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 |
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Speaker 1
0:00
Senate Insurance and Commerce, come to order. Please be seated or get where you can go. Take your conversations outside. All right. Senator Irvin, Senate Bill 621. NEW
Senator Missy Irvin
Unverified
0:31
SPEAKER: SENATOR MISSY IRVIN, DISTRICT 24.
Speaker 4
0:34
NEW SPEAKER: GOOD MORNING, AND JASON HENDRIN FROM HULBOO SMITH. NEW
Speaker 7
0:42
SPEAKER: WHAT ABOUT THE NEXT GUY? NEW SPEAKER:
Speaker 6
0:46
JASON HENDRIN FROM HULBOO SMITH. NEW SPEAKER: NO, I'LL GET YOU A
Speaker 10
0:55
MIC. NEW SPEAKER: MY APOLOGIES, JASON HENDRIN
Senator Missy Irvin
Unverified
0:59
FROM HULBOO SMITH. NEW SPEAKER: ALL RIGHT. YOU'RE RECOGNIZED,
Speaker 15
1:03
SENATOR. Thank you. I'm going to turn it over and let them
Speaker 4
1:07
explain the bill. Thank you and good morning. In 2023, the legislature passed a bill to allow for ambulatory surgical centers to convert to temporary hospitals for the purposes of a 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 answer 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
of companies when a demand for a temporary hospital facility contract is made shall provide that bill and it makes it retroactive to again to recognize that the two ASEs 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 Medicaid to provide for these reimbursements and the Department of Health, excuse me, to provide for these reimbursements. Because there is no trigger
in the original bill that passed, the insurance companies have just refused to honor
Speaker 17
2:28
the law that you have passed. This bill makes it clear that they have no choice. They have to honor
Senator Missy Irvin
Unverified
2:37
the law you passed. So 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 approve this program. We followed suit, passed legislation, which was my bill, to say that when we need a temporary hospital, these 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 think Samaritan's Purse, they stood up a hospital under tents, you know, in New York because they were allowed to do this under the federal executive order and federal legislation. We passed legislation in this General Assembly with full approval to do this.
And 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
3:52
going to restate what i heard and you can confirm see we have an insurance company so there was a 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
Speaker 4
4:11
Senator McKee? I think, Mr. Chair, so this doesn't have a fiscal impact on the state? It really shouldn't at all. It really goes and just makes clear from what
Speaker 17
4:25
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. Got it.
Speaker 36
4:38
Thank you. any other questions we have one to speak for the bill i think it's jason do you want to speak for
Speaker 5
4:52
the bill mr chairman i'll defer to mr all right no one else speak for against the bill you want to close your
Senator Missy Irvin
Unverified
5:04
bill thank you i'm closed
Chair
Unverified
5:06
i make a motion do pass motion by senator ervin Second by Senator Boyd. Any discussion? All in favor say aye. Aye. All opposed, like sign. Thank you, Senator. You passed
Senator Missy Irvin
Unverified
5:21
your bill. Thank you. 626 is in the process
Chair
Unverified
5:24
of being amended. All right. Thank you, Senator. We're going to go to House Bill 1572.
Senator Matt McKee
Unverified
5:40
1572 You ready? You ready? No Thank you, 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
6:36
I'd be happy to take any questions. All right, Senator Boyden.
Senator Clarke Tucker
Unverified
6:43
Thank you, Senator McKee. I just, again, have to ask my usual... It's not going
in Fort Smith. There's nothing in here that 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 about that. And nothing that encourages us studying specifically Fort Smith over anywhere else in the state. This bill is designed to help us determine what are
Senator Matt McKee
Unverified
7:05
the best locations. Thank you. Is there any other questions?
Chair
Unverified
7:15
Seeing none, I have no one speak before against
Dawood Rassam
Unverified
7:18
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 make a
Chair
Unverified
7:27
motion for due pass. Motion by Senator McKee, second by Senator Johnson. Any discussion? All in favor, say aye. Aye.
Speaker 53
7:33
All opposed, like a sign. Thank you, Senator. PAST 1572. Jack, you just got yours passed.
Chair
Unverified
7:48
All right. Does anybody have, any of the members have anything else to run for House members? 17:35. Just introduce yourself and you're recognized to do the best you can
Senator Missy Irvin
Unverified
8:26
do. I will so I basically just tried to go through and if they
didn't have a a Senate sponsor. I try to put my name on this just so that I could handle this for the committee. Representative Eves has a bill, House Bill 1735. I'm Senator Missy Irvin, District 24. Again, this amends the Arkansas Underground Facilities Damage Prevention Act, revised the membership in the one call center under this so that making sure that they and operators of underground
facilities do become members of this One Call Center and then you'll see on line 33 to 36 there is warnings and fines if they if an operator fails to become a member of the One Call Center and basically that's what the bill does is it just makes sure that there is membership from the One Call Center to the one on one call center and that the Commission is defined as a Public Service
Chair
Unverified
9:36
Commission is there any questions seeing none no one's signed up to speak for
Speaker 36
9:48
against the bill anybody want to speak for against this bill seeing none you want close to the bill I'm closed I'll make a motion do pass motion by Senator Irvin
Chair
Unverified
9:57
second by Senator Johnson any discussion seeing none all in favor say aye aye aye all opposed like sign thank you senator for doing the best you can do
Speaker 64
10:08
all right we're going to go to house bill 1150. we
Chair
Unverified
10:20
have multiple folks to speak for against this bill introduce
yourself senator and you're recognized Thank you, Mr.
Senator Kim Hammer
Unverified
10:33
Chairman, Kim Hammer, State Senator, District 16. Mr. Chairman, may I, if I could have a couple people come sit to present what I've instructed
our presenters, it will be, I'm going to read a short two-minute statement, and then I've asked them to keep their comments condensed to about five 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 to speak for and a few to speak against.
Chair
Unverified
11:00
So whoever come to the table with you, this is their time, and they can help you close also, but no testimony from them in between. Bring them to the table if you want. All right. If I can
Senator Kim Hammer
Unverified
11:12
get those that I'll ask to come help present, and I'll let them introduce themselves.
It'll be John Vincent and the president of the association. Mr. Chairman, we have a handout. 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 rumors in the room I'll go ahead and begin with my opening comments okay go
Speaker 78
11:55
ahead. Would you like her to introduce yourself?
Speaker 79
12:01
Introduce. Thank you for the opportunity to be here today. My name is Brittany Sanders. I'm co-owner of the pharmacy at Wellington and serve as the
Chair
Unverified
12:10
current president of the Arkansas Pharmacists Association. Thank
Senator Kim Hammer
Unverified
12:14
you and you're 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 three PBM-owned pharmacies. That number is $225 billion, by the way, being filled at three 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 1150 matters so much to Arkansans, patients, and communities. Right now, pharmacy benefit managers, or PBMs, are steering patients to out-of-state mail-order pharmacies that they own or 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 routing prescriptions through their own pharmacies,
sometimes by charging thousands of percent. 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 their 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 pharmacist actually knows them. 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
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 that as Core 1150 is about restoring choice, improving access, ensuring affordability, and trusting the local care that so many arkansas depend on and mr chairman before i yield to mike to uh john vincent who will introduce
himself we will also address the multiple emails and the last few days as far as uh inserting information uh regarding how this would affect the military uh there have been questions about having already given to the pharmacist the ten dollar 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
Speaker 83
15:52
he introduces himself. Introduce yourself and your recognize.
