Insurance & Commerce- House
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Transcript
1 document
Bills discussed (41)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1424
Act 628
· 7 mentions in transcript, agenda, chapter
Matched: “…will be my last one. I appreciate everyone's patience. Uh, House Bill 1424. And if I could, Mr. Chairman, I'd like to”
|
TO MANDATE COVERAGE FOR SEVERE OBESITY TREATMENTS. | L. Johnson | Notification that HB1424 is now Act 628 |
|
HB1288
Act 423
· 3 mentions in transcript, agenda, chapter
Matched: “OK. You may proceed with House Bill 1288. Members, this bill is about trying to expediate the creden…”
|
TO AMEND THE ARKANSAS HEALTH CARE CONSUMER ACT; AND TO REQUIRE A HEALTHCARE INSURER TO … | L. Johnson | Notification that HB1288 is now Act 423 |
|
HB1300
Act 510
· 3 mentions in transcript, agenda, chapter
Matched: “out of order, I'd like to go down to House Bill 1300. And I do have an amendment to this bill. Yeah. OK.”
|
TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT. | L. Johnson | Notification that HB1300 is now Act 510 |
|
HB1238
Act 306
· 2 mentions in chapter, agenda
Matched: “HB1238 Cavenaugh TO AUTHORIZE A MORTGAGOR TO RECOVER FEES IN CERTA…”
|
TO AUTHORIZE A MORTGAGOR TO RECOVER FEES IN CERTAIN CIRCUMSTANCES UNDER THE STATUTORY FORECLOSURE LAW. | Cavenaugh | Notification that HB1238 is now Act 306 |
|
HB1297
· 2 mentions in agenda, chapter
Matched: “…E LAW CONCERNING LOANS INVOLVING THE STOCK OF A STATE BANK. HB1297 L. Johnson CONCERNING ARTIFICIAL INTELLIGENCE, ALGORITHMS,…”
|
CONCERNING ARTIFICIAL INTELLIGENCE, ALGORITHMS, AND OTHER AUTOMATED TECHNOLOGIES; AND TO REGULATE CERTAIN PRACTICES OF HEALTHCARE … | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1299
· 2 mentions in chapter, agenda
Matched: “HB1299 L. Johnson TO PROHIBIT HEALTHCARE INSURERS FROM EXERCISING…”
|
TO PROHIBIT HEALTHCARE INSURERS FROM EXERCISING RECOUPMENT FOR PAYMENT OF HEALTHCARE SERVICES MORE THAN ONE … | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1301
Act 511
· 2 mentions in chapter, transcript
Matched: “HB1301 L. Johnson TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY AC…”
|
TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT. | L. Johnson | Notification that HB1301 is now Act 511 |
|
HB1307
Act 308
· 2 mentions in chapter, agenda
Matched: “HB1307 McAlindon TO ENSURE RESPONSIBLE FUND MANAGEMENT; AND TO AME…”
|
TO ENSURE RESPONSIBLE FUND MANAGEMENT; AND TO AMEND THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS … | McAlindon | Notification that HB1307 is now Act 308 |
|
HB1316
Act 390
· 2 mentions in chapter, agenda
Matched: “HB1316 F. Allen TO MANDATE COVERAGE FOR LUNG CANCER SCREENINGS.”
|
TO MANDATE COVERAGE FOR LUNG CANCER SCREENINGS. | F. Allen | Notification that HB1316 is now Act 390 |
|
HB1426
Act 569
· 2 mentions in chapter, agenda
Matched: “HB1426 L. Johnson TO AMEND THE HEALTHCARE CONTRACTING SIMPLIFICATI…”
|
TO AMEND THE HEALTHCARE CONTRACTING SIMPLIFICATION ACT. | L. Johnson | Notification that HB1426 is now Act 569 |
|
HB1509
Act 452
· 2 mentions in chapter, agenda
Matched: “HB1509 Beaty Jr. TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY…”
|
TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY ACT; AND TO PROHIBIT FINANCIAL INSTITUTIONS FROM USING … | Beaty Jr. | Notification that HB1509 is now Act 452 |
|
HB1547
· 2 mentions in chapter, agenda
Matched: “HB1547 L. Johnson TO AMEND THE WATER AUTHORITY ACT; AND TO AMEND T…”
|
TO AMEND THE WATER AUTHORITY ACT; AND TO AMEND THE DEFINITION OF "QUALIFIED CORPORATION" UNDER … | L. Johnson | WITHDRAWN BY AUTHOR |
|
HB1602
Act 633
· 2 mentions in transcript, chapter
Matched: “House Bill 1602. And I have a, I have an amendment to that bill if the staf…”
|
TO AMEND THE ARKANSAS PHARMACY BENEFITS MANAGER LICENSURE ACT; TO ESTABLISH FEES UNDER THE ARKANSAS … | L. Johnson | Notification that HB1602 is now Act 633 |
|
HB1652
Act 393
· 2 mentions in agenda, chapter
Matched: “…estrictions designating areas as 'Members and Staff Only'. HB1652 Tosh T0 AMEND THE LAW CONCERNING SELF-SERVICE STORAGE FACIL…”
|
T0 AMEND THE LAW CONCERNING SELF-SERVICE STORAGE FACILITIES; TO ENFORCE AN UNSIGNED SELF-SERVICE FACILITY STORAGE … | Tosh | Notification that HB1652 is now Act 393 |
|
HB1659
· 2 mentions in chapter, agenda
Matched: “HB1659 S. Meeks TO AMEND THE UNIFORM COMMERCIAL CODE; AND TO CLARI…”
|
TO AMEND THE UNIFORM COMMERCIAL CODE; AND TO CLARIFY THE PRIORITY AMONG SECURITY INTERESTS AND … | S. Meeks | Died in House Committee at Sine Die adjournment. |
|
HB1700
Act 638
· 2 mentions in agenda, chapter
Matched: “…RY PRACTICES; AND TO PROVIDE FOR ENFORCEMENT OF VIOLATIONS. HB1700 Achor TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT; AN…”
|
TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT; AND TO CLARIFY THE PROCESS OF AN ADVERSE … | Achor | Notification that HB1700 is now Act 638 |
|
SB229
· 2 mentions in chapter, agenda
Matched: “SB229 J. Boyd TO CREATE THE DEPARTMENT OF FINANCIAL SERVICES WITH…”
|
TO CREATE THE DEPARTMENT OF FINANCIAL SERVICES WITHIN THE DEPARTMENT OF COMMERCE. | J. Boyd | Sine Die adjournment |
|
SB237
Act 554
· 2 mentions in agenda, chapter
Matched: “…TING OF CERTAIN INFORMATION BY A PHARMACY BENEFITS MANAGER. SB237 J. Boyd TO AMEND THE LAW CONCERNING THE LICENSING AND REGUL…”
|
TO AMEND THE LAW CONCERNING THE LICENSING AND REGULATION OF CAPTIVE INSURERS. | J. Boyd | Notification that SB237 is now Act 554 |
|
SB242
Act 344
· 2 mentions in agenda, chapter
Matched: “…RUG REIMBURSEMENT PROCESS FOR CERTAIN HEALTHCARE PROVIDERS. SB242 Hill TO AMEND THE LAW CONCERNING LOANS INVOLVING THE STOCK…”
|
TO AMEND THE LAW CONCERNING LOANS INVOLVING THE STOCK OF A STATE BANK. | Hill | Notification that SB242 is now Act 344 |
|
SB276
Act 345
· 2 mentions in chapter, agenda
Matched: “SB276 B. Johnson TO AMEND THE LAW CONCERNING SURPLUS LINES INSURA…”
|
TO AMEND THE LAW CONCERNING SURPLUS LINES INSURANCE; AND TO CLARIFY THAT SURPLUS LINES INSURANCE … | B. Johnson | Notification that SB276 is now Act 345 |
|
SB307
Act 373
· 2 mentions in transcript
Matched: “…o have to meet next Monday after the House adjourns to hear SB 307. So mark your calendar for that.”
