be allowed, and in my opinion that is all this bill is doing, it's us codifying into a law. That we're not going to allow a vertically integrated monopoly. Now you cited an example of Exxon, and I think that was interesting that you did. You remember what the original name of Exxon was and before the Standard Oil, it was Standard Oil, which is literally the law school textbook case for antitrust
situations. So how can you justify that when you've got small businesses that are filling this room and then you're going with the oligarchs of an sign or the PBMs. I'm just, I'm flabbergasted and usually you support our local businesses around the state and I'm, I'm grateful when you do that, but I'm, I'm literally shocked that that your organization would oppose. This bill and, and I've there have been very few times, not just since I've been in the Senate, but since I've been
around these halls which is really the majority of my life. That I have seen something that is as black and white, right and wrong as this bill is, and I'm, I'm just shocked that I don't know, I don't know how much money they're spending. I drive to capsule every day. There's a billboard on 6:30. It's lying about what this bill does. I'm getting emails from constituents and like Senator Hammer, every time I call them, uh, do you know about this? Uh, no, I don't remember sending you
that. Someone's clicking. This is not grassroots opposition. this bill. This is astroturf. And I, I'm just saying, how can you justify Going against the Constitution's clear mandate on opposing monopolies when, you know, we get to pass bills, but we don't get to pass bills that are contrary to the Constitution. I just don't know how you can justify that, Senator. I appreciate your comments.
Speaker 221
1:32:08
I don't equate big with a monopoly. Exxon is not a
monopoly, neither is CBS. Neither is Neither are any of these companies at one time. Standard Oil was, but that was two centuries ago, and we got, we got it cleaned up. We changed the law. We enforced the law. All we're saying is there are laws in place that are adequate to To discipline or, or put out of business. Anybody who is so egregiously against or violating these laws. The laws are there. Enforce them.
Senator Mark Johnson
Unverified
1:32:47
I, I, I think that's where we, you and I can agree on a point to disagree because AID, I don't think has all the tools they need and in committee before I have likened this issue to the old game of whack a mole. If you whack them over here, they're going to pop up in another manner, and when you're $1 trillion industry, you've got all the research you do to figure out where to make the mold
pop up again. So anyway, thank you for your testimony. Thank you, Senator Senator Boyden.
Senator Clarke Tucker
Unverified
1:33:18
Thank you, Mr. Chair. Mr. Zuck, thank you
for being here today and expressing the opinion of, I guess some of your members. I don't know if it's
Senator Clarke Tucker
Unverified
1:33:27
all of them or not, but you had mentioned that this bill, you know, it affected consumer choice, so I guess my question is when the company directs people, certain directions, gives them financial incentives. Does that feel like consumer choice, or does that feel like somebody's taking control, taking the reins, and telling someone where to go. And
Speaker 233
1:33:48
well, I mean, a consumer can always find an
alternative consumer could say, hey, I'm gonna just not worry about the insurance that I've paid for, and I'm just gonna go pay more, not my copay or co-insurance. Well, part
Speaker 229
1:34:02
of what we're, what part of what's got me here at the end of this
Speaker 221
1:34:08
table taking the potshots is the fact that um our many of our employers use PBMs to minimize their drug costs. They are happy with that contractual arrangement. They
get value for the money they pay to those PBMs, and this would do away, this would constrain or eliminate that possibility for many of our most successful companies who
Senator Clarke Tucker
Unverified
1:34:32
use them. So, On that front, are you familiar with how Johnson and Johnson is employees are suing Johnson and Johnson and how
Wells Fargo employees are suing Wells Fargo for failing a fiduciary for arguably Fidel, you know, not failing to fulfill a fiduciary
obligation in managing drug costs? No, not familiar with either case. OK, well, maybe you should do that then.
Senator Clarke Tucker
Unverified
1:34:58
You had mentioned that we were picking winners and losers, I guess my question is, is if we gave this industry over here, a tax cut, but not this industry. Would that not be government picking winners and losers.
Speaker 221
1:35:12
It's they're there becomes very subtle nuanced definitions of winners and losers. This to me is a clear one and to us. So if
a taxpayer were paying 19,000 or $19,200 at the PBM owned pharmacy that the PBM directed them to versus 97
Senator Clarke Tucker
Unverified
1:35:31
at the local pharmacy. Who, who is picking the winners and losers in that, that front. I'd be really interested in
Speaker 221
1:35:37
the particulars on that because it, it is an out. outrageous set of numbers. Well, it's in
Senator Clarke Tucker
Unverified
1:35:43
a federal trade commission report. Thank you. Thank you, Senator
Senator Reginald Murdock
Unverified
1:35:48
Murdoch. Thank you, Chair. Um, thank you, Mr. Zuck, for being here. Uh, so if
In a report I have and I want to verify this, but I want to ask you a question. If I can verify for you that The PBMs are in violation and they have about $1.6 million or so dollars in claims now that's being reviewed and dealt with with you then change your position based upon you're saying they're compliant. That's a big you're saying they're playing the game right. That's what we've done. We're not trying to deal with business making money, not making money.
The chamber and others deal with that. What we're trying to deal with is making sure that our constituents at the end of the day are treated fairly. And even those that do business in Arkansas, so we kind of have something together here that we're trying to help with from a legislative standpoint policymaking standpoint, but if that is True that they are not compliant to the tune which I which I know this now and here's the thing that makes a lot of sense to Senator Johnson mentioned to
you. We're dealing with a $1 trillion baby. And a 1.65 million, probably 10 million even fine may not even matter to them. They may just laugh at what we have here. What I want to do, chair, if I can, I want
to get AID to the table for a second. Because I want to
Speaker 229
1:37:18
verify what I'm saying. I in those cases, you know, maybe it's suspending the license revoke the license. Anybody from the insurance department here?