John Vinson
Unverified
15:58
Thank you Mr. Chairman 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 in 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, it would give the PBMs and pharmacies a 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 and 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 shut a pharmacy last week in pine bluff there are also from a pharmacist 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 in 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 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
and 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 owned and affiliated with the clinics we think fair competition open access is better for our kansans 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 three years. 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 three 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 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 open up more access for our nation's finest that have served our country. And we would be supportive of that. In the worst case scenario, that the PBM remained a bad actor or the U.S. Department of Defense did not take action and listen to the citizens of Arkansas and to the Attorney General of Arkansas, if they continue to restrict that to a single melder pharmacy, I'm confident with the amendments that were made
that our 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, there have been a lot of, I think, what I would characterize as fake news about that 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 UAMS, 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. are complicating care, 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 three companies, according to FTC report. With that, I'd be happy to take any questions. Thank you, members of the committee. anything else
Chair
Unverified
22:28
to say for questions yeah thank you for asking mr. chairman the
John Vinson
Unverified
22:36
bill sponsors reminded me I do have two other things one is a handout that I passed out we continue to get questions that we passed a 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 has been challenged to the U.S. Supreme Court in Arkansas, was victorious 8-0, solidifying 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 and the u.s postal workers we talked earlier in this committee about u.s postal workers overcharging the government through the rebate
manipulation and the 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 grips 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 percent, that pharmacy and one other pharmacy
all consolidated and shut its doors at the end of the year. So the lights are out in Dumas, Arkansas for Metter 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 8 000 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 appear 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 and 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 gotten hundreds of emails and calls and when they call the patient back they don't have any recollection of of being opposed or even understand what the bill does so with that i appreciate everybody listening to what i have to say and take any more questions i'll
Speaker 36
25:42
never do that again thank you any questions all right go ahead
senator boyd uh john or britney john vinson or britney
Senator Clarke Tucker
Unverified
25:55
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 understand this, I think, before we vote on this bill, because there's all these issues surrounding specialty. So, my question to you is, 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?
Speaker 79
26:29
Thank you, Senator Boyd. It 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 not accessible. There are pharmacies in the state that mail or hand deliver prescriptions to all corners of the state. I
John Vinson
Unverified
26:59
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 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 as a specialty drug or regular insulin as a specialty
drug? I mean, how do we get, I mean, what makes a drug, one drug more special than
Speaker 79
27:44
the other? 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 it 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 to clarify, and I'll be done asking
Senator Clarke Tucker
Unverified
28:20
you questions on this, 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?
Speaker 79
28:35
The degree is based on 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
John Vinson
Unverified
28:52
other healthcare professional on earth has more training as you described than pharmacists do. Yeah, so
Senator Clarke Tucker
Unverified
28:59
at the end of the day, a specialty drug is not something that a 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 any other, you know, any other medication, like it's got to be stored at a certain temperature. These are 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, are pharmacists licensed in Arkansas, in your opinion, equipped to handle that?
Speaker 79
29:32
Yes, in my opinion, pharmacists licensed in Arkansas are equipped to handle that and we do handle that every single
Speaker 36
29:41
day thank you is there any other questions seeing none thank you for your
Chair
Unverified
29:47
presentation members without objection we have many people to speak on these bills we have I have two sheets I have eight four and four against on the first sheet and nine four and one against. Without objections, I'm going to give both sides 20 minutes, 20 minutes for, 20 minutes against. They can use that time as they wish. I have a
second by Senator Boyd. All in favor say aye. Aye. All right. We're going to 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
Dawood Rassam
Unverified
30:47
20 minutes. I'm going to begin with, apparently
Speaker 1
30:53
these are doctors because you can't read their writing.
Speaker 70
31:02
Darwood Ransom or something like that I'll let you clear that up it's fine right
Dawood Rassam
Unverified
31:13
there because that's a long ways down there just a
Speaker 1
31:19
minute okay you're recognized good morning mr.
Daud Rasan
Unverified
31:25
chairman members of the committee my name is Dawood Rassam. 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 first time talking in public.
Dawood Rassam
Unverified
31:49
I'm going to tell you if you take up too much time you're going to ruin on everybody
Daud Rasan
Unverified
31:55
else's testimony. Go ahead. I'll do my best. Psychiatric relapse rate after the first episode is
Speaker 110
32:01
30% within the first year and 80% within five years.
Number two 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. I've got two examples. I'll do my best. One of the most important medications 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. One of them is a shot that's given every three 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 $4,000 to make these patients or to keep them out the hospital and keep them compliant. The PBNs does force the pharmacy to stop dispensing these medications and eventually transfer it to their own male-order pharmacy or big
store they own. I've got a second example. There are two medications to treat TD, tardive dyskinesia. It's a movement disorder characterized by involuntary repetitive movements after often affecting the face, tongue, and limbs that can develop as a side effect for long-term use of certain medications, particularly antipsychotics. They're considered specialty medications due to their cause and complexity of monitoring side effects and educating patients. I expect 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. PBNs have used this tactic for so long and so often that at any point they can determine a drug being specialty is 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 pharmacist 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 waiting
for their meds to be mailed. And with that
Chair
Unverified
35:01
I conclude my statement all right thank you the rest of y'all have 16 minutes and 25 seconds any questions hold on anybody have any questions saying none thank you thanks sir so next we have two from Dean's Pharmacy if those two will come to the table
Speaker 1
35:24
all right thank you this is all four okay
Speaker 63
35:28
just so everybody knows, these are the fours. Loretta Bozing.
Speaker 1
35:40
So, I mean, you wrote in here four, is that correct? Absolutely. All right. Just introduce yourself, and you're recognized, and you have 16 minutes and 25 seconds.
Speaker 53
35:53
Use however much of it you want. Thank you.
Loretta Bosing
Unverified
35:58
Good morning, and thank you for having me. My name is Loretta Bosing, and I am the founder of Unite for Safe Medications. Today, I've
Speaker 117
36:05
brought with me three 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 is so precious to me. But for the pharmacy benefit managers, his life is nothing more than a toll they call that they use to distort drug prices in their favor and for shareholders' profits.
My son was eight 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, change just 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 is quickly diminishing.
I never imagined that I'd have to be fighting like this, but PDMs left us no choice. They forced us to accept life-saving medications shipped in flimsy bags, sitting in scorching hot mailboxes and freezing trucks, damaging the very drugs meant to keep my son alive. Exposing medications to two times room temperature in mailboxes and trucks that quickly reach 140 degrees. No mother would ever get by with it, but it's okay for a PBM to force mothers to do it.