|
TO AMEND THE LAW CONCERNING PUBLIC UTILITIES; TO CREATE THE GENERATING ARKANSAS JOBS ACT OF … | J. Dismang | Notification that SB307 is now Act 373 |
|
HB1009
· 1 mention in agenda
Matched: “…NCE COVERAGE. PENDING FISCAL IMPACT Number Sponsor Subtitle HB1009 A. Collins TO ALLOW PREGNANCY TO BE A QUALIFYING EVENT FOR…”
|
TO ALLOW PREGNANCY TO BE A QUALIFYING EVENT FOR ENROLLMENT IN CERTAIN HEALTH BENEFIT PLANS. | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1014
· 1 mention in agenda
Matched: “…FYING EVENT FOR ENROLLMENT IN CERTAIN HEALTH BENEFIT PLANS. HB1014 A. Collins TO REQUIRE COVERAGE OF IN VITRO FERTILIZATION UN…”
|
TO REQUIRE COVERAGE OF IN VITRO FERTILIZATION UNDER THE STATE AND PUBLIC SCHOOL LIFE AND … | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1055
· 1 mention in agenda
Matched: “…BLIC SCHOOL LIFE AND HEALTH INSURANCE PROGRAM. Page 2 of 4 HB1055 J. Mayberry TO ESTABLISH COVERAGE DIAGNOSIS AND TREATMENT T…”
|
TO ESTABLISH COVERAGE DIAGNOSIS AND TREATMENT TO SLOW THE PROGRESSION OF ALZHEIMER'S DISEASE OR OTHER … | J. Mayberry | Died in Senate Committee at Sine Die adjournment. |
|
HB1150
Act 624
· 1 mention in agenda
Matched: “…STATE AND PUBLIC SCHOOL LIFE AND HEALTH INSURANCE PROGRAM. HB1150 J. Moore TO PROHIBIT A PHARMACY BENEFITS MANAGER FROM OBTAI…”
|
TO PROHIBIT A PHARMACY BENEFITS MANAGER FROM OBTAINING CERTAIN PHARMACY PERMITS. | J. Moore | Notification that HB1150 is now Act 624 |
|
HB1159
· 1 mention in agenda
Matched: “…EALTH BENEFIT PLANS. DEFERRED BILLS Number Sponsor Subtitle HB1159 J. Richardson TO CREATE THE RETAIL CONVENIENCE STORE SECURI…”
|
TO CREATE THE RETAIL CONVENIENCE STORE SECURITY ACT; AND TO REGULATE SECURITY MEASURES AT RETAIL … | J. Richardson | Died in House Committee at Sine Die adjournment. |
|
HB1240
· 1 mention in agenda
Matched: “…Y BENEFITS MANAGER FROM OBTAINING CERTAIN PHARMACY PERMITS. HB1240 Andrews TO EXPAND ELIGIBILITY FOR COVERAGE UNDER THE STATE…”
|
TO EXPAND ELIGIBILITY FOR COVERAGE UNDER THE STATE AND PUBLIC SCHOOL LIFE AND HEALTH INSURANCE … | Andrews | Recommended for study in the Interim by the … |
|
HB1290
· 1 mention in agenda
Matched: “…HEALTH INSURANCE PROGRAM TO CERTAIN VOLUNTEER FIREFIGHTERS. 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. |
|
HB1314
Act 512
· 1 mention in chapter
Matched: “HB1314 L. Johnson TO AMEND THE LAW CONCERNING CERTAIN AUDITS OF HE…”
|
TO AMEND THE LAW CONCERNING CERTAIN AUDITS OF HEALTHCARE PROVIDERS; AND TO CREATE THE ARKANSAS … | Irvin | Notification that HB1314 is now Act 512 |
|
HB1320
Act 626
· 1 mention in agenda
Matched: “…COVERAGE FOR HEALTHCARE SERVICES PROVIDED IN MOBILE UNITS. 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 |
|
HB1321
Act 513
· 1 mention in agenda
Matched: “…CERNING CRISIS STABILIZATION UNITS AND HEALTHCARE INSURERS. HB1321 Wooldridge TO REGULATE STEP THERAPY AND FAIL FIRST PROTOCOL…”
|
TO REGULATE STEP THERAPY AND FAIL FIRST PROTOCOLS CONCERNING CERTAIN PRESCRIBED VENTILATORS. | Wooldridge | Notification that HB1321 is now Act 513 |
|
HB1333
Act 627
· 1 mention in agenda
Matched: “…FIRST PROTOCOLS CONCERNING CERTAIN PRESCRIBED VENTILATORS. HB1333 Hudson TO MANDATE COVERAGE FOR BREASTFEEDING AND LACTATION…”
|
TO MANDATE COVERAGE FOR BREASTFEEDING AND LACTATION CONSULTANT SERVICES. | Hudson | Notification that HB1333 is now Act 627 |
|
HB1354
· 1 mention in agenda
Matched: “…VERAGE FOR BREASTFEEDING AND LACTATION CONSULTANT SERVICES. HB1354 Lundstrum TO REGULATE PHARMACY BENEFITS MANAGERS; TO AMEND…”
|
TO REGULATE PHARMACY BENEFITS MANAGERS; TO AMEND THE LAW CONCERNING THE STATE AND PUBLIC SCHOOL … | Lundstrum | Recommended for study in the Interim by the … |
|
HB1409
· 1 mention in agenda
Matched: “…TO REGULATE SECURITY MEASURES AT RETAIL CONVENIENCE STORES. HB1409 Long TO AMEND THE LAW REGARDING ENERGY; AND TO CREATE THE E…”
|
TO AMEND THE LAW REGARDING ENERGY; AND TO CREATE THE ELECTRIC RELIABILITY ACT. | Long | Died in House Committee at Sine Die adjournment. |
|
HB1443
· 1 mention in chapter
Matched: “HB1443 Pilkington TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY…”
|
TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY ACT; TO PROHIBIT FINANCIAL INSTITUTIONS AND PAYMENT NETWORKS … | Pilkington | Died in House Committee at Sine Die adjournment. |
|
HB1467
Act 557
· 1 mention in agenda
Matched: “…NG A FLEXIBLE SPENDING ACCOUNT OR A HEALTH SAVINGS ACCOUNT. HB1467 Achor TO AMEND THE UNIFORM MONEY SERVICES ACT. HB1519 Caven…”
|
TO AMEND THE UNIFORM MONEY SERVICES ACT. | J. Boyd | Notification that HB1467 is now Act 557 |
|
HB1531
Act 630
· 1 mention in chapter
Matched: “HB1531 Achor TO PROHIBIT PHARMACEUTICAL MANUFACTURERS FROM RESTRIC…”
|
TO PROHIBIT PHARMACEUTICAL MANUFACTURERS FROM RESTRICTING OR LIMITING PRESCRIPTION MEDICATIONS TO A LIMITED DISTRIBUTION NETWORK … | Achor | Notification that HB1531 is now Act 630 |
|
HB1533
· 1 mention in agenda
Matched: “…ULATE SOLICITING RESIDENTIAL CONTRACTORS AND TREE TRIMMERS. HB1533 Gramlich TO CREATE THE DECENTRALIZED UNINCORPORATED NONPROF…”
|
TO CREATE THE DECENTRALIZED UNINCORPORATED NONPROFIT ASSOCIATION ACT. | Gramlich | Recommended for study in the Interim by the … |
|
HB1625
Act 974
· 1 mention in agenda
Matched: “…K DEPARTMENT, AND STATE Page 3 of 4 SECURITIES DEPARTMENT. HB1625 Barnett TO AMEND THE LAW CONCERNING INSURANCE REQUIREMENTS…”
|
TO AMEND THE LAW CONCERNING INSURANCE REQUIREMENTS FOR LICENSED HOME INSPECTORS. | Barnett | Notification that HB1625 is now Act 974 |
|
HB1703
Act 570
· 1 mention in chapter
Matched: “HB1703 L. Johnson TO PROVIDE A DRUG REIMBURSEMENT PROCESS FOR CERT…”
|
TO PROVIDE A DRUG REIMBURSEMENT PROCESS FOR CERTAIN HEALTHCARE PROVIDERS. | L. Johnson | Notification that HB1703 is now Act 570 |
|
SB240
Act 343
· 1 mention in chapter
Matched: “SB240 Hill TO AMEND THE CREDIT REPORTING DISCLOSURE ACT OF 1989;…”
|
TO AMEND THE CREDIT REPORTING DISCLOSURE ACT OF 1989; AND TO CLARIFY THE CONTENT REQUIRED … | Hill | Notification that SB240 is now Act 343 |
Machine transcript
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At some point, um, and we're just going to remove that from the agenda. And of course, if you have something on deferred that you're wanting to run, um, then, then let me know that also we did get numerous fiscal impacts back, so we're making progress on that. Um, again, we're hoping to start cleaning up this agenda somewhat. Um, I do have one. This isn't terrible news, but we are going to have to meet next Monday after the House adjourns to hear SB 307. So mark your calendar for that.