Senator Reginald Murdock
Unverified
1:37:32
Wow. Really? You would think, right, that's a whole other conversation but um so I was going, I like to verify what I'm saying to you, and I was going to because it's with them, but. That being what what it says, we're, we're, we're clearly here and we've been here many times before and I don't know that I've seen you at the end of the table like this before, but
we've been here many times before in this situation. Simply trying to provide policy to make it right for how business is done in Arkansas and and at the end of the day to send the boy's point, when you say when you can just choose someone else. Many times in business one of the common things we do is in competition, just choose someone else. But in this it's a little different when it's that medicine, uh, prescription that they can only get through a system called insurance and
there's a copay and this is inside of a system and it gets kind of complex and then they can't just go out of market and spend those independent dollars out of their pocket where they've already paid insurance premiums so that other option Mr. Zuck is not as easy as if I choose Burger King over McDonald's. It's just a little different in this situation, but really what I wanted to do was deal with that compliance piece that you had mentioned, but uh my insurance department is
not here, so I can't really verify that. Thank you. Thank you.
Speaker 221
1:39:05
Look, we, we as an organization are fully aligned with what you're describing. We want people to play by the rules, but we're, our view in this case is there are rules in place to enforce them. Don't, don't say that this business model is suddenly verboten and kick them out. They're not a monopoly officially. You know. All right, Senator Irvin. Does the state of Arkansas
Senator Missy Irvin
Unverified
1:39:35
determine who's a monopoly and who's not. No. Is
there any federally, is there any designation that we have that is made it through any type of authority that designates these as monopolies at the federal level or at the state level. None that I'm aware of. Anybody else that can answer that question would be happy to have them come to the table. Last question is, many of the independent pharmacists that are in this, um, room are vertically
vertically integrated. it themselves. They own or own pieces of several pharmacies all across the state of Arkansas. That is that not vertical integration?
Speaker 233
1:40:20
Well, technically not vertical integration vertical
Speaker 221
1:40:22
integration would be like a a company in, in one business buying its suppliers and owning its suppliers or likewise buying its
Senator Missy Irvin
Unverified
1:40:36
Walmart owning a bank or that's vertical or a
pharmacy or optometry. So, so that's the vertical integration. And then also I know that from our last report, we've actually increased independent pharmacies in the state of Arkansas, and I, I wish somebody would be able to answer that question for me because I, it's my understanding that, uh, independent pharmacies have increased in the state of Arkansas, and, and, and then, and we've had people testify in this committee that have opened
up brand new pharmacies, uh, as well. So I need to understand. I need to understand that, I think a little bit better, and I'm not sure if they're members of the state Chamber of Commerce or not, or if you have any data or information
Speaker 233
1:41:22
on that, but none that I know of. Well, so I'm
Speaker 221
1:41:27
not, I'm not just not familiar with them. I'm, I'm aware of pharmacies that have opened as well, but I'm not here to Cook that kettle of fish. OK,
Speaker 253
1:41:36
thank you. Thank you, seeing no other questions.
Chair
Unverified
1:41:42
Appreciate your testimony. Thank you, Mr. Chairman. Have a with Navitus. Sharon. Introduce yourself and your recognized. Thank you, Sharon
Speaker 254
1:41:59
Faust. I'm here with Navitae Solutions, Transparent pass-through PBM, not one of the big three that we're talking about, but a PBM nonetheless. I'm a pharmacist. I've spent a lot of my time in in community
settings, mental health, hospice, health systems and and in PBM. I want to talk a little bit about this bill and how it's not actually addressing what we're talking about. We're talking about reimbursement, access, and choice. And my concern is that this reduces the access and the choice of members, has an impact on our overall costs. We want to support pharmacies of all kinds. they're affiliated or not affiliated. We want to make sure that everybody has a fair chance
to have a pharmacy in the state and that that includes access. We've talked a lot about the access issues that that have arisen. Military members, well, yes, a majority of them are all over the country. They may travel. They have Tricare and Express Scripts. They, they also um have access to special programs at some of these pharmacies, which includes includes freedom
fertility's low or discounted fertility products for them. So the access is not just the pharmacies, it's the programs that Arkansas residents would have access to. Well that's free drug, uh, free drug access for low income, whether it's Rogovi or weight loss direct to consumer through Humana pharmacy. There's all sorts of choices and options out there that Arkansas residents would lose access to. We support our local businesses and want to make sure that all
of these employees back here have the ability to continue to operate in the state, uh, and that, and that we can really support that patient disruption is a huge issue. We talked about independent pharmacies reducing. If we reduce another Upwards of 60 pharmacies, all of those patients will be displaced. A lot of Arkansas members will have access issues. I want to talk a little bit about monopoly, not being one of
the big three PBMs, um, CVS, for example, in a recent drug channels Institute has 25% of the market, which means that a CVS retail pharmacy would need to negotiate for the other 75% and negotiate against their biggest competitors. So It is, it is not, not a monopoly. Yes, there are 3 major companies, but there are 66 PBMs in the country. One of those being Kroger prescription plans. I've heard
today that Kroger would still be Tricare members will still be able to to access Kroger. So Kroger must be a winner. Uh, versus other losers in this bill. I just want to very strongly access or state that the mental health with Genoa pharmacies being removed out of our out of the mental health facilities
would would have access issues for those patients. There are specific programs set up in that. I spent a lot of my time early in my pharmacy career in that area. And, um, and now those are important for military nonmilitary members alike. Ultimately, when we talk about specialty pharmacy, there is a CMS definition. It's over $900 unique route of administration and special handling those pharmacies help, help.
Clients and employers lower costs. Ultimately, we want to support all employers, whether they're pharmacy or non nonpharmacy alike. And so that's why we're here today, urging you to vote no on this bill. Senator Boyd.