That's what makes a specialty drug a specialty drug. The delays, interruptions, and treatment often go without any repercussions. And there's no real counseling. That was different. In fact, there was much less than what we had at local pharmacies, and the relationship with doctors was just not there. The way they risk lives, the way the distort drug prices, as the FTC report had 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, TBMs are profiting from monopolistic control. 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
Speaker 36
38:36
you. Thank you. Any questions? Senator Johnson?
Senator Mark Johnson
Unverified
38:40
Thank you, Mr. Chairman. Ms. Bosing, your son was the 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 you must have read my op-ed on this, but do you, is that true? That was a son that was refrigerated? That was my son,
Speaker 117
39:05
yes, and it's not just the sitting on the porch, but also the hot trucks that are not protected.
Senator Mark Johnson
Unverified
39:12
And before, when you were able to access your local pharmacy, you didn't have that problem, is
Speaker 117
39:17
that correct? Never. It was never a problem at the local pharmacy, and now I do everything I can to use our local pharmacy, and they'll deliver in a temperature-controlled truck or vehicle at
Senator Mark Johnson
Unverified
39:29
a scheduled time. Okay, great. Thank you for your answer. Thank you, Mr. Chairman. Thank you. Any
Chair
Unverified
39:36
other questions? Seeing none, thank you for your testimony. we have 13 minutes and 57 seconds left dylan jones
Speaker 1
39:49
all right christian riddle all right thank you
Speaker 131
39:57
harps foods robert accord Kathy and Blake Goodman.
Speaker 1
40:16
All right, we're going to the next page, which has eight fours.
Lee Stice. All right, thank you.
Speaker 135
40:46
Lane Chapel Pharmacy. All right. All right.
Speaker 70
40:56
TIM FINLEY. GREG RAYNOLD OR RONALD. OKAY. ALL RIGHT.
Speaker 5
41:05
IF YOU WOULD JUST INTRODUCE YOURSELF. I'M SURE I DESTROYED THAT. GREG
Speaker 137
41:13
RAYBOLD: THANK YOU, MR. CHAIRMAN. GREG RAYBOLD WITH AMERICAN PHARMACY COOPERATIVE. I'm the general counsel and vice president of health care 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 verge of pushing forward a solution that will be comprehensive and that 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 managers 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 competitive 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 percent, 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, two fills, Arkansas patients have to use the PBM-owned mail-order pharmacy where they pay more money. Then you get to the, quote, 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 measures have failed. This cuts to the quick, and that's why they don't like it, because 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 bill gives them a choice, PBM or pharmacy.
It gives them a choice, and it's a choice that they don't give patients. 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 strong in support of this legislation, grateful for the work of Arkansas and this body and ask for favorable consideration. Thank you.
Senator Missy Irvin
Unverified
45:24
Senator Irvin. Thank you. Thank you for your testimony and I apologize for not coming in. I've been running
bills and other committees. So I just have a quick question for
you. I mean so we have and I was a co-sponsor on the pharmacy benefit managers licensing act. 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. 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. 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 getting worn out, to be just frank with you. You're wearing us out, in a sense, because we have bent over backwards time and time and time again
to accommodate and help and and we and we have done that and we have had policy after policy after policy but but my question and my concern is coming from a veteran okay and and i i understand we have independent pharmacies and that's great and we have independent pharmacists and they are a very important uh 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 I, and that's unfortunate. And that, 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 medication that helps you know patients but
also helps those 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 talking about these issues but this is particularly a question as it relates to a veteran who texted me he's a former state representative and he's opposed to this bill and he said that U.S. military retirees get our meds at the VA airbase
and from Tricare's mail order pharmacy called Express Scripts. The military VA and Express Scripts would fall under this law adversely since all three have pharmacies and pharmacy benefit managers. This bill, he believes, should exclude VA military services and U.S. government-sponsored Tricare-designated pharmacies. He says, please, I get a biological shot every four weeks to keep me alive through Express Scripts. The cost is $4,000.
I pay $38. Every few years, the U.S. 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 U.S. Civil Service retiree pharmacy operates, but I do know the U.S. 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.
Speaker 137
49:25
What is your response? So I would say a couple things. First of all, acknowledge that Arkansas has absolutely led the nation
Speaker 150
49:33
and you all have worked really hard to rein in these practices and appreciate some of the frustration. I think ultimately this solution is comprehensive in 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 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 that it 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 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 at 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 some examples, but we have found significant overcharges for those very specialty medications that you're talking about within the TRICARE program, thousands of percent above the national average drug acquisition cost. When you take away the PBM-affiliated, quote, specialty,
we believe you're going to see those prices come down to the rates that their non-affiliated pharmacies are being
Senator Missy Irvin
Unverified
51:11
paid for those same services. And I have one more question. 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? Correct. That is state law. Correct. You do also acknowledge that we have had numerous, I would say, reviews of claims submitted and our insurance department has
done, I think, a very thorough job at looking at that and correcting it and enforcing the law.
Speaker 137
51:46
Would you agree with that? I would agree. Yeah. I mean, I don't, I'm not in Arkansas every day, but I
Speaker 150
51:55
think Arkansas has done, you know, has led the nation in terms of
Senator Missy Irvin
Unverified
51:59
passing important legislation and enforcing important legislation. Okay. So if
we have this law in 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?
Speaker 138
52:18
I think the problem persists, right, and these things can be complicated, but if you look at the one
Speaker 150
52:24
pager, you'll see for the commonly prescribed generics, 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, high blood pressure, things like that. These are the drugs that pharmacies 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 two fills. Now, that data is based on a federal health care plan.
Speaker 137
53:04
You know, a federal employee health plan is the largest self-funded employer in the nation. These are really big
Speaker 150
53:10
companies with really sophisticated counsel, really sophisticated attorneys. And they've proven willing to push the envelope and have really aggressive interpretations. 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
Senator Missy Irvin
Unverified
53:34
to the insurance department? I have not. Why not? I
Speaker 137
53:41
would say two reasons. First of all, we just pulled this data really, really recently, and so would look forward to sharing that information with not just this committee, but
Senator Missy Irvin
Unverified
53:51
with the commissioner's office as well. Well, again, it's fully our intention for everybody to follow the law that's already been passed.
And I'm confident that law supported that law, voted for that law, but we need to let that law work. And so I appreciate your
Senator Clarke Tucker
Unverified
54:14
answers. Yeah, thank you for your questions. Senator Boyden. Thank you, Mr. Chair. So in states, I'm up here. So in state, does the state or the federal government have the ability to license pharmacies or license PBMs?
Speaker 161
54:27
Who does the licensing? So states enjoy broad authority when
Speaker 137
54:30
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 states. And I appreciate the question because, again, what
Speaker 157
54:41
this bill looks to do is speak to licensure. Okay, so
sometimes would you would you agree with this that sometimes the federal
Senator Clarke Tucker
Unverified
54:49
government gets states to do things by incentivizing them with dollars to do certain things? So they take our money, they go circulate it around a 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. Okay, 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 not 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. Thank you, Senator.