something that could take some time, um, and again, we are trying to to kind of clean up our agenda. So next Monday, um, after the House adjourns, we'll hear that one bill, um, and that is the energy bill you've probably heard a lot about, just so you know, but it's SB 307, so be prepared for that next Monday afternoon. I believe the first person on the agenda is Representative Kavanaugh. If you would come to the table. Introduce yourself and I believe
Representative Frances Cavenaugh
Unverified
1:13
you have a concurrence. Thank you, Mr. Chair. Uh, Frank Kavanaugh,
State Rep District 30. And this is just to concur on an amendment on HB 1230H, which defines more of when I um attorney fee may be awarded. And with that take any questions.
Representative Lee Johnson
Unverified
1:35
OK, um, representative Kavanaugh has explained the concurrence, uh, she's open to any questions? Are there any questions from the committee?
OK, seeing no one. Sure one in the other two would like to speak against this.
Representative Frances Cavenaugh
Unverified
1:54
Anyone else likes to speak for this? Do you like
to close? Thank you, I'm close. I appreciate it. A good vote. Thank you. Represent Allen, you are recognized. We have a motion for a concurrence on the Senate amendment. All in favor say aye. Any post say no. Congratulations, you've passed your bill. Thank you, members.
Representative Johnson, I believe you have a few bills that you. I think we'll go fairly quickly, is my understanding, um. If you would go to the end of the table and please, please identify the bill number you plan to start with. And again, uh, members and Um People in the audience were trying to run through the bills, um, beginning that aren't going to take too much time. So that's why we're jumping out of order. So Representative Johnson,
Speaker 14
2:49
you may proceed. Yeah, Representative Lee Johnson, District 47. I'd like to present
Representative Lee Johnson
Unverified
2:53
House Bill 1602. And I have a, I have an amendment to that bill if the staff could
pass that amendment out. OK, members, um, staff is passing out the amendment, Representative Johnson, if you'd like to go ahead and start with, um, the amendment. Yeah, this
Representative Lee Johnson
Unverified
3:26
amendment changes some language that was in the original bill around the licensure fee and also add some language around protecting some of the data in the bill, and I'd be happy to answer any questions on the amendment. Any questions on
Speaker 23
3:37
the amendment, members? Seeing non, do you have a motion, Representative Johnson? Make a motion to adopt the
amendment. I have a motion to adopt the amendment. All in favor say aye. And if I say no or some John you recognize to proceed with your bill as amended. Sure. Members under the
Representative Lee Johnson
Unverified
3:58
current PBM licensure Act, I was reviewing that in the interim and came across the lozener fee. This act was passed back in 2017, and when it was passed, it was sort of first in the nation of its kind. It was we were a leader in this kind of bill around lots of PBMs and the original fee was set at $1000. with no renewal and that felt like a fee to me at this point with how PBMs have grown and how they progressed that maybe needed a market adjustment, um, and so in addition to that, the
way PBMs are structured, um, it can be a little complicated. I've learned a little bit about that over the last few weeks. They have different banking identification numbers that divide up how they are, who they are, and so what this bill intends to do is two things really. One is to increase the fee. We were increasing the fee. To $20,000 as an initial fee and $20,000 as a renewal right now that's a negotiated rate. I don't think that there's anyone here that's going to come and speak against that rape proposal. We have that money going directly back as special
revenue to the AID for enforcement issues around PBMs, you know, because of the PBMs we have, you know, incurred some increased costs around enforcement through AID, and so the intent of that money is to go back to AID for that purpose, and then additionally we've got some transparency language in there to try to help, help us understand better how PBMs are structured, how AID understand better how they're structured so that again from an enforcement standpoint they'll have better ways to identify and
know exactly who is or is not, you know, responsible
for different actions in the market, and I'd be happy to try to answer any
questions on this bill if anyone has any. Any
Representative Jim Wooten
Unverified
5:46
questions from the members? Representative Wootton, you're recognized. Representative Johnson, what, what, what information do they have to give about their ownership in uh in in uh Requesting a license. So I, I, I, I would have to look
Representative Lee Johnson
Unverified
6:01
back and refer to the original act. I'm not changing anything around the original act and what kind of information they have to give. I am changing about information as to
how they're structured around these BIN numbers, but as far as the specific ownership, I don't know that I would know the answer to that question.
Representative Jon S. Eubanks
Unverified
6:15
All right. Thank you. Thank you, Representative Eubanks. Thank you, Mr. Chair. Representative Johnson, is it an annual renewal? Did that,
Representative Lee Johnson
Unverified
6:22
did you get a doctor's note to be here banks just out of curiosity, I looked down there
and I was surprised to see you. Yes, it's an annual renewal. Yes, sir.