Speaker 144
1:46:09
Senator Urban Senator Irvin. Thank you. Thank you. Thank you,
Mr. Chair. So, um, you, you mentioned
transparency. Does that mean you'd be willing to open your books to employee
Speaker 254
1:46:29
benefits division and let them see what's going on in there. Yeah, we, we actually passed through direct to the client. So what the pharmacy is being paid is exactly what the what the client is
being charged. So so then you can verify then at the table that Gina Pharmacy is paid significantly more than other community
pharmacies for the same product and explain to us why that makes sense for Arkansas taxpayers. I don't know
Speaker 254
1:46:53
that specific. You said Genoa. Um, I don't know why that specific pharmacy or what the rate at that pharmacy is compared to others likely has to do with some of the the handling that they have, but I don't know the exact rates. OK,
but you can't confirm that they are paid more because you think they can do something that other pharmacies can't, and that's good for Arkansas taxpayers. I cannot confirm if they're paid
Speaker 254
1:47:15
more or if they're paid less. I cannot confirm that because I don't have the information in front of me. Will you get the
information and get it back to me. Thank
Speaker 53
1:47:31
you. Yeah, our networks are transparent. Any other questions? See none. Thank you for your testimony. Next we have Ashley Ellis, uh, Ms. Ellis, you have 7 minutes and 35 seconds. OK, thank you for the
Speaker 266
1:47:54
opportunity to speak today. My name is Ashley Ellis and I serve as district leader for CVS Pharmacy. I live in Greenbrier and I work out of Conway supporting pharmacies across 23 CVS pharmacies across Arkansas. I've been with CVS Health for 10 years, but my roots in Arkansas are much deeper. I have lived here my whole life and I'm a proud graduate of the UCA and UAMS, where I studied pharmacy. I'm here today to express my deep concerns about House Bill
1150 and the devastating impact it will have not only on me and my colleagues, but on the patients we serve every day. Let me be clear, if this bill passes, I will lose my job. It will also cost hundreds of colleagues their jobs. Pharmacists and pharmacy staff who live and work in communities across Arkansas. Some of those folks are here with me across the room today. We are not just professionals behind the counter. We are your
neighbors, friends and family members. We're deeply embedded in the fabric of the communities we serve, providing care and guidance to 340,000 Arkansans who rely on us every year. This bill doesn't just threaten our livelihoods. It threatens the health and well-being of our patients. It will disrupt the trusted relationships that patients have built with their pharmacist over years. Relationships that are critical to ensuring safe, effective care. These are not relationships that can be built overnight.
I've seen firsthand how vital these connections are. As a pharmacist, I've been there for patients when they needed it most, like the ones who come in late on a Thursday or early on a Saturday because they need care when no one else is available. This bill will strip away that access, leaving patients with fewer options and longer wait times. It will disrupt their care, interrupt their medications, and put their health at risk. Over the past few days, we have had a groundswell of support from our CVS pharmacy patients.
Please don't take their choice in pharmacy away. For me this is personal. My journey to become a pharmacist was inspired by my grandfather who struggled with Parkinson's disease. I saw how hard it was for my family to navigate his care and how much we needed someone to guide us to the confusion and fear. That experience drives me to help others every day, providing not just prescriptions but medication therapy management, counseling and support for those facing similar challenges. This
bill takes that away. It will For patients to stand in longer lines at fewer pharmacies. And it will leave them without the trusted pharmacists that they've come to rely on. I came to Arkansas. I came to Little Rock today because I care deeply about my patients, my colleagues and my community. I want to go back to doing the work that I love helping people live healthier, better lives. Today I urge you to vote no on HB 1150. I'm asking you to
consider the real human cost of this legislation. I'm asking you to think about the patients who will suffer, the communities that will be disrupted and the hundreds of Arkansans, including myself and again those here in this room with me. Thank you, and I'm happy to answer any questions. Thank you, Senator Irvin. So
Senator Missy Irvin
Unverified
1:51:20
if I vote for this bill, you're going to lose your job. Yes, ma'am.
Speaker 266
1:51:30
Me and all of these folks that are here in the room with me and
Senator Missy Irvin
Unverified
1:51:35
hundreds more across the state. Can they stand, please, just because we may not
have time for them to speak. So what we have are employees versus Independent pharmacy owners. Is that what we have here? Because y'all are pharmacists. Yes, ma'am.
All right, so again, if I vote for this bill, not just you, but everybody standing up is
Speaker 266
1:52:07
going to lose their job. Yes, and the 100 more that are still serving in their communities
Senator Missy Irvin
Unverified
1:52:11
as we speak. Well, I want to say That you're very
brave to come and I appreciate You being a pharmacist, telling us your story and being here. Thank you. Thank you. Senator Boyd, thank you. I,
Senator Clarke Tucker
Unverified
1:52:27
I appreciate you being here. I know this is emotional. I, I acknowledge
that, but it's also public testimony and sometimes we have to ask hard questions. It's not directed at you directly. So I just, we say that all these people are going to lose jobs, but I just want to ask, are you familiar with the public quote by David Joyner, CEO of Savis Health, that says, I think today you would argue that there are more pharmacies than we probably need. No, OK, thank you. All right, any other questions?
Speaker 36
1:53:04
Seeing none, thank you for your testimony. All right. Next we have Priscilla Griffin.
Dawood Rassam
Unverified
1:53:19
Miss Griffin, you have 4 minutes and 12 seconds. Just introduce yourself and your records. Thank you. My
Priscilla Griffin
Unverified
1:53:26
name is Priscilla Griffin, and I'm the general manager of Omnicare Pharmacy of Little Rock.
I really appreciate the opportunity to testify today. I am the general manager for the Omnicare facility in Little Rock, and I have lived in Arkansas for 6 years. And I currently reside in Bologna. I came here today to ask you to sincerely to vote no on this legislation because of its potential impact on long-term care residents in Arkansas. Long-term care residents are by definition, medically fragile.