Senator Reginald Murdock
Unverified
55:36
Senator Murdoch. Thank you, Chair. And I
think Senator Boyd did a good job of maybe 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 pharmacy, independent pharmacist, I got a call from Mr. Dean Watts on a Saturday morning related to these games that the PBMs
have played for many years, and she mentioned former Representative Michelle Gray and many of us others, including Senator Irvin. 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. 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 pressures, if you will, from their lobby. But we've 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 they became our watchdogs, if you will.
We gave them the authority and the power to, hey, 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 Senator Boyd just kind of answered what happened federally where they do some workarounds to come back at us in a different way because of their capacity, if you will. But what we're trying to do is make sure we capture finally.
But now we have to have the help of the pharmacies reporting. They can't get weary in 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 differently. So, again, I think Senator Boyd kind of mentioned what's happening on the workaround, 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, as Senator Irvin asks, why not report? We need you to make sure. We need the members to make sure that you report these 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
Speaker 137
59:04
not come back again as we're seeing. Yeah, I appreciate the comment and understand, right? Sometimes it's like with the expression, fatigue makes cowards of men and women, right? And, you know, sometimes it's attrition. And so certainly there are periods where even pharmacists 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 what we found is certain aspects they're effective, certain aspects they evolve and they're not, right? 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 legislating PBMs and 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 get overcharged. The patients lose choice. Independent pharmacies continue to close. They continue to feed the mouth, right? two-headed beast 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 ball
Speaker 173
1:00:27
away, and it takes away- Thank you, Senator Irvin.
Senator Missy Irvin
Unverified
1:00:32
So to that point, takes the ball away, that's concerning to me. We're using government to deny a 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. They're getting paid. They're going after all the private insurance. They get more money from Medicare and Medicaid
than 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 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'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 really do want somebody to answer that question. I'm trying to be as real and honest as possible. Yeah. I don't, I am a conservative woman. I believe that government is here for good policy. But when you start using government to shut down and close out your competition and by denying permits and licenses, that gets a little weird for me, especially when it comes to health care.
Speaker 161
1:02:55
So, and I'll be brief here, but what I would say is we're talking about three
Speaker 150
1:03:01
of the biggest companies on earth 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 this state. And what this bill is looking to do is end those monopolistic anti-competitive
Senator Missy Irvin
Unverified
1:03:28
practices. Are they defined as a monopoly by
the federal government? Who's defining them as a monopoly? You? Or do you have an official document
Speaker 138
1:03:38
that says they are monopolies? We can certainly provide you with some FTC documents where
Senator Missy Irvin
Unverified
1:03:43
they have absolutely expressed concern. Has it
Speaker 137
1:03:46
been ruled as a monopoly? Or is that your opinion? These would be in-term reports as a result of FTC 6B
Senator Missy Irvin
Unverified
1:03:52
study and happy to provide those with you 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 seen that at the federal level. Yeah. So the answer to that
Speaker 161
1:04:09
would be no. I think there's a lot of concern that I wouldn't say the answer is that they're
Speaker 157
1:04:15
not monopolies but I can't point you to a legal
Senator Missy Irvin
Unverified
1:04:17
court case where they. Okay so that is your opinion that they're monopolies. Senator. It is. Okay. Senator. I
Speaker 64
1:04:24
don't I like to exchange. I don't want you anybody speaking over the other. So just for the future. Are we done with this?
Chair
Unverified
1:04:32
All right. Thank you. We're going to move on. Thank you, Mr. Chairman. Okay. Next is Adam Head.
You have nine minutes and 52 seconds. Just introduce yourself and you're recognized. Thank you,
Adam Head
Unverified
1:04:55
Mr. Chair, members of the committee. Yes, my name is 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 is coordination of care, and this actually speaks to Senator Irvin, something you mentioned earlier in reference to your husband. And 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 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 DON'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 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 so i'm happy to answer any questions i
Senator Missy Irvin
Unverified
1:06:58
can senator ervin 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 car tie i believe and
Adam Head
Unverified
1:07:14
highlands oncology yeah i've actually got maggie smith that's here with me so it's if it's okay
Senator Missy Irvin
Unverified
1:07:20
i'd like to be able to bring her up with me yeah i just want to i just want to understand you know we we have worked really hard to accommodate CARTI and Highlands Oncology with legislation this session already so I just need to understand yes Senator you know what those bills you
Speaker 186
1:07:39
know what recap that sure so hang on just a minute now what is she going
Adam Head
Unverified
1:07:47
to do I was just bringing her up to answer some of the specific questions on those those other bills just to answer the, as it relates
Speaker 188
1:07:58
to cancer. Introduce yourself. Hi, I'm Maggie Smith.
Speaker 77
1:08:02
I'm director of legal policy at Carti.
Speaker 188
1:08:04
Okay. Keep it short. Okay. 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
Speaker 176
1:08:16
of certain drugs to certain pharmacies. So it was not related to PBMs. So that's why, that's why these two are
Speaker 5
1:08:26
different. Okay thank you. All right any other questions? Seeing none you're dismissed. Thank
Speaker 70
1:08:33
you. Thank you. Next we have Brandy chain chain what is it you have seven minutes and 52 seconds
Speaker 5
1:08:45
okay you're right yeah introduce yourself and you're
Brandy Chain
Unverified
1:08:52
recognized hello thank you for thank you for being 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 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, where 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 in 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
Chair
Unverified
1:10:53
courage and leadership. Thank you. Thank you. Is there any questions? Seeing none,
Speaker 1
1:11:01
we have two more. Two more to speak for the bill. Jason Finke. All right.
Speaker 53
1:11:13
Introduce yourself. You have five minutes and 53 seconds. All
Jason Finley
Unverified
1:11:18
right. I'll be brief. My name is Jason Finley. I'm the director of pharmacy for Birch Tree Communities, which is a nonprofit corporation, much like Centers for Youth and Family. And so we serve 380 severely mentally ill patients across the state and many of those patients come from the state hospital. And so I know that there is the worry of deserts for facilities and patients in 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 so the other side of it 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 PBM 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 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, I've never had an issue with that being considered a specialty medication, even though there's a lot of special circumstances other than price that has to make that a specialty 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 retail, 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 Irvin.
Senator Missy Irvin
Unverified
1:13:53
- Thank you, I appreciate your testimony, I really appreciate what y'all do for your patients. - Sure. -
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, are you aware of that? - I have
Jason Finley
Unverified
1:14:11
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
1:14:31
Okay. Well, I have concern if this affects community mental health centers not being able to function or get their permits. That would be a major problem for me because I feel like pharmacies are important as a component inside those community mental health centers. And I'll say that... And somebody else may be able to speak to
Jason Finley
Unverified
1:14:55
that other than you. Birch Street Communities 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 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 from my own experience, but 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. Mental health centers that have their own pharmacy like that.
Senator Reginald Murdock
Unverified
1:15:36
Senator Murdoch. Thank you, Chair. The neutrality that you mentioned, that you said
they expressed they want to be on this bill, that concerns me. When anybody's neutral on this because of the way I perceive this to be in the Senator Irvin is bringing out some things that I need to hear answers to in terms
of consideration for those concerns. Why would they be neutral on this? I cannot speak to that, sir. I've
Speaker 204
1:16:05
simply got a text message today not to use any of their,
Jason Finley
Unverified
1:16:09
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 further information regarding that and I'm not involved in those committee meetings or any of their meetings.