Representative R. Scott Richardson
Unverified
6:33
Any other Representative Richardson. Representative Johnson, the 20,000 negotiated. What, what caused it to jump? Well, so again, it's hard to know how to work backwards
Representative Lee Johnson
Unverified
6:41
from remembering what's fair and what's not fair. Uh, I had originally looked at a rate of 50,000 and I was just trying to look proportionately based on what, like I know my license your fee every year is about $500. And I know on average what a physician's going to generate in the way of income, and I'm just trying to look proportionately at what I thought was fair related to what
PBMs generate and what there would be and that's based on The money's a little bit bad. I mean, it's a little bit based on pulled out of thin air too, right? And, and having a starting point for a conversation, and in that conversation this was the number that we came to that everyone on both sides, which would be, you know, myself, the people that I've discussed this with around the PBM space and then also the pharmacist as something NAID as something that would be reasonable and again provide a reasonable amount of annual revenue to support the expense that AID feels like they're incurring. That's part of it
too, represent rich is kind of having an idea of how much, how much have we had to add in the way of cost at AID to support some of the um
You know, investigation and different enforcement things that are going on and how do we meet that cost and this was again that number that we sort of came to that is a grand total with 47 PBMs, which generates around $800,000 a year, which is about what You know, we're, we're now incurring an increased costs. That's where the number came from. Hm
Any other questions from the committee? OK. Saying none. Is there anyone in the audience who would like to speak against this bill. President Johnson, you're recognized. I'm making. Merchant to pass
Speaker 44
8:23
as as amended that's proper motion. We have a motion to pass
as amended all in favor say aye. In the post, I know. Congratulations, you've passed your bill. Thank you. If I may now, House Bill 12288.
Representative Lee Johnson
Unverified
8:48
OK. You may proceed with House Bill 1288. Members, this bill is about trying to expediate the credentialing process and make sure that once a physician has completed a certain part of their application, uh, the, the, the payments can be made back retrospective to that date. Uh, so sometimes there's a delay in processing credentialing application with the payer, and that delay sometimes can result in a time period where a physician is practicing, seeing patients. that aren't being reimbursed because they aren't enrolled
with the payer, so this is an effort to try to tie that start date back to the CCBS, which is the credentialing information process we use as a state through the medical board. This again is a negotiated bill worked on with the payers and at this point I don't think there's any opposition to this bill, and I'd be happy to answer any questions. Any questions from the committee? saying no,
is there anyone in the audi like speak against this bill. Hm Representative Johnson, you recognized. I'm close for my bill.
The person's job is closed for his bill motion do pass,
Representative Lee Johnson
Unverified
9:52
all in favor say aye. And pose no. Congratulations, you passed your bill. Members, if I may take
out of order, I'd like to go down to House Bill 1300. And I do have an amendment to this bill. Yeah. OK.
Speaker 51
10:28
Staff is passing out the amendment. You may, you may proceed, Representative John, proceed on the
Representative Lee Johnson
Unverified
10:32
amendment. Members of this amendment just changes some language in the original bill. This is, this is a bill that's looking at the prior authorization Transparency Act, and you know, there have been some you know, uh, opportunities for improvement around how we do prior authorizations. I think everybody would agree with that, both the payers and the providers. Uh, we've been working on that for several sessions. This is another attempt to
try to uh both clean up and clarify some issues around prior authorization and this amendment is just.
negotiated language from the original bill based on meetings with payers and
providers, and I'd be happy to answer any questions on the amendment itself. Questions on the amendment, members. Seeing none. Make
a motion we adopt a motion to adopt the amendment by view banks all in favor say aye. Any post say no. You may proceed with your bill as amended. Members,
Representative Lee Johnson
Unverified
11:20
as I mentioned, this is an effort to try to clarify some things around the prior authorization Transparency Act. There's a lot of parts of this
bill. It's a big bill, but it is something that's been worked on a lot. This is a bill we started on before the session was shared early with payers, and we've had a lot of meetings back and forth and right now I would say this is a result of a lot of good negotiations, and at the moment. I don't think anyone's here to oppose this bill. I have agreed to continue to work on the bill once it gets over in the Senate. If there are any further amendments I've agreed to continue to work through this process, but at this point I think we have a good bill that we can get out of the house, and
I'd be happy to try to answer any questions on the specifics
of the bill if anyone has any. Members, any questions? Representative Landstrom, you're
Representative Robin Lundstrum
Unverified
12:06
recognized. Could you give me like the three big points of the bill where we're going with this.
Representative Lee Johnson
Unverified
12:10
I'm going to have someone come to the table with me because I could, I could certainly try it. Well, let me try to give you the big points. 11 of the things we're doing with this is we are creating a, a fund to go back to uh AID again trying to recognize that we've asked AID to do a lot of enforcement in different areas, including prior authorization, and so we've
created a fine section at the bottom of the bill that will feed back into this prior authorization transparency. Fund Act that will allow AID to have a funding source for some of the enforcement around these issues. Additionally, we're trying to clarify what is defined as a prior authorization. So one of the issues we had when we passed the gold card legislation last session was sort of we said, you know, here's what a prior authorization means. In the interim there's been some terms that have come out and there's a list of those you'll
see them on page 3, lines 11 through 22. This is clarifying that all of those things on that page are actually considered a prior authorization, so we're clarifying the definition of prior authorization as well. To try to make sure that people that that there's clarity on both sides. So if you say we're using one of these processes, pre-admission review, pre-treatment review, pre-certification. These are all synonyms for prior authorization. Um, There are other things in the
bill, but those are the those are the main things that we're trying to do there. Um, I, I, I could go through it sort of along the line. I could also have somebody come to the table that's a lot more familiar with the bill if you want a more detailed synopsis. I get the
Representative Robin Lundstrum
Unverified
13:44
big, where we're going. Yeah, those are the big pictures,
Representative Lee Johnson
Unverified
13:48
I would say. Thank you Westrom. Any other questions from the committee? OK. Saying that is really one of the other two like to speak against this bill. In order to like speak for
anyone else likes for this bill. OK, Representative Johnson, you're
recognized. I'm close to the bill making a motion to do pass
Speaker 23
14:10
as I did. I apologize. Um, we're gonna back up and
Representative Les D. Eaves
Unverified
14:12
we're gonna let Representative Eaves ask a question. You, you're establishing a new fund, is that right?
Representative Lee Johnson
Unverified
14:18
Correct. And how is it being funded? It would be funded through funds as related to prior authorization. So if someone has a, a, you know, an issue and, and Andy says, hey, you actually did something that was inappropriate or against regulation rule, then they could impose a fine and then that fine would feed back to the do you have any idea how much?
We can expect to be in that fund I don't. I'd have to ask someone from AD to come and say what they expect. I will say that there were negotiations around the amounts of the fee, and I would say the payers are not supportive of fees in the amounts of the fees, but they are also understand that there has to be some sort of, you know, penalty imposed, and so I don't want to mislead and say this is like supported by the industry, but it is something I think is fair. I mean, I think it's fair in the process if you're going to have a rule, a law, and it's violated that there There should be some kind of
penalty imposed, and that's the design. Thank you, Representative Eaves. Um, you'll recognized for your motion first. I make a motion and do pass as amended.
OK. We have a motion to pass as amended. All in favor say
Representative Lee Johnson
Unverified
15:21
aye. You both say no. Your bill is passed. If I could present House Bill 1301. I appreciate the committee's patience. There is
an amendment to that bill as well. Members, this is the go-kart legislation that we passed last session. This is an amendment again, like
1300, this is a bill that's been out there for a while, as you can imagine, there's a lot of discussions around the bill we passed last session around GoCart, um, and, you know, as you do with any law, sometimes you don't get it exactly right out of the gate and so we come back, and we make changes to it to try to improve it for both, uh, for all people involved in the in the in the law, this amendment is an amendment to the bill that's been negotiated and agreed upon language, and I don't think
there Any, anyone with any opposition to the amendment, and I'm happy
to take any questions on the amendment. Thank you, Representative Johnson. Questions from the committee? Saying that anyone else like
to speak against this bill. Representative Johns still recognized. So members, this bill, one of the things we did not do last session
when we passed this legislation, which we actually did not include a definition of go-kart, and what that means, that's a term we used a lot around the legislation that you recall,
that's a process let me interrupt you.