They cannot live independently because of chronic conditions. Or a disability, but with care they can live vibrant and healthy lives. Long-term care residents are not just seniors, they are all ages. And they come to long-term care for many reasons. They may be your parents, your siblings, or your children. Omnicare provides essential medication dispensing pharmacists consulting and clinical education services to the long-term care facilities
that serve these patients. We provide an incredibly broad range of services to these facilities and their patients. We provide care for long-term care residents through prescription optimization and clinical programs supporting fall prevention, antipsychotic reduction, polypharmacy, infusion support and nursing education. We also provide 24/7 support for long-term care facilities, including personalized delivery of
medications from my our team and access to providers who specialize in the conditions that these long term care residents are facing. Much of the testimony today has focused on retail pharmacies, providing relatively common maintenance drugs. I understand this is how most commonly interact with pharmacy, however, I urge the committee to consider that House Bill 1150 will have enormous consequences across the health care system that you may
not be taking fully into account, especially for specialized long-term care pharmacies who will face enormous upheaval. If we are forced to cease operations, our long term care partners will be left without a pharmacy that is able to meet their specific needs, jeopardizing the care that their residents receive because long-term care residents need round the clock care in many cases, any disruption to care will have immediate and serious risk for their care. I came here
today because I care about the work that we do. Many long-term care patients cannot advocate for themselves. And they are vulnerable, but they are the ones who will pay a price if the legislation passes. There is still time to pump the brakes on this legislation and to better understand the chaos and damage it will cause in health care and Arkansas. We are asking you to do that on behalf of the patients that we support. So please consider the voices of Arkansas long-term care providers, the families we serve
and the patients who depend on us. We urge you to vote no on House Bill 11. 50 and work with us to find alternative solutions to strengthen care in our state. Thank you. Any
Chair
Unverified
1:56:55
questions? See none, thank you for your testimony. We have one more.
Dawood Rassam
Unverified
1:57:04
Thank you. We have one more to speak against the bill. It is uh Vincent Fayette.
Speaker 283
1:57:15
You have 43 seconds. Thanks everyone. Thank you. It Hi, I'm Vince Fayette. I'm director of pharmacy practice
Speaker 284
1:57:30
for Accredo Health Group. We are a specialty pharmacy, and we do oppose the House Bill 1150 due to the negative impact to Arkansas patients. We are an accredited specialty pharmacy that serves patients with rare, complex, and chronic
health conditions, including cancer, hepatitis C, HIV, bleeding disorders, and multiple sclerosis drugs are these drugs are often available through different pharmacies, but Accredo does have access to the widest list of limited and exclusive distribution drugs for specialty. We have specially trained pharmacists and nurses who take pride in delivering personalized care, providing educational information to facilitate medication adherence and manage adverse events. Thank you, sir.
Speaker 109
1:58:17
That time's up. Any questions? Senator, just,
Senator Missy Irvin
Unverified
1:58:20
just a quick question as far as your specialty pharmacy, and where are you located? We have
Speaker 284
1:58:29
locations all across the country, so I'm personally in Tennessee. I got you, OK,
Senator Missy Irvin
Unverified
1:58:35
and do you know roughly how many patients you serve in the state of Arkansas. Probably
Speaker 284
1:58:41
approximately 3000 patients, 3000 patients multiple therapies, and these are more special needs for specialty
Senator Missy Irvin
Unverified
1:58:48
drugs, OK. Thank you. Is there any other questions?
Speaker 36
1:58:52
Seeing none, uh, thank you for your testimony. Thank you for your time. All right. We've reached the
Speaker 5
1:58:59
end of the testimony, uh. You want to Senator, you close your bill.
Senator Kim Hammer
Unverified
1:59:19
Mr. Chair and members committee, I want to recognize Representative Jeremiah Moore, who is the House sponsor, lead sponsor on this in the room, but we've decided I'll just make my comments because you've heard a lot of testimony today. Um, first of all, I want to say that I sympathize with those who are fearful that they are going to lose their jobs. I'm fearful or I sympathize for those that stood a while ago. I am a
sympathetic also to those who've already lost their job. Because of where we are currently. And When I get done at the end of my points, I hope to clarify a thought on that a little bit further, but there are those who have already lost their job. I'm in a very unique position, I think. Because I represent an area that had a CVS. Pharmacy And all of a sudden one day they weren't there. I can only speculate the reason they weren't there is because
It was no longer financially beneficial to him, so they cut their losses and pulled out of town. On the other side, I can, I can, I represent. What was at the time the largest independent pharmacy, Smith Caldwell. And I'll go ahead and make a statement of fact. The reason they aren't there, the reason they had to cut a deal. Cash flow, what causes cash flow? They're getting choked out by the PBMs and exactly the subject of what we're talking about. CVS is not immune to shutting
down a store. It's not going to meet the profit margin, they're gone. On the other hand, you got Smith Caldwell, who wanted to be there, had been there for years but no longer could be there because they didn't have a choice that they couldn't be there. And the amazing thing is, you know, who picked up the slack? You know who picked up the slack. CVS just kicked out of town and when Smith Caldwell didn't have a choice, you know, who picked up the slack. Local pharmacies And I would even give credit to Walgreen.
I didn't give credit to hearts. I give credit to Walmart. I give a lion's share credit to the independent pharmacies. When corporate PBM pulled out. Who picked up the slack. The ones that were still there who got the jobs that were left. Local pharmacies. And the ones that stay committed to their area. On the other hand, there were many that stood up, or, well, actually there were many that signed up, but what did they do? They yielded their time.
Probably because a lot of what needed to be said. was said, but their presence also speaks volumes just by the fact they yielded their time. They're the ones who've taken time and probably like a lot of these pharmacists from CVS that stood up. I want to give them credit too. Probably a lot of them have taken out of their time, have had to pay people. are taking vacation time in order to be here in order to weigh in on this very important subject. Who, who did the PBM send? Who have they sent?