Senator Reginald Murdock
Unverified
1:16:25
So then, as you come forward to speak for this bill, from your perspective, can you see why anyone in this equation, in this, of what we're doing here, dispensing cost, fare, 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 whenever someone is neutral, an entity becomes neutral, that's concerning. But explain to me how you're for it, and do you understand neutrality in this?
Or is it clear for you that this is a problem and this needs
Jason Finley
Unverified
1:17:37
to pass to help take care of a problem? I'm here to simply state that as a pharmacist that has always been an independent pharmacy, opportunity has not always been there for independent pharmacy. When I started this pharmacy in 2011, the opportunity was great at that time. However, over the years as bills chase this, we talked about this earlier,
as bills were made through the assembly, that opportunity did change over time and And so that neutrality, 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. 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 so I can only speak for my personal testimony. And as far as neutrality, I simply can. 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 I'm speaking from my personal viewpoint for the bill.
Senator Missy Irvin
Unverified
1:19:03
Thank you. Thank you. Senator Irvin? Are y'all, is Birch Tree designated as a community mental health center? Do y'all meet that criteria or are you
Jason Finley
Unverified
1:19:18
an independent business? No, no, no. So our pharmacy is owned by the community mental health center 503, 5013C non-profit corporation and it is not an independent business. I do not own it whatsoever. owned by the corporation governed by board of directors no single entity owns
that pharmacy and so I'm a just a employee as director of pharmacy for that mental health center. Okay but it but
Senator Missy Irvin
Unverified
1:19:44
okay so you're is that a federal designation? I believe so I yes okay nonprofit
Speaker 204
1:19:50
I'm not an expert on that okay by all means I've tried to learn and educate myself but my expertise ends there I was just trying to get us right
Senator Missy Irvin
Unverified
1:20:00
thank you see no other questions thank
Dawood Rassam
Unverified
1:20:07
you sir for your testimony we have one more Blake Torres Westside Pharmacy you have three minutes and
Speaker 215
1:20:22
20 seconds Frank Torres, Westside Pharmacy. First off to the committee, thank you all for having me today. If you'll recall, this is not my first time in front of this legislative bond. Two years ago, I'm testifying before ALC.
Speaker 217
1:20:38
Mike, thanks. Sorry about that. Frank Torres, Westside Pharmacy. This is not my first time before this committee. I testified before ALC almost two years ago. community pharmacy was dying by 1,000 slashes. And here we sit today in T-Miles Point, rehashing the same thing over and over again. I had a testimony prepared, but due to the time venture, I'll keep it short. Tricare. Captain Brian Damon Torres, United States Marine Corps,
F-18 fighter pilot, just got back from two tours in Japan. His squadron is now in Panama. I have empathy for those who have served our military and are currently serving. The idea that they will lose access, while partially true, is not the whole truth. They will still be able to get prescriptions filled at military bases, along with local and community pharmacies. It keeps being an independent pharmacy issue. This is a community pharmacy access issue. Kroger, Walmart, Walgreens, Harps, all of those will maintain access for
veterans. Westside Pharmacy is initiating contract with Express Scripts, and we've gotten pending response after pending response. We're reviewing network advocacy. We will find a way where my brother, who is 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. When we decided that, and the federal government inside that when they instituted Medicare. And then they allowed vertical integration
with consolidation where insurance companies were allowed to buy pharmacies and buy PMs and the reverse triangle presented. So now my direct competitor, not only is mine competing in the marketplace, they are setting my prices. And then we forced myself to publish my acquisition costs and a model called NADAC for the entire world to see. So they now have my price files. How do you compete against that? And Senator Irvin, to your point, I empathize with you.
And if there was another private or public commitment that's not an FQHC, and they were sending your reimbursement directly, as well as paying, I will stand with you in this. And I know that y'all are worn out. I'm worn out. But this is a trillion-dollar industry that we are fighting here. This is not some mom and pop against each other. They don't answer to the U.S. conference. They're sure as heck not answering to our AID. And in my professional opinion, fighting for my patients,
to give you a real example, and I'm going to chase the rabbit here for one second. On Monday, yesterday, I had my team count how many times a patient was forced to go to a mail order or CVS. Five patients. Five patients lost access. They lost Walgreens. They lost Walmart. They lost Harps. lost all of them so we're going to talk 36 but all that ends thank you for a good vote any questions thank you sir
Speaker 64
1:23:57
we're going to switch over to the against and just as
Speaker 70
1:24:05
a reminder the against total 20 minutes questions do not count Randy Zook just introduce yourself and you're recognized
Speaker 221
1:24:24
thank you thank you mr chairman randy zook with
the arkansas state chamber of commerce 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 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 the government's job extend to such arbitrary demands on our markets?
This bill is a direct assault on innovation of 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 removed 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 to recognize it which is to eliminate competition from the market And just an aside on the much-quoted comment about the 100-year-old pharmacy in Dumas that had to close, regrettably. I'm familiar with that business, Meadors Pharmacy. I grew up in Deshaies County. I also remember Vickers Chevrolet in Dumas. I remember Peterson Ford in Dumas, all of which have gone away for one simple reason.
When I graduated high school in McGee, there were 26,000 people living in Deshaies 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 audit any 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 they 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 them, 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 bill. Just a few months ago, independent pharmacists were advocating for a dispensing fee rule because they claimed Arkansas' 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 you, Senator Johnson. Thank
Senator Mark Johnson
Unverified
1:29:40
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. 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? Yes, sir. And before that? Oh, Standard Oil.
It was Standard Oil, which is literally the law school textbook case for antitrust situations. Right. 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 Exxon or the PBMs? I'm just, I'm flabbergasted. And usually you support our local businesses around the state. And I'm grateful when you do that. But I'm literally shocked that your organization would oppose this bill.
And 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 just shocked that, I don't know, I know how much money they're spending. I drive to Capitol every day. There's a billboard on 630 that's lying about what this bill does. I'm getting emails from constituents, and like Senator Hammer, every time I call them.
Do you know about this? No, I don't remember sending you that. Someone's clicking. This is not grassroots opposition to this bill. This is astroturf. And 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
Speaker 221
1:32:03
appreciate your comment. I don't equate big with a monopoly.
Exxon is not a monopoly. Neither is CVS. Neither is any of these companies. Standard Oil was at one time. Standard Oil was, but that was two centuries ago. Not quite. And 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 discipline or put out of business. Anybody who is so egregiously against or violating these laws, the laws are there.
Senator Mark Johnson
Unverified
1:32:39
Enforce them. I think that's where 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 a trillion-dollar 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 Clarke Tucker
Unverified
1:33:09
Senator Boyden. Thank you, Mr. Chair. Mr. Zook, 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
1:33:22
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?
Speaker 233
1:33:42
Well, I mean, a consumer can always find an alternative.