I apologize. Someone came up and talked to me and got me, um. It's all good, Mr. Chan, off my game anyway, um, I believe we need to, I don't believe we
adopted the amendment. They commotion adopt the motion to adopt the amendment. OK. All in favor of the most to adopt the amendment,
Representative Lee Johnson
Unverified
16:59
say aye. Any posts say no. OK. So members, as you recall, go-kart is a process where we reward providers that are that are exhibiting uh quality uh choices around when they order
tests, you know, in the process and the idea behind that is that we say, hey, listen, if you are getting this right, a certain percentage of the time, then you can be exempt from asking for prioritization for that procedure for a period of time. Uh, conceptually what we did last session is we forgot to define gocarts, so that's one of the things this does. Again, the last session. We did everything retrospective because we had no prospective data and so we're switching that process now that we've got this up and running, we're striking all the retrospective language
and we're moving to a prospective process for people that are new to gokart, moving to the state and new for people that are needing renewals for people that maybe have been denied a go card and so we're just better defining that process and switching mainly from a retrospective to prospective look and then clearing up. Clerical things that came up in the interim around executing the process for both the payers and the providers. Again, this is negotiated and agreed
to bill, and I'd be happy to answer any questions on it.
Thing and Johnson. Any questions from the committee? OK. Saying none, should anyone else should like to speak against this bill. Represent
Josh be recognized. I'm close to the bill and make a motion
to pass as amended. We have a motion to pass
as amended. All in favor say aye. You say no. You've passed your bill, members,
Representative Lee Johnson
Unverified
18:28
this will be my last one. I appreciate everyone's patience. Uh, House Bill 1424. And if I could, Mr. Chairman, I'd like to
have uh Doctor Sam Bledsoe come to the table with me to speak to this bill. Yes, just have, um, have your
guest introduce himself and who he's with and then y'all can proceed with your testimony. Good
Sam Bledso
Unverified
18:54
morning. My name is Doctor Sam Bledso. I'm from the Arkansas Heart Hospital. I'm
Speaker 75
19:01
Doctor Aaron. I'm Doctor Eric Paul from uh Baptist Health Medical Center, bariatric surgeon. The
Representative Lee Johnson
Unverified
19:06
members, I think we all know the the uh problems with obesity we have in this country, in this state in particular, and the challenges that presents from a healthcare
perspective. There are, there are all sorts of solutions to try to address obesity. Many tools in the toolbox and one of the most important tools we have is bariatric surgery. I'm no expert in this matter. That's why I brought folks to the table and I'm going to turn it over to them for some testimony
Sam Blitz
Unverified
19:31
and questions. Thank you committee and my name is Doctor Sam Blitz. I'm a general and bariatric surgeon over the Arkansas Heart Hospital where I serve as the medical director of one of Arkansas's few certified bariatric programs. I'm also the medical director of Encore Medical Center over in Bryant, and I've
got over 20 years of bariatric surgery experience, including 16 years in private practice and so I've seen firsthand the toll that obesity takes on Arkansans, and I'm here to urge you to support House Bill 1424. This is a practical bill. It's a pro-patient step forward in our state's health. 3 years ago in March of 2022 Act 109 became law in the state of Arkansas, and many of you were co-sponsors of that legislation, and this bill mandated bariatric surgery coverage for Arkansas employees through the employee benefits division. You passed it because
it made sense. It made sense medically. It made sense economically, and it made sense ethically. House Bill 1424 builds on that with the same rationale, extending coverage to virtually every Arkansan. This is not a radical overhaul. It's a expansion could provide this benefit to 250,000 to 500,000 Arkansans struggling with obesity and the devastating effects. We do estimate that 1 to 2% of those people would probably avail themselves of the surgery, so by no means would everybody do that. Um, Arkansas, as you know, is one of the
sicker states in the nation. The latest CDC data shows that we rank 3rd for obesity with over 40% of our population adults affected by obesity. This drives alarming rates of obesity-related diseases and health care costs. During AT 109's passage, the Siegel Group, acting as outside consultants identified 4 major cost drivers of Arkansas's EBD health plans. One was diabetes. 2 is cardiovascular disease. Number 3 is cancer. And number 4 were the orthopedic issues, all
of which will positively benefit from bariatric surgery. And of course cost concerns will arise and appropriately so you were stewards of the state's resources, but the language contained in Act 109, I think, tells a really good story in Act. I says this, quote, Payers can rely on bariatric surgery, paying for itself through decreased comorbidities within 2 to 4 years. Act 109 also documented the Siegel finding of a reduction of 45% in medical costs per member per month. Uh, these numbers were not global numbers. These
weren't national numbers. These numbers were based on EBD data. This data was cross referenced with Blue Cross filings, and these are Arkansas numbers showing real savings for Arkansas taxpayers. Uh, bariatric surgery addresses these economic realities in two ways. Number 1, curing current disease, and number 2, preventing future ones, curing disease saves dramatically, but prevention yields even bigger savings as the Seag Group said the best cost discount is the service that didn't have to happen. Imagine the cost savings
if an at-risk patient never develops diabetes in the first place or avoids a joint replacement altogether or set another way. What is the cost savings of a heart attack that never happened. Uh, we're not alone, we're not alone in recognizing these benefits. Last year, Louisiana passed similar legislation proving that our neighbors see the same need and the same value. House Bill 1424 isn't about spending more. It's about spending smarter, tackling obesity, and now and tackling obesity now to avoid paying for its consequences later. House Bill 1424 gives Arkansans a
fighting chance against diabetes, against heart disease, and against a cycle of perpetual sickness that can be broken, and I respectfully ask for your support to pass House Bill 1424 and make Arkansas. healthier for all
Speaker 77
23:06
of us. Thank you for your time. Just to piggyback on what Dr. Bledsoe just said, um, This is a this is a, um, um, a disease of, of, uh. Ongoing Um
Just, and I'm blanking, of course. I'm sorry. Um, I'm in the prevention business. I'm here to prevent people from going on dialysis. I'm here to get people off of disability. I'm here to increase the quantity and quality of someone's life, um, what I do is something that is uh. It is a benefit to not only the patient themselves but to their families and um we touch so many
people by our by our science, our art, and I would also like to uh ask that you please give this bill careful consideration because Uh, as we are always in the top 5 states in obesity in this country, I would, I would like to help as
Speaker 79
24:06
many people as possible. Thank you. Thank you for that testimony. If you think every one of us in here hasn't blinked to
Representative Lee Johnson
Unverified
24:15
the microphone at some point. You just watch us because it happens to all of us. Members will be
happy to answer any questions on this bill if anybody has any.
There are there are questions in the queue. Resident Eaves, I believe you're first. Thank you. Any idea what this is going to cost, um. The Medicaid
Speaker 84
24:35
program. I And I may be wrong, but I don't think, I
Representative Lee Johnson
Unverified
24:39
think, I think we've, I don't think Medicaid's included in this bill. I don't think DHS included this bill. There's no fiscal impact to DHS. Mhm And one more question.
Representative Les D. Eaves
Unverified
24:58
There's a um page one, it does not require Arkansas Medicaid program to provide coverage for injectables. So those would be the ones that lower glucose levels or any other drugs. Is there a reason we're, we're
Representative Lee Johnson
Unverified
25:09
taking that. So, that came directly from DHS, so you know with this bill started a little
different than it was, and we took amendments from different people, and that was an amendment that came directly from them. I think they're just clarifying, you know, any, any law or bill that came after this bill that was different, obviously, as I know all the members in here know would supersede this bill with regard to anything, even if it was
super, even if it was injectables. OK. So
Representative Les D. Eaves
Unverified
25:34
you're adding the coverage though, but we don't know who's paying for the coverage. The
Speaker 88
25:39
coverage would be specific to commercial payers in the marketplace.