Who's put up the money on the billboards, who's put up the money on all the emails. She's put up all that money. Concerning about CBS going out of business. Is anyone also concerned about the nest loss of the pharmacies that we've already experienced in this state. If you look, Yes sir, are some pharmacies that have expanded. Why they expanded, they had to pick up the slack of the ones that could no longer make it. They had to pick up the slacks of the one they had to pick up the slack of the ones that
donate. To your yearbooks to buy ads in the sports programs that make donations back into the local community. Good luck getting that out of the big PBMs. Has been established the current laws are being broken. I want you to let that sink in for a minute. Why are we even debating that? Why does our insurance department have to invest the resources and probably don't have the resources necessary to do what they need to do, but they're limited on the resources that they have. So let's give
them more resources. Let's take more tax dollars and let's beef up the insurance part. Why? So we can accommodate what has already been established in this committee today that the laws are being broken, so we're going to reward them by letting them stay in business. And as was mentioned, a million against 1 trillion. I take those bets any day. I'd take that leverage any day. I'd take those averages every day. When we got local pharmacies and other pharmacies. that are struggling with hundreds of dollars and thousands, and we're not talking millions or trillions.
Using the government. To allow one side to take preference over another side. That's not new news. That's already happening. That's already happening. In fact, one of the comments that was made in response to the question about standard and Exxon, we've got to clean it up, change the laws. That's how it was fixed then. Why can't it be used to fix it now? Where's the double standard? We acknowledge that we have to
fix that. We acknowledge that that was a manipulation a monopoly. Well I almost hesitate from using this phrase if it walks like a duck, it quacks like a duck. Sounds like a duck. It's a duck. Bottom line We got to use the law, so we want to use the law to do that, but we don't want to use the law to fix this. Congress is pursuing this issue. Why? Because states like Arkansas are not sitting on the sideline and being quiet about
it. Congress. is involved in this discussion. Well, let's sit back and wait for Congress. Like sit back and wait for the Lord to come. It ain't going to happen soon enough. And you know, and I I think about all these conversations and there's people who have spoken on both sides of the bill. Long term care have spoken on both sides of the bill. Employees who are going to lose their jobs spoken on both sides of the bill.
Mental health providers have spoken on both sides of the bill, specialties spoken. And I, and I just, I guess I bring it down to this, and I'll close with this thought. The question I've got is this. Why would a PBM who owns a pharmacy pull out of Arkansas. If this law passes. Why? Why would a PBM pull out of Arkansas? if this law passes, and I'm like
you, I'm tired of this. I'm, hey, this is my last legislative, you know, session as far as the general session been involved in fighting this for I can't remember how long, and I always use the analogy it's like a chess game. You use whac amo. I use chess because chess is a is a long played game. A few pawns have been taken off the table a few nights have been taken off the table. A few castles have been taken off the table. It's a, it's a long process and it's getting down to the point of a check and a checkmate.
The question is who's going to be the checkmate. It's going to be the Pharmacy deserts because the local pharmacies have gone out of business. Who is it? Who is it going to be? Go back to that last nagging question. Why would a PBM Who owns a pharmacy, pull out of Arkansas if this law passes, and I've come down to just two answers. PBMs would only go out of business. If they paid themselves.
The same prices that they are currently paying pharmacies that have either gone out of business or are going out of business. Second thing I thought is the cash cow is dried up because they have play. The cash cows dried up. Because they have to play by the same rules. As they will have to go and they will have to go to other states. that have not been as aggressive as Arkansas.
Only two answers that I boiled it down to. They won't go out of business. If they want to argue these local pharmacies and the Walmart pharmacies and the heart pharmacies and the Kroger Pharmacy shouldn't be going out of business. Because they get paid adequately, fine, put your money where your mouth is. Prove it. Start paying yourself like you're paying these others, and there will be no reason to fire the CVS employees behind me. There'll be no reason for these employees to lose their jobs.
Why would they lose their jobs if what the PBM is saying that these independent and all these other pharmacies are ought to be able to survive by if they're not willing to pay their self the same thing. It's a lie Straight up lie if they pull out of the state of Arkansas. If they pull out of the state of Arkans, and by the way, We're talking about 3. Some mentioned 66. Just like these other pharmacies had to pick up the slack. When people like CVS, and I'm not talking about these
employees. I am not talking about these employees. These are our citizens too, and I'll be it's gut wrenching to sit right here. I promise you that. But if CBS decides to pull out. We do have other PBMs that are good PABMs. This one's just going to separate the good from the bad, and if they start pulling out, we'll know who the bad ones are. With that, I'll close and appreciate a good vote. Thank you, Senator. What's the
Speaker 5
2:09:16
will of the committee? Motion by Senator
Speaker 36
2:09:19
Johnson, second by Senator Penzo discussion. I appreciate the passion with
Senator Missy Irvin
Unverified
2:09:26
which Senator Hammer speaks about this, and I could talk about, I could talk about the community mental health centers that are going to be affected by this in the 70,000 Arkansas mental health patients that are going to be affected by this, an amendment was offered, it was rejected.
To, to assist with those 70,000 Arkansas mental health patients. An amendment was offered and it was rejected. I don't understand why it was rejected, but it was. So those 70,000 Arkansas mental health patients weren't worth it, or we would have amended the bill. The veteran that talked to me and texted me, he's not worth having an amendment for him or all the other veterans.
They weren't worth it either. So I could talk about that. There is, there's no There is absolutely no Federal designation that this is a monopoly. I
get that we don't like it, but some would argue that independent pharmacies are also vertically
integrated with their PSAOs. I don't know enough about that to even talk about that subject. But These things happen within the business world.
That's what happens. I, I cannot go on just what an opinion is. And for me to say,
if this bill fails, you still have your job if you're my constituent. But if this bill passes, that constituent of mine at the end of the table loses her job. So again, if the bill fails, my constituent still has a job.