So a consumer could say, hey, I'm going to just not worry about the insurance that I've paid for and I'm just going to go pay more, not
Speaker 229
1:33:57
my co-pay or co-insurance? Well, part of what's got me here at the end
Speaker 221
1:34:03
of this table, taking the pot shots, is the fact that 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
Senator Clarke Tucker
Unverified
1:34:27
most successful companies who use them. So on that front, are you familiar with how Johnson &
Johnson's employees are suing Johnson & Johnson and how Wells Fargo employees are suing Wells Fargo for failing to fulfill a fiduciary obligation in managing drug costs?
No, not familiar with either case. Okay, well, maybe
Senator Clarke Tucker
Unverified
1:34:53
you should do that. And 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
Speaker 221
1:35:07
not this industry, would that not be government picking winners and losers? 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 $19,200 at the PBM-owned pharmacy that the PBM directed them
Senator Clarke Tucker
Unverified
1:35:26
to versus $97 at the local pharmacy, who is picking the winners and losers in that front?
Speaker 221
1:35:32
I'd be really interested in the particulars on that because it is an outrageous set
Senator Clarke Tucker
Unverified
1:35:38
of numbers. Well, it's in a Federal Trade Commission
Senator Reginald Murdock
Unverified
1:35:43
report. Thank you. Thank you. Senator Murdoch. Thank you, Chair. Thank you, Mr. Zook, for
being here. 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, would you then change your position based upon you're saying they're compliant?
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 and 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 co-have something together here that we're trying to help with from a legislative standpoint, policy-making standpoint. But if that is true, that they are not compliant to the tune, which I know this.
And here's the thing that makes a lot of sense that Senator Johnson mentioned to you. We're dealing with a trillion-dollar 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.
Speaker 229
1:37:13
Because I want to verify what I'm saying. In those cases, you know, maybe it's suspending the license. Revoke the license.
Dawood Rassam
Unverified
1:37:21
Is anybody from the insurance department here?
Senator Reginald Murdock
Unverified
1:37:31
Wow. Really? You would think. All right. That's a whole other conversation. But, 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 it says, 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 at the end of the day, to Senator Boyd's point, when you say, well, you can just choose someone else. Many times in business, one of the common things we do is in competition is just choose someone else. But in this, it's a little different when it's that medicine 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
when they've already paid insurance premiums. So that other option, Mr. Zook, 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 want to do is deal with that compliance piece that
you had mentioned, but my insurance department is not here, so I
Speaker 221
1:38:58
can't really verify that. Thank you. Look, we as an organization are fully aligned with what you're describing. We want people to play by the rules. But our view in this case is there are rules in place to enforce them.
Don't say that this business model is suddenly verboten and kick them out. They're not a monopoly officially. All right,
Senator Missy Irvin
Unverified
1:39:28
Senator Irvin. Does the state of Arkansas determine who's a monopoly and who's not? No. Is
there any federally, is there any designation that we have that has 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 room are vertically integrated themselves. They own or own pieces of several pharmacies all across the state of Arkansas. Is that not vertical integration? - Well, technically not.
Speaker 221
1:40:18
- Vertical integration would be like a company in one business buying its suppliers and owning its suppliers or likewise buying its customers. So like Walmart owning a
Senator Missy Irvin
Unverified
1:40:29
bank or that's vertical. Or a pharmacy. Or a pharmacy or optometry. Right.
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 wish somebody would be able to answer that question for me
because it's my understanding that independent pharmacies have increased in the state of Arkansas. And we've had people testify in this committee that have opened up brand new pharmacies as well. So 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 on that. None that I know
Speaker 233
1:41:17
of. Well. So I'm just not familiar with them.
Speaker 221
1:41:22
I'm aware of pharmacies that have opened as well, but I'm not here to cook that kettle
Speaker 253
1:41:31
of fish. Okay, thank you. Thank you. Seeing no other questions. Appreciate your
Chair
Unverified
1:41:38
testimony. Thank you, Mr. Chairman. I have with Navitus, Sharon. Introduce yourself and you're recognized. Thank
Speaker 254
1:41:54
you. Sharon Faust. I'm here with Navidus Health
Solutions, transparent pass-through PBM. Not one of the big three that we're talking about, but PBM nonetheless. I'm a pharmacist. I've spent a lot of my time in community settings, mental health, hospice, health systems, 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 kind whether 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 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 also have access to special
programs at some of these pharmacies, which 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, whether that's free drug, free drug access for low income, whether it's Wagovi or weight loss direct to consumer through Humana's 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 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. 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 not a monopoly. Yes, there are three 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 would still be able to access Kroger, so Kroger must be a winner 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 the mental health facilities
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 those are important for military, non-military 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 clients and employers lower costs.
Ultimately, we want to support all employers, whether they're pharmacy or non-pharmacy alike. And so that's why we're here today, urging you to vote no on this bill. Senator Boyd.
Speaker 144
1:46:04
Senator Irvin. Senator Irvin. Thank you. Thank you, Mr. Chair.
So you mentioned transparency. Does that mean you'd be willing to open your books to Employee Benefits
Division and let them see what's going on in there?
Speaker 254
1:46:24
Yeah, we actually pass through direct to the client. So what the pharmacy is being paid is exactly what the client is being charged. So then you can verify
then at the table that Genoa 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
1:46:46
that specific. You said Genoa. 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 handling that
they have. But I don't know the exact rates. Okay. 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
Speaker 254
1:47:10
paid more or if they're paid less. You can't or you won't? I cannot confirm that because I don't have the information in front of me. Will you get the information
Speaker 23
1:47:17
and get it back to me? Yeah, our networks are transparent.
Speaker 254
1:47:20
Any other questions? Seeing none, thank you for your testimony.
Speaker 53
1:47:28
Thank you. Next, we have Ashley Ellis. Ms. Ellis, you have 7 minutes and 35 seconds. Okay. Thank
Ashley Ellis
Unverified
1:47:47
you for the opportunity to speak today. My name is
Speaker 266
1:47:50
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
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 pharmacists 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 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 through 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 force patients to stand in longer lines at fewer pharmacies, And it will leave them without the trusted pharmacist that they've come to rely on. 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 if
Senator Missy Irvin
Unverified
1:51:15
I vote for this bill, you're going to lose your job.
Speaker 266
1:51:19
Yes, ma'am. Me and all of these folks that are here in the room with me and
Senator Missy Irvin
Unverified
1:51:30
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?
Yes, ma'am. 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
1:52:02
going to lose their job. Yes, and the hundred more that are still serving in their
Senator Missy Irvin
Unverified
1:52:06
communities 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 Boyden.
Senator Clarke Tucker
Unverified
1:52:22
Thank you. I appreciate you being here. I know this is emotional. 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 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 Sevis Health, that says, I think today you would argue that there are more pharmacies than we probably need? No. Okay. Thank you.
Speaker 5
1:52:53
All right, are there any other questions? Seeing none, thank you
Speaker 36
1:53:00
for your testimony. All right, next we have Priscilla Griffin. Ms.