Representative Les D. Eaves
Unverified
25:43
Um, this is Arkansas Medicaid program shall reimburse for the treatment of diseases and conditions caused by severe obesity, and you've got bariatric surgery in there. And I don't know if anyone's
Speaker 50
25:53
here from DHS right now. But Blitzer, you can speak to them. I do. Medicaid already
Speaker 89
26:01
covers it and so, but very few people avail themselves of it because of
Sam Blitz
Unverified
26:06
the reimbursement rates to the hospitals and and so that shouldn't change anything to my to my understanding any further expansion to Medicaid or DHS was carved out, and so this should go directly to the commercial payers, um, and to people who have commercial insurance currently
Speaker 89
26:22
we estimate there's upwards of 500,000 people who In the state of Arkansas who do not have bariatric surgery coverage, which is
the Medicaid already covers bariatrics, Medicaid already covers bariatric surgery, yes, sir. And so this would not be an expansion of anything in the Medicaid realm, yeah, and I think there's
Representative Lee Johnson
Unverified
26:40
there's some things in here, including in the bill if you read, as you know, that are beyond just bariatric surgery that we're asking for and it doesn't expand anything within the Medicaid. I think that's part of the reason they had language is they wanted to clarify that, hey, we're covering what we're covering. We're not going to expand what we cover, and I think that was. of the language. So
Representative Les D. Eaves
Unverified
26:57
Both of you guys do bariatric surgery? Yes, sir. Do you take Medicaid patients?
Speaker 89
27:03
No, I do. Why is that? They don't care enough. Exactly, you know, it's, it, it's very, very difficult to, you lose money on every single case, and I'm not talking about me personally, I would do
Sam Blitz
Unverified
27:14
it, but the hospitals can't can't afford to do it, um, because there's, um, because you lose money on every single case and it's hard to cover your expenses when you're, when that happens, and so it's a very difficult thing to do. I would do it myself, but that's a it's a different animal when you start talking to hospitals, and that, by the way, is very consistent across the the state of Arkansas. But, but
Speaker 89
27:33
there would be a cost to the private insurance companies.
Representative Les D. Eaves
Unverified
27:36
And then I guess potentially your, your rate, your insurance rate might go up because it's being covered. get to be max
Representative Lee Johnson
Unverified
27:42
I'm concerned about uh, yes, Representative Eaves, I mean, and
that's consistently the conversation that these committee meetings, right? I mean, this is a, this is a risk reward payoff. Anytime we come in here and and have a coverage mandate, the idea is to improve health care of our Kansans, and the idea is that that would have cost savings down the road. Those cost savings, as you all know, are very difficult to calculate.
It's difficult to have a dynamic fiscal impact that tells us what we're going to save. It's very easy to come up here and tell us what something's going to cost. So yeah, there's going to be a cost to the system and I'm sure. The payers would say that's going to translate to some increases in premiums, but again, Premiums go up and they've been going up and I'm not sure that you can argue that they're not going to go up if we don't pass this bill. So again, it's kind of back to the argument of, you know, is the payoff worth it? And in this particular case, when you consider this is a one-time surgery, no ongoing costs. It solves the problem of
obesity for many patients with many out downstream, you know, health care benefits around some of the issues Dr. Blitzer brought up around cardiovascular disease, orthopedic injuries, all the different things that create further costs downstream.
Yeah, I think there are would be
Representative Les D. Eaves
Unverified
28:48
cost savings down the road for people that get this. I'm just kind of, if we're gonna force insurance companies to cover bariatric surgery,
I mean, But we're excluding these new, what do you call them, you're a doctor's, yeah, but we're specifically excluding those. Is that what we're doing or just not including them in
Sam Blitz
Unverified
29:07
the bill or in this bill specifically, we were advised that when we were kind of putting this bill together to kind of break those out into two different things because the cost is very, very different. It's 10 $15,000 a year on average for these injectables. The surgery is a one time 1000 to $15,000 cost. And so, um, so the economics of it is very different and, and we thought it'd be better for y'all to be considering the economics. But on an individual basis. Thank you sir. Representative Wootton, you are next.
Representative Jim Wooten
Unverified
29:37
Thank you, Doctor Bledsoe, um, explain the difference again. relative to the injection and, and the, and the surgery. Um, would some people prefer to have the surgery versus the shot or does the shot come into play after the surgery. Yep. If they have a problem. No, very
good question. I see these as complementary. There are some people who
Speaker 89
30:02
would better benefit from the shots. There are some people who would better benefit
from the surgery, and there are some people who who would better benefit from both. And so, um, and so the, the, these things are just complementary. I use them in my own practice. There are some people who are Very, very overweight,
Sam Blitz
Unverified
30:18
who, um, they're gonna need shots afterwards or they need shots before to get them down to a safer weight so that we can operate. Some people would come in and they might prefer to have the shots, and I think that's a fine choice for them. I think the point of the legislation is that the choice should be offered to Arkansans so that they can have that choice of the shots or the surgery. This is a
specific carve out that insurance companies have done to say, hey, listen, we're not going to cover this, and so what we're saying is that, well, you don't have a carve out for breast cancer. You don't have a car, a carve out for. wrecks. So why do we have a carve out for um the most prominent metabolic disease in the country and certainly in the state of Arkansas. That doesn't make any sense, especially when the downstream effects our cardiac disease, orthopedic issues, diabetes, high blood pressure, sleep apnea, and all these other things that contribute to early mortality rates and costs to the system.
Representative Jim Wooten
Unverified
31:09
So this bill covers both requires. It does not, does not cover the the injections, just the surgery. Is that forthcoming because I've had a lot
of people share with me that they would prefer the shot versus the surgery. Is that going to be a later date I do think there's
Representative Lee Johnson
Unverified
31:28
a bill out there that I've seen that's been followed by different legislator around injectables, but that's separate and
Representative Jim Wooten
Unverified
31:36
apart from this bill. OK. All right, one more question. So,
If they, if they have the surgery.
Then long range. They will be their medical costs to the insurance companies will be reduced. So You want to respond? Sure.
Speaker 89
31:57
Yes, sir. So that that is what happens over time. Usually takes about, depending on which surgery you have, let's say 2
Sam Blitz
Unverified
32:04
years to recoup costs when the Siegel Group looked at it, they saw 45% decrease in medical costs per member per month. And
so that that is in Arkansans who were being who are being followed by the pilot program that we had for about 10 years here in the state of Arkansas. Um, the, the catch is, is that it takes 2 years for it to happen, which I think is part of the problem, and I don't mean this disparagingly, but insurance companies look kind of quarter to quarter. And so, um, and so I think that's part of the problem is is
Sam Bledso
Unverified
32:32
that since the cost savings are recouped over time, but that's a, that's part of the issue as to why that was a carve out on the on the front end is that the cost savings are over time versus versus a immediate. Thank you. Thank you, Mr.
Speaker 101
32:43
Chairman. Reverend layman. recognized. Thank you, Mr.