But if I, if the bill passes, my constituent at the end of the table who's also a pharmacist, loses her job. I just want y'all as a profession to understand the position that you've put her in, not me. My vote's gonna be real clear. Because if I vote for the bill, she loses her job. If I don't vote for the bill, the bill still passes. Y'all don't lose your jobs. And I would argue that you
wouldn't because y'all have all I I I know many, many, many people that are in this industry that our small business owners outside of this, they own a lot of other small businesses. That they
that they have diverted all of their money and investments in. They're going to be just fine. And so I, I, I, I cannot be
in this position and vote for a piece of legislation that is
against what I believe in in my principles and my values about what government is and what the role of government is, and I would argue what Senator Johnson
was talking about the Constitution. OK, yes, but there's nobody actually designated as a monopoly, so you cannot hold somebody to a standard that's in our Arkansas const itu tion that's just based on your opinion, it has to be documented and it's not, and so I appreciate all the arguments,
but you've put me in a horrible situation. And
so I have no other choice but to vote no on this bill because my constituent's going to lose her job that she testified for and I'm not going to sit here and let anybody call her a liar. That's not appropriate. She was honest. She was passionate. And she is advocating for
her livelihood. And so therefore, I have to be a no on this bill.
Speaker 5
2:13:29
Thank you, Senator. We have a motion in a second. We're past. Thank you. All in favor, say Aye. All opposed? Black sign. All right. Thank you, Senator. You passed your bill. All right,
Speaker 64
2:13:49
we got 2 bills before we adjourn, Senator Payton.
Speaker 285
2:13:59
Representative still here. You're on
Speaker 263
2:14:05
your own, buddy. Yeah, she, it's a 1847.
Senator John Payton
Unverified
2:14:16
John Payton, state Senate District 22. All right. House Bill 1847, you have
Chair
Unverified
2:14:24
an amendment motion by Senator McKee on the adopt the amendment
seconded by Senator Boyd. All in favor say aye. I opposed like son.
Senator John Payton
Unverified
2:14:35
All right. So as a man did House bill. 1847 would create a statewide comprehensive self-exclusion list. Now, what that is is in the gambling industry, if you've heard their commercials, they always have to advertise at the end, call this number if you have a problem. Well, one thing that a person with a gambling problem can do is ask the casino
or or gambling establishment to exclude them, put them on a list and, and not do business with them. This allows that to become a statewide thing where it's self-exclusion. The person does it on their own accord. They asked to be put on the list so that when they have a weak moment and they show up at a casino or something, they'll be turned away. It's already being done on a one by one basis from what I understand, but this would allow, allow us to establish and keep a statewide list, and it's all voluntary,
and I think the uh gambling commission is here or I was told that they're here. If you uh In support and there's no known opposition. I'm sorry, I can't give you a more clear definition. I was dependent on Representative Michael Lindon to be here. Is there any questions, Senator Murdoch?
Speaker 299
2:15:46
Yeah, so you said they can do it one by one on one now, but this list makes it be for all the casinos, so what
Senator John Payton
Unverified
2:15:56
I understand is right now you have to go to each casino in person to ask to be on
the self-exclusion list. This would allow it to just To be done and be
Senator Reginald Murdock
Unverified
2:16:10
a statewide list. What if you only wanted to be for that casino does does you signing up for for Saracen mean that sovereign and what's the other one?
Senator John Payton
Unverified
2:16:19
Oh, this, this is done for people with a gambling addiction that have self-identified as having a gambling problem, so I don't know that they would want to do just one. I would assume that it could be, uh, elected
that way, but I don't know because We might get asked to if they're still here. I think that's the point because they made a gambling commission still here? And I'm really on my own here. I don't know. The, the short answer is I don't know. I mean, I would think that would be something that, that would be easily done in the uh rules and rigs when they establish it. You know the questions.
Chair
Unverified
2:17:07
Seeing none, there's no one to testify for against the bill, uh, you want to close I'm closed. Thank you. What's the real motion by Senator Johnson motion to as amended by Senator Johnson, second by Senator McKee, any discussion. All in favor say aye. I opposed like sign. Thank you, Senator, for being patient. Thank you. Mary.
Representative Mary Bentley
Unverified
2:17:46
Your bill, uh, is 1826 House Bill 1826, very simple bill. All right, just you, you recognized
Speaker 70
2:17:54
and thank you, Chairman. Thank you committee. State Representative Mary Bentley
Representative Mary Bentley
Unverified
2:17:57
from District 54. This is a simple bill to allow for insurance
coverage for birthing centers, um, right now we have no birthing centers in our so one of the very few states that have now but licensed birthing centers in the state of Arkansas licensed to the Department of Health will get coverage for delivering a child just like a hospital will,
so we used to have a birthing center in Northwest Arkansas, but because we didn't have any, uh, this bill passed, they weren't able to get any insurance coverage in the birthing center closed. So now those women in Northwest Arkansas are traveling to Missouri because they would like to have their birth with a certified nurse midwife or a physician and a birthing center instead of at the hospital, so they're traveling out of state to get this coverage. It simply asks that when a delivery standing a birthing center that they will get insurance coverage. We know that Arkansas So right now only 50 of our counties have a place for women
to give birth and then um states across the nation, small hospitals are opening up birthing centers instead of a labor delivery unit much cheaper and easier for them to run is this a way for us to allow more deliveries with positions and certified nurse midwives and a birthing center, so very simple bill. I'll be happy to take questions on this. Thank you, Representative in an emergency situation, you
Speaker 53
2:19:05
can give birth anywhere, right? Yes, sir. You can do it in
Representative Mary Bentley
Unverified
2:19:07
a barn, I guess if it happens there you, Senator Irvin. Just checking to see if you discussed this bill with anybody
in the insurance, are they OK with this? They're saying I've not had anybody come to speak at all in the house and no one's
Senator Missy Irvin
Unverified
2:19:26
I've not seen any opposition from anybody at all on this
Representative Mary Bentley
Unverified
2:19:29
bill. Are the birthing centers, are they licensed? Are they, there's a Department of Health, yes, through the Department of this whole go for them to be licensed with with licensed staff with certified nurse midwives, not just lay
Senator Missy Irvin
Unverified
2:19:39
midwives, very much, yes, OK, and then, yeah, and so they meet all the quality measures that are are required by the Department of Health. To
be licensed. Therefore, yes, yes, OK, thank you. Motion to pass.