Dawood Rassam
Unverified
1:53:14
Griffin, you have four minutes and 12 seconds. Just introduce yourself and you're recognized. Thank
Priscilla Griffin
Unverified
1:53:21
you. My 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 six years. And I currently reside in Valonia. 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, pharmacist 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, anti-psychotic reduction, polypharmacy, infusion support, and nursing education. We also provide 24-7 support for long-term care facilities, including personalized delivery of medications from 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 1150 and work with us to find alternative solutions to strengthen care in our state.
Chair
Unverified
1:56:49
Thank you. Any questions? Seeing none, thank you for your testimony. We have one more.
Dawood Rassam
Unverified
1:56:59
Thank you. We have one more to speak against the bill. It is Vincent Fayette. You have 43 seconds. Thanks, everyone.
Speaker 63
1:57:06
So you reach yourself and you're recognized. Hi, I'm Vince Fayette.
Speaker 283
1:57:20
I'm Director of Pharmacy Practice for Credo Health Group. We are
Speaker 284
1:57:25
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. These drugs are often available through different pharmacies,
but Acredo 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
1:58:10
that time's up any questions senator just just
Senator Missy Irvin
Unverified
1:58:15
a quick question as far as your specialty pharmacy yes and where are you located we
Speaker 284
1:58:24
have uh locations all across the country so okay i'm personally in
Senator Missy Irvin
Unverified
1:58:28
tennessee i gotcha okay and uh do you know roughly how many patients you serve in the
Speaker 284
1:58:36
state of Arkansas? Probably approximately 3,000 patients. 3,000 patients? Across multiple therapies. And these are
Senator Missy Irvin
Unverified
1:58:41
more special needs for specialty drugs? Correct. Okay, thank you. Any other questions?
Speaker 36
1:58:47
Seeing none, thank you for your testimony. Thank you for your time. All
Speaker 5
1:58:54
right, we've reached the end of the testimony. You want to,
Speaker 36
1:59:00
Senator, you want to close your bill?
Senator Kim Hammer
Unverified
1:59:05
Thank you, Mr. Chairman, members of the 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. 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 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 them so they cut their losses and pulled out of town. On the other side I can 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 caused 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. If it's not going to meet the profit margin, they're gone. 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 when 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'd even give credit to Harps. I'd give credit to Walmart. I'd 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 utilized their time. They're the ones who've taken time, and probably like a lot of these pharmacists from CVS have 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, or have taken vacation time in order to be here in order to weigh in on this very important subject. 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? Who's put up all that money? Concerning about CVS 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? And yes, there are some pharmacies that have expanded. Why have they expanded? They had to pick up the slack of the ones that could no longer make it. They had to pick up the slack of the ones that donate to your yearbooks,
that buy ads in the sports programs, that make donations back into the local community. Good luck getting that out of the big PBMs. It's been established that 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 a trillion, I'd take those bets any day. I'd take that leverage any day. I take those averages every day. When we have 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 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 gonna happen
soon enough and you know and I'm I think about all these conversations and there's people have spoken on both sides of the bill. Law and current 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 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 a general session, been involved and fighting in this for I can't remember how long. And I always use the analogy, it's like a chess game. You use whack-a-moe, I use chess, because chess is a long play game. A few pawns have been taken off the table, a few knights have been taken off the table, a few castles have been taken off the table. 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? Is it going to be the pharmacy deserts because the local pharmacies have gone out of business? Who is it going to be? But 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 has 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 bowled it down to. They won't go out of business. If they want to argue these local pharmacies and the Walmart pharmacies and the Harp pharmacies
and the Kroger pharmacies 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'll be no reason to fire these 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 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 Arkansas, and by the way, we're talking about three. Somebody 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 it's gut-wrenching to sit right here. I promise you that.
But if CVS decides to pull out, we do have other PBMs that are good PBMs. 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.
Speaker 5
2:09:09
With that, I'll close and appreciate a good vote. Thank you, Senator.
Speaker 36
2:09:14
What's the will of the committee? Motion by Senator Johnson, second
Senator Missy Irvin
Unverified
2:09:21
by Senator Penzo. Discussion? I appreciate the passion with which Senator Hammer speaks about this.
And I could talk about the community mental health centers that are going to be affected by this and the 70,000 Arkansas mental health patients that are going to be affected by this,
an amendment was offered, it was rejected 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 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 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 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 going to 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 know many, many, many people that are in this industry that are small business owners outside of this. They own a lot
of other small businesses that they have diverted all of their money and investments in. They're going to be just fine. And
so I cannot be in this position and vote for a piece of legislation that is against what I
believe in and 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, okay, yes, but there's nobody actually designated as a monopoly. So you cannot hold somebody to a standard that's in our Arkansas Constitution 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
Speaker 5
2:13:24
bill. Thank you, Senator. We have a motion and a second. We're passed.
Thank you. All in favor say aye. Aye. All opposed? Black sign, all right. Thank you, Senator, you passed your
Speaker 64
2:13:44
bill. All right, we got two bills before we adjourn. Senator
Senator John Payton
Unverified
2:14:11
State Senate, District 22. - All right. - House Bill 1847. -
Chair
Unverified
2:14:19
You have an amendment. - Yeah. - Motion by Senator McKee to adopt the amendment, second by Senator Boyd. All in favor say aye. - Aye.
Senator John Payton
Unverified
2:14:30
- All opposed, lack sign. All right. So as amended, 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 gambling establishment to exclude them, put them on a list, 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 ask 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 us to establish and keep a statewide list, and it's all voluntary. And I think the Gambling Commission is here, or I was told that they're here 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 McElindon to be here. Is there any questions, Senator Murdoch? So you
Speaker 299
2:15:41
said they can do it one-on-one now, but this list makes it be for all the casinos, is that what you're saying?
Senator John Payton
Unverified
2:15:51
Yeah, so what 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
Senator Reginald Murdock
Unverified
2:16:05
and be a statewide list. What if you only wanted to be for that casino? Does you signing up for Saracen mean that Southland and
Senator John Payton
Unverified
2:16:14
what's the other one? Well, 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 elected that way, but I don't know because we might get asked if they're still here. I think that's the point, because they may... Is the Gambling Commission still here? I guess I'm really on my own here. I don't know. I don't know. The short answer is I don't know. I mean, I would think that would be something that would be easily done in the rules and rigs
Chair
Unverified
2:16:55
when they establish it. Any other questions? Seeing none, there's no one to testify four against the bill. You want to close? I'm closed. Thank you. What's the will? Motion by Senator Johnson. Motion to. As amended. As amended by Senator Johnson. Second by Senator McKee. Any discussion? All in favor say aye. Aye. All opposed. Like sign. Thank you Senator for being patient. Thank you. Mary.