Representative Jack Ladyman
Unverified
32:51
Chairman. I mean, this is a great idea, but I have a lot of great ideas that we can't afford, and that's my concern. I mean, If Uh, we, we passed a bill for state employees, correct? Yes. And how many years ago was that? It was signed in 2022. So do we have any data on that that shows that there was a
savings and how much was that? Not, not that
Speaker 89
33:17
I'm aware of. I that we could get that information from EBD, I would imagine, but we did have data from the pilot program showing a 45% savings per member per month, and that was Arkansas data through EBD and through Blue Cross, but I think
Representative Jack Ladyman
Unverified
33:29
I heard you say that in 2 years we should be able to see some savings. We've had this more than
Sam Blitz
Unverified
33:35
2 years. It started, it was passed in 2022 and it went into effect
Representative Jack Ladyman
Unverified
33:38
in 2023. OK. Uh, well, I know, uh, private uh insurance, you know, is the one
that's going to pay this, but my concern is, will this raise rates. Uh, for everybody, people that are not affected by this, and I understand what you're trying to do, and I agree with that, but uh You know, our rate's going to go up. What, what, where are the insurance companies on this? Do they, are they opposing this? Are they for it? Are they neutral? Where are they? I think there'll be someone come to the table
Representative Lee Johnson
Unverified
34:07
when there's an opportunity to come and speak and you'll have an opportunity to talk to them and ask them some questions. All right, I'll wait to listen to them. Thank you.
Representative Robin Lundstrum
Unverified
34:18
Reps in stroke, you're right. Thank you. You talked about that this would be a cost savings, correct? Do
you have any idea of how much per customer after the $20,000 bariatric surgery, this would say. Well, the, the data I would go
Sam Blitz
Unverified
34:33
back to is what we got through the Segal Group with the EBD program, which is consistent with what we see nationally too. You get the savings after about 2 years, and of course it depends on the patient and how much medical savings you get individually, uh, but we expect
about a 40 to 50% savings reduction on individual patients across the board. On that 40 or
Representative Robin Lundstrum
Unverified
34:52
50%, if that was the cost savings, insurance companies would be lining up to do this. If you could save an insurance company 40 or 50%. So this to me is a market thing. The insurance companies would want to do this. We shouldn't have to make I think I think you'll hear that they are looking at it when they come to the table, I think it's something
Representative Lee Johnson
Unverified
35:10
they're looking at, and it's something that I guess we're just in a difference of opinion on when to take action. We feel like it's time to take
action now. We feel like the the data is there to support the action. We do think long term it will result in savings, which again should translate back to premiums, right? At some point was the savings come in, that
should translate back, you know, having more at some point. accountability around premiums, while premiums increase, how they increase. That's a different conversation, but I do think to your point, eventually you should see those savings downstream back to the people that are paying the premiums. I'm a little concerned
Representative Robin Lundstrum
Unverified
35:45
if it, if they could save a buck, I'm confident they would save a
buck. So I'm, I'm a little concerned. I want to go back to, um, page one, I think Representative Eads made this comment on line 22. It says Arkansas Medicaid program shall reimburse. the treatment. So, this
is Medicaid paying for it, or what am I missing again, and I
Representative Lee Johnson
Unverified
36:08
don't know, I don't know that there's anyone here from DHS. I can try to get someone here to clarify, but My recollection
of the amendments that were made, it's any language in there around DHS
came from DHS, and they're not expecting any cost increase from this, so if it's already covered, again, I would have to get some clarification on that. I'm happy to try to do that for you. OK,
Representative Robin Lundstrum
Unverified
36:31
thank you. My last question is how many people do you think would take advantage of something like this because we need to do a cost analysis of what
Sam Blitz
Unverified
36:41
this is gonna actually cost. Our estimates would be usually about 1 to 2% of people who qualify would take advantage of it. And so up 250,000 people there's probably about 15 to 20% of those people would qualify, and then you would take 1 to 2% of those people would actually
avail themselves of it, so it'd probably be in the neighborhood of a few 1000 people that would take advantage of this, and that would be on an annual basis, so all right, all right, thank you.
Representative Jon S. Eubanks
Unverified
37:10
I'll step out. Reps represent view banks question. Thank you, Mr. Chair. I was curious as to what the long term success rate is for individuals that avail themselves of this type of surgery, and the reason I ask that is I know people in my own community that have had it like several years ago and it seems
after a couple of years they're back where they were. So I'm just, I'm just curious if it's. At the long
Speaker 75
37:36
term benefit is actually there. Well, I, I would say in my practice our recidivism rate is Possibly around
Speaker 77
37:43
30%. Um, which is. Significantly better than, say, diet and exercise, uh, which is close to 98%, um, it all depends a lot on the patient themselves, the program that they're
participating with, um, our program. Provides an exorbitant amount of preoperative education and postoperative support, so There are examples, of course, of people that have completely regained all their weight after this surgery, but I think you don't see the vast numbers of people that lose their weight and maintain their weight loss for an extended period of time. And if I could piggyback on that because that as well, though
Sam Blitz
Unverified
38:23
obesity is a chronic disease, and so we know that we're going
to be fighting this for the rest of their lives. It would be sort of like, you know, a cardiologist who has an intervention, you don't necessarily expect them to have just one intervention. There's also the expectation with the chronic disease aspect of it that that it could come back or that it could worsen or it could come back in a different way. And so the same thing is with obesity. There are people who are fixed with one surgery, then there are people who still have a struggle with the chronic disease of obesity.
Representative Lee Johnson
Unverified
38:59
Any other questions, members? OK. Thank you. Is there anyone in the I should like to speak against this bill? The That. Like just introduce yourself for the record, sir, and you may
proceed with your testimony. Yeah, this is the right time. Sure, absolutely.