Chair
Unverified
2:19:53
Bill, motion by Senator Ervin, seconded by Senator Boyd in your discussion all in favor. Say aye.
Speaker 1
2:19:59
I oppose like sign thank you for being
Representative Mary Bentley
Unverified
2:20:02
patient. Thank you, Chairman. Thank you. We're all working together on this. I appreciate you.
Speaker 1
2:20:10
I can do 1850, 18 Sen Senator Irvin has a couple and then representative. Makes uh, Senator Irvin, which one do you want to do first?
Senator Missy Irvin
Unverified
2:20:25
Um, well, I mean, Representative Minx is here,
Speaker 63
2:20:32
so let's do his first. All right, is that is
Senator Missy Irvin
Unverified
2:20:35
that 1957 or it is, um, I can be the Senate sponsor if we need to, Jane.
Speaker 1
2:20:42
Jane is on it, so. We have an amendment. Oh yeah, yeah, yeah, 1957. Yeah, the amendment
Chair
Unverified
2:20:52
just add Senators on motion by Senator McKee's second by Senator
Dawood Rassam
Unverified
2:20:57
Johnson to adopt the amendment. All in favor say aye. All oppose likeson are at is amended uh, go ahead with the bill. Alright,
Representative Stephen Meeks
Unverified
2:21:06
thank you, senators, and I appreciate Senator Ervin helped me on this one. So colleagues, if you remember back in the early days of the internet, you'd get home and you dial up the internet, you'd hear the whirls and beeps and all that, and then eventually you got those 3 magical words you've got mail. Remember how exciting that was, right? Well, of course, in today's day and age, trying to go through all your emails is a
is a burden a lot of times and so what the genesis of this bill was a couple of months ago, I got an unsolicited commercial text message, and my fear is if we're not careful what's going to end up happening is our text messages are basically going to become the same thing or we're gonna get so much dumped on us through texting that it's going to become overly burden burdensome and cumbersome. Um, right now in Arkansas law, it is currently against the law for whatever good it does. It is currently against the law to get unsolicited commercial emails
and sexting emails and so all I'm basically doing with this is I'm adding texting to that provision that says it is against the law to receive unsolicited commercial text messages and unsolicited sexual text messages, uh, authorized commercial text messages that do come to you. be, it must be clear where they're coming from, and they must offer an opt out for it and I think that's pretty industry standard, so that's what it does.
Speaker 315
2:22:31
Any questions, Senator, Senator McGee? What about political texts because we
Speaker 316
2:22:38
could get rid of those too. Hey, I'm right here. It's not included, but I would be welcome
Speaker 126
2:22:43
to that some, yeah, right, Senator Johnson Senator John. Go ahead, Senator
Speaker 5
2:22:49
Johnson. All right. All right, uh, any other questions saying none, you want to close your bill? Yeah, I'm close
Chair
Unverified
2:22:58
and appreciate a good motion by Senator Johnson, second Senator
Ervin, all in favor. Say aye.
Speaker 53
2:23:04
All opposed like sign thank you for being patient. Do pass as
Senator Missy Irvin
Unverified
2:23:14
amended it was. All right, Senator Senator Missy Urban District 20 what are we on? Let's do 1850.
Speaker 1
2:23:21
OK, 1850. Yeah. 150, you're recognized, we know who you are. Thank you Representative Johnson's done a
Senator Missy Irvin
Unverified
2:23:33
lot of work with uh making sure that we have ambulance services, uh, that they can get paid and so what this does is clarify the minimum, um, Thank you. Um, both of these, it's to correct a code revision error that was created when we passed the bill's last session dealing with the in-network and out of network reimbursement rates to the ambulance providers, and 1850 removes the reference to workers' comp rates and sets a minimum reimbursement
rate at 325% of the Medicare rule rate or the providers bill charges if the provider does not have rates that have been adopted by city or county ordinances. The 325% rate has been negotiated with the primary insurance providers in the state. Is there any questions? Senator McKee. So
Senator Matt McKee
Unverified
2:24:24
I was looking, I was looking for the language that you discussed about city and county. Contracts
Speaker 320
2:24:33
Was that not, that's not in the bill, right? Ma, is there any effect?
Speaker 322
2:24:48
It's on, it's on line 31. shall be at the rates approved or contracted this doesn't affect their rights. Thank you. Any other
Speaker 36
2:24:52
questions? So no there's, I have no one signed up to speak for or against the bill. You want to close your bill. I'm closed. I motion by Senator Ervin,
Chair
Unverified
2:25:04
seconded by Senator Boyd, any discussion, all
Speaker 1
2:25:08
in favor say aye. All opposed like sign thank you Senator Irvin, what is your next bill? 1863. 186363. All right. Just, uh, you're recognized.
Senator Missy Irvin
Unverified
2:25:25
So 1863 just requires the Arkansas Ambulance Association to be responsible for gathering the rates that
are contracted by ordinances, keeping it updated
and providing it to the Arkansas Insurance department, so that will be readily available to all insurers. Any questions? Seeing none, you want to
close your bill? I'm closed. I'll make a
Chair
Unverified
2:25:52
motion to pass. Motion by Senator Irvin, seconded by Senator Boyd. Any discussion saying none at all in favor. Say aye. All pose like sand. All right, thank you
was 1863. What do you got 1320 1320. Senator Justin Boyd, with your permission here to present
Senator Clarke Tucker
Unverified
2:26:27
House Bill 1320 for Clark Tuck Senator Tucker. You're recognized so literally what this bill does is it adds crisis stabilization units to the any willing provider list.