Representative Mary Bentley
Unverified
2:17:44
very simple bill all right I think just right you're recognized and thank you
Speaker 70
2:17:49
chairman thank you committee state representative Mary Bentley from
Representative Mary Bentley
Unverified
2:17:52
district 54 this is a simple bill to allow for
insurance coverage for birthing centers right now we have no birthing centers in Arkansas, 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, this bill passed they were not 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 is simply asked that when a delivery is done in a birthing center that they will get
health insurance coverage we know that Arkansas right now only 50 of our counties have a place for women to give birth and in states across the nation small hospitals are opening up birthing centers instead of a labor and delivery unit much cheaper and easier for them to run is this a way for us to allow more deliveries with physicians and certified nurse midwives and a birthing center so very simple bill I'd be happy to take questions on this thank you
Speaker 53
2:19:00
representative in an emergency situation you can give birth anywhere
Representative Mary Bentley
Unverified
2:19:02
right yes sir you can do it in a barn I guess if it happens thank you senator Irvin just
Senator Missy Irvin
Unverified
2:19:10
checking to see if you discuss this bill with anybody in the insurance are they okay with this yeah
Representative Mary Bentley
Unverified
2:19:15
they're saying I've not had anybody come to speak at all in the house no one's up I've not seen any opposition from anybody at
Senator Missy Irvin
Unverified
2:19:21
all on this Oh, are the birthing centers, are they
Representative Mary Bentley
Unverified
2:19:24
licensed, are they through the Department of Health? Yes, through the Department of Health. There's a whole protocol for them to be licensed with licensed staff, with certified nurse midwives, not just lay midwives. Not just laymen. Very much protocol.
Senator Missy Irvin
Unverified
2:19:34
Yes. Okay, and then, yeah, and so they meet all the quality measures that are required by the Department of Health to be licensed, therefore.
Yes, everything, yes. Okay, thank you. Motion to
Chair
Unverified
2:19:46
pass. Bill, motion by Senator Irvin, second by Senator Boyd. Any discussion? All in favor, say aye.
Speaker 1
2:19:54
Aye. All opposed, like sign. Thank you
Representative Mary Bentley
Unverified
2:19:57
for being patient. Thank you, Chairman. Thank you, Committee. We're all working
Speaker 1
2:20:05
together, and I appreciate you. I can do 1850, 1850. Senator Irvin has a couple, and then Representative Meeks, Senator Irvin.
Senator Missy Irvin
Unverified
2:20:16
Which one do you want to do first? Well, let
Speaker 63
2:20:27
me, Representative Minx is here, so let's do his first. All right,
Senator Missy Irvin
Unverified
2:20:30
is that 1957? It is. I can be the Senate sponsor if we need to. Jane is on it,
Speaker 1
2:20:37
so. We have an amendment. Oh, yeah, yeah, yeah. 1957? Yep. Yeah, the amendment, just to add Senator English on it.
Chair
Unverified
2:20:47
Motion by Senator McKee, second by Senator Johnson to adopt the amendment. All in favor, say aye. Aye. All
Dawood Rassam
Unverified
2:20:53
opposed, like sign, all right. The bill is amended. Go ahead with the bill. All right. Thank you, Senators, and I
Representative Stephen Meeks
Unverified
2:21:01
appreciate Senator Urban helping me on this one. So, colleagues, if you remember back in the early days of the Internet, you'd get home and you'd dial up the Internet, you'd hear the whirls and beeps and all that, and eventually you got those three 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 burden a lot of times. And so 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. We're going to get so much dumped on us through texting that it's going to become overly burdensome and cumbersome. 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, authorized commercial text messages that do come to you, 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 53
2:22:24
Any questions, Senator McGee? What about political texts? We
Speaker 315
2:22:30
could get rid of those, too, Ben. Hey, I'm waiting here.
Speaker 316
2:22:33
It's not included, but I would be welcome to that. Senator Johnson? Senator Johnson? Go ahead, Senator Johnson.
Speaker 126
2:22:38
I don't have a question. All right. I have a motion.
Speaker 5
2:22:44
All right. Any other questions seeing none? You want to close for your bill? I'm closed and appreciate a good vote.
Chair
Unverified
2:22:53
Motion by Senator Johnson, second by Senator Irvin. All in favor, say aye. Aye. All opposed, like
Speaker 53
2:22:59
signed. Thank you for being patient. Thank you, Senator. Do
Senator Missy Irvin
Unverified
2:23:09
pass as amended, it was. All right. Senator. Senator Missy Irvin, District 24. What bill are
Speaker 1
2:23:16
we on? Let's do 1850. Okay. 1850. Yep. 1850. You're recognized. We know who you are.
Senator Missy Irvin
Unverified
2:23:23
Thank you. Representative Johnson's done a lot
of work with making sure that we have ambulance services that they can get paid. And so what this does is clarify the minimum.
Thank you. 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. 1850 removes the reference to workers' comp rates and sets the minimum reimbursement rate at 325% of the Medicare rule rate, or the provider's 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.
Senator Matt McKee
Unverified
2:24:14
Is there any questions? Senator McKee. So I was looking for the language that you discussed about city and county contracts. That's not in the bill, right? Is there any effect? It's on line 31.
Speaker 320
2:24:30
Yeah. shall be at the rates approved or
Speaker 322
2:24:43
contracted between so this doesn't affect their rates
Speaker 36
2:24:45
correct okay thank you any other questions seeing none there's I have no one signed up to
Chair
Unverified
2:24:56
speak for or against the bill you want to close your bill I'm closed I'll make a motion motion by Senator
Speaker 1
2:25:03
Irvin second by Senator Boyd any discussion all in favor say aye aye all opposed like signed thank you Senator Irvin uh what is your next bill hb 1863 1863 63 all right just
Senator Missy Irvin
Unverified
2:25:20
uh you're recognized 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 am closed. I'll make a motion
Chair
Unverified
2:25:47
to pass. Motion by Senator Irvin. Second. Second by Senator Boyd. Any discussion? Seeing none, all in favor say aye. Aye. All opposed, like
sign. All right. Thank you. It was 1863. What do you got? 1320? Yes, very top of the agenda. 1320. Senator Justin
Senator Clarke Tucker
Unverified
2:26:22
Boyd, with your permission here to present House Bill 1320. For Clark, Senator Tucker. You're recognized. So literally what this bill does is it adds
crisis stabilization units to the any willing provider list and there is
no expected fiscal impact for EBD. All right. Is there any questions? Seeing none
Speaker 5
2:26:37
I have no one speak for against the bill. Anybody here to speak for against
Chair
Unverified
2:26:44
the bill? Seeing none. I'll close you bill. I'm closed I'll
make a motion do pass and would appreciate a second
Chair
Unverified
2:26:50
motion and a second by senator johnson all in favor say aye aye all opposed like sign i think that'll do us for today uh we're not coming back this afternoon if we
Speaker 64
2:27:02
need to any anybody any other business would be thirsty thank you we're adjourned thank you 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 70
Daud Rasan
Unverified
Speaker 110
Speaker 63
Loretta Bosing
Unverified
Speaker 117
Senator Mark Johnson
Unverified
Speaker 131
Speaker 126
Speaker 135
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
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Speaker 217
Speaker 221
Speaker 233
Speaker 229
Speaker 253
Speaker 254
Speaker 144
Speaker 23
Ashley Ellis
Unverified
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