Speaker 5
2:26:39
And there is no expected fiscal impact for EBD. All right. Is there any questions? Seeing that I have no
Chair
Unverified
2:26:49
one to speak for against the bill. Anybody here to speak for or against
the bill saying that I'll close your bill. I'm closed. I'll make
Chair
Unverified
2:26:55
a motion do pass and would appreciate a second motion and a second by Senator Johnson, all in favor say aye. All opposed like sign. I think that'll do us for today. We're not coming back this afternoon if we need need to
Speaker 64
2:27:09
anybody, any other business would be thirsty. Thank you. We're adjourned. Thank you.
Agenda
REGULAR AGENDA
Call To Order
HB1320 Wooldridge TO AMEND THE LAW CONCERNING CRISIS STABILIZATION UNITS AND HEALTHCARE INSURERS.
HB1290 L. Johnson TO MANDATE COVERAGE FOR MENTAL HEALTH WELLNESS EXAMINATIONS; AND TO ESTABLISH THE ARKANSAS SUPPORT OF MENTAL HEALTH WELLNESS EXAMINATIONS ACT.
HB1735 Eaves TO AMEND THE ARKANSAS UNDERGROUND FACILITIES DAMAGE PREVENTION ACT; AND TO REVISE MEMBERSHIP IN THE ONE CALL CENTER UNDER THE ARKANSAS UNDERGROUND FACILITIES DAMAGE PREVENTION ACT.
HB1826 Bentley TO MANDATE COVERAGE FOR DELIVERY OF A NEWBORN IN A LICENSED BIRTHING CENTER.
SB621 Irvin TO CLARIFY ENFORCEMENT PROVISIONS AGAINST A HEALTHCARE INSURER; TO RETROACTIVELY APPLY TO A HEALTHCARE CONTRACT FOR THE BENEFIT OF A TEMPORARY HOSPITAL FACILITY; AND TO DECLARE AN EMERGENCY.
SB626 Irvin TO REQUIRE FAIR AND TRANSPARENT REIMBURSEMENT RATES; TO ENSURE PARITY OF HEALTHCARE SERVICES; TO AMEND THE BILLING IN THE BEST INTEREST OF PATIENTS ACT; AND TO DECLARE AN EMERGENCY.
HB1150 J. Moore TO PROHIBIT A PHARMACY BENEFITS MANAGER FROM OBTAINING CERTAIN PHARMACY PERMITS.
HB1572 Ladyman TO CREATE A TECHNICAL FEASIBILITY STUDY ON NEW NUCLEAR ENERGY GENERATION; AND TO DECLARE AN EMERGENCY.
HB1847 McAlindon TO AUTHORIZE THE ARKANSAS RACING COMMISSION TO MAINTAIN A STATEWIDE SELF-EXCLUSION LIST.
HB1850 L. Johnson TO AMEND THE LAW CONCERNING GROUND AMBULANCE SERVICES; TO CLARIFY THE MINIMUM ALLOWABLE REIMBURSEMENT FOR GROUND AMBULANCE SERVICES; AND TO DECLARE AN EMERGENCY.
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.
HB1863 L. Johnson TO AMEND THE TRANSPORTATION BENEFIT MANAGER ACT; AND TO DECLARE AN EMERGENCY.
HB1942 L. Johnson TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR HOME- AND COMMUNITY-
BASED SERVICES WITHIN RISK-BASED PROVIDER ORGANIZATIONS.
HB1957 S. Meeks TO AMEND THE UNSOLICITED COMMERCIAL AND SEXUALLY EXPLICIT ELECTRONIC MAIL PREVENTION ACT TO INCLUDE UNSOLICITED COMMERCIAL AND SEXUALLY EXPLICIT TEXT MESSAGES.
DEFERRED BILLS
SB592 D. Wallace TO REQUIRE A FINANCIAL INSTITUTION TO RENEW CERTAIN CERTIFICATES OF
DEPOSIT AT THE HIGHEST INTEREST RATE CLOSEST TO THE TERM OF THE PREVIOUS CERTIFICATE OF DEPOSIT AND FOR THE SAME TERM.
Adjourn
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — INSURANCE & COMMERCE - SENATE, Apr 8, 2025 | Agenda | 2 | Official source ↗ |
Speakers
Speaker 1
Senator Missy Irvin
Unverified
Speaker 4
Speaker 7
Speaker 6
Speaker 10
Speaker 15
Speaker 17
Senator Clarke Tucker
Unverified
Senator Justin Boyd Chair
Unverified
Speaker 36
Speaker 5
Chair
Unverified
Senator Matt McKee
Unverified
Speaker 47
Dawood Rassam
Unverified
Speaker 53
Speaker 64
Senator Kim Hammer
Unverified
Speaker 78
Speaker 79
Speaker 83
John Vinson
Unverified
Speaker 88
Speaker 70
Daud Rasan
Unverified
Speaker 110
Speaker 63
Loretta Bosing
Unverified
Speaker 117
Senator Mark Johnson
Unverified
Speaker 131
Speaker 126
Speaker 137
Speaker 150
Speaker 138
Speaker 161
Speaker 157
Senator Reginald Murdock
Unverified
Speaker 173
Adam Head
Unverified
Speaker 186
Speaker 188
Speaker 77
Speaker 176
Brandy Chain
Unverified
Jason Finley
Unverified
Speaker 204
Speaker 215
Speaker 217
Speaker 221
Speaker 233
Speaker 229
Speaker 253
Speaker 254
Speaker 144
Speaker 266
Priscilla Griffin
Unverified
Speaker 283
Speaker 284
Speaker 109
Speaker 285
Speaker 263
Senator John Payton
Unverified
Speaker 299
Representative Mary Bentley
Unverified
Representative Stephen Meeks
Unverified
Speaker 315
Speaker 316
Speaker 320
Speaker 322