Speaker 123
39:29
Just introduce yourself. Hi, David Mans with Arkansas Blue Cross and the senior vice
Chair
Unverified
39:36
president for policy. I'm Dr. Mark Jansen. I'm Chief Medical Officer of Arkansas
Speaker 123
39:41
Blue Cross, Vice President. And, and I'll be honest with you, I wasn't clear if I wanted to, if I needed to come up for, uh, opposed or for support because we're kind of in between, but I just wanted to kind of provide some uh some perspective for you. Um, so we have been working with Representative Johnson on language and really appreciate
his willingness to work with this, uh, we have, um, I've been working on some amendments we haven't um really kind of gotten through that process yet. um, and it's our fault. We We have Been working to try and identify exactly what the cost will be for our policyholders. We have some numbers, um, just not sure that, you know, it's based on the current bill and we also want to take a better look at it
to make sure that all of our assumptions are correct, uh, also, you know, has been, as has been discussed, there are long term benefits, short term costs, and so forth, and just trying to make sure that we get, get that balance, and and and We fully understand it. We have been running, uh, internally with Blue Cross an employee bariatric surgery pilot program for years, um, and, uh, so it's something that we've been experimenting with trying
to find the right answer to that question, um, and, and I'll let Doctor, uh, Doctor Danson speak to, you know, sort of where we are on that a little bit, but overall I would say the other part of the conversation that we We've been having with Representative Johnson is, um, Just overall with with mandates and just trying to figure out, you know, is there a um You know, is there an overarching, um, I guess, uh,
philosophy that we use with, you know, which mandates are the ones that we pass and so forth. I know the Affordable Care Act, you know, it had a layer of mandates that came with it, um. And you know those did increase costs for a while, you know, and then they kind of grow from there, but um, you know, it's just, you know, as we, as we go through the process, you know, every, you know, some mandates will have like a back end kind of reduction. Others will not as
much. Some of that depends on the medical care, the provider quality that is there as well. Um, but you know, overall, You know, our state and federal policymakers are really managing a health care system that is headed for destruction, um, and you know it's really a question of what that, what that trajectory looks like, uh, is the trajectory going to be
steeper, or is it going to be, or are we going to bend it down a little bit, um, but we, we see an affordable, affordability issue. Uh, for policies, especially in small business, the small business groups that we, that we insure more and more of them are are stretching, taking on a lot more risk and uh and that's a, that's a troubling trend, um, but I'll go ahead and let Doctor
uh, Doctor Jansen speak for a couple of minutes about the medical side. I appreciate
Chair
Unverified
43:12
the time compression. I'll be as quick as I can on what I have to say, so I don't know what your vision is of an insurance doctor. I'm hoping that I change that vision with my presence here today, so I was a country family doctor in Arkadelphia for 30 years. I grew up in Little Rock, but I saw that I couldn't stay around here. My family banished me to Arkadelphia, so I had to go there for 30 years. Great town, wonderful community. My wife is a nurse practitioner, so we
served down there for 30 years. Then I came back to my home and was at UAMS as a medical educator or associate professor. I was also chief medical officer of the regional programs which we all really know as AEC that put all the primary care doctors, so I did that for 6 years. I'm now in my 6th year as chief medical officer of Arkansas Blue Cross. I get money. I know we're talking a lot about money. I'd like to address the science and let the actuaries and health economists talk about the money, please. So bariatric surgery has been covered by Arkansas Blue
Cross Blue Shield since 1998 as a policy under. There are qualifying conditions and, you know, obesity is not a thing, it's many things, so it's multifactorial and I'm speaking to the science that we recognize that Arkansas Blue Cross that bypass surgery is a legitimate approach to an individual who is properly selected, but that's critical that and you sought to experts up here from Baptist and from Encore and what they have in their program is a program that's properly selects
patients. make sure that they go through all of the the priming that's required to understand what the surgery's going to involve, and then as Representative Eubank said a moment ago, you know, he knows people who ate through their bypass surgery. Yes, that happens, and I think you heard a recidivism rate of 30% sod. I thought it was around 33%. So why do these surgeries fail? The very early surgeries were not as understood. The science has
advanced tremendously in this area, but to have an outcome that you expect, you have to have the right people doing it. That's why Representative Johnson has recognized that in the legislation to be sure that senators Excellence that are recognized by the American Society of bariatric and Metabolic Surgery or the American College of Surgery performed these surgeries. You've got to have a lot of ancillary support. You just don't do the surgery on somebody home and say, hey, go eat less and you'll be fine. So, so you have to do the right thing, so we recognize that the
problem with insurance is that there's no guarantee that a person is on a certain plan who gets the surgery done is paid for by that plan. If you see the return, if you will, in 2 years, is that person having the financial return two years later, but we do not oppose this legislation. Members, I do have
Representative Lee Johnson
Unverified
46:02
DHS here if there's questions at DHS, and I want to say like my experience working with both of these gentlemen, this session has been exceptional. Part of the reason we've had bills that have gone
through quickly today is because of the good negotiations and good faith that we've had, the good conversations constructive conversations we've had back and forth. This is an example of that. The difference between this bill and some of the other bills you've seen as you've noticed, I don't have an amendment on this bill. That's because we've been working on a lot and we are, you know, he said it's their fault. I don't know whose fault it is. It's hard. This is a hard process sometimes to get amendments. I think the sponsors are open to amendments. Certainly, I'm open to amendments, but we are sort of starting to run out of time in this session, which is why I wanted to go ahead and bring this forward today. Um, my hope
is that we could get this out of committee today, and I'm committed. I've committed to these gentlemen here to work with them on the Senate side on amendments and not try to force something through that that people aren't comfortable with,
so that would be my ask of the committee today and again thank you both for coming up here and giving some testimony, and I'll, if it's OK. What we have questions to these guys, yeah,
Representative Jon S. Eubanks
Unverified
47:05
that's fine. Web banks. Thank you, Mr. Chair. So, so you're saying everybody won't necessarily qualify.
for this procedure unless they've gone through a lot of preliminary type training or screenings of some sort to see if they are have a high probability of success. So the qualifications to have the surgery
Chair
Unverified
47:27
is dependent upon two things. One is the BMI, which is really turning out to be a pretty poor representation of obesity, but you have Class 1, Class 2, Class 3 obesity. Class 3 is a BMI of 40 or above. 2 is 35 to 40 and, and number
one is uh 30 or more up to 35. So first of all you have to have obesity, ideally above 40 unless you have qualifying conditions. The qualifying conditions are in the legislation related to hypertension, cardiovascular disease, diabetes, and obstructive sleep apnea. Those are the ones that are identified in the legislation. So if you have qualifying conditions either by the sheer amount of weight you have to lose or less weight to lose, but qualifying medical conditions, then you qualify for the
surgery. The, the accredited entities that you heard from earlier will do the review of that patient and make sure that they are in the right mindset. They're qualified from a scientific standpoint. They'll look for a payer source if it happens to be us. We're aligned as far as what we consider proper qualification and only at that point will they be offered the surgery. We talked about the GOP ones and you know, that's, that's a thing I think you're seeing fewer surgeries done because
The GOP ones, but everybody in the US wants an easy answer to everything. Let me get this surgery and I'm done. Let me get, just get these shots, please, and I'm through. It's just not that easy because the condition is much more complex. There are people that eat through hedonistic eating. There are other folks that eat through cultural exposure, you know, foods that are cheap sometimes tend to put on a lot of weight, so folks are financially challenged, they tend to be more obese. So it's a super complex area that has all kinds of both scientific
And socioeconomic ramifications to try to pick the right person. And then they've got to be motivated to do the right thing. The surgery doesn't fail the patient, you know, all doctors want to blame patients for poor outcomes, right? What happens is the patient fails the surgery, not because the surgeon did wrong, but because the patient chose not to follow the guidance post post op. Zimmer, you. I'm sorry, rep and you're right.
Representative Jim Wooten
Unverified
49:52
I want to follow up on, uh, Representative Eubank's questioning the, the qualifications for Having the surgery. They're sent to you by the doctor, and then do you evaluate what you receive and make a decision. And my second question, along with that would be what, what is the success rate that you're Uh, company has relative to your
Representative Les Warren
Unverified
50:22
people who you cover, what, what is their success rate. I'd have to look at the statistics. I just looked in general as far as the
Chair
Unverified
50:33
success rate of the surgery long term and again if we can talk positive or negative. You can say success of 66% or failure of 33%. I think the figure that was cited by the good doctor from Baptist was 30%. As far as the qualifying conditions, as with everything in our business, we would like to see documentation that what a person has claimed to have, they actually have, so we would
expect medical records that would show the qualifying conditions. It would also be nice if we saw that that person had had the opportunity to look at a diet and exercise program. Easy to say, very hard to do. But again, if somebody's considering the surgery, these accredited entities that you heard from today mandate that they go through. all of that and make sure there's not an opportunity as Dr. Bledsoe said, some folks will say, I don't want to have that surgery. It's a life altering forever surgery, even if you eat through it and it
doesn't work, you're wiring has been changed forever inside, and there are, there are potential complications with vitamin deficiency, something we call dumping syndrome. It's probably too early in the morning to talk about that graphically, so it's a, it is a thing, but we look for those qualifying conditions and the medical records suggest. To buy the surgery before it's done.
Representative Jim Wooten
Unverified
51:46
follow up if I may, um, So you're saying 33% of the, of your clientele. This is covered
Chair
Unverified
51:59
That they, they are, they are successful. No, sir, what I'm saying is the general data is that of those folks that have had the surgery, the success rate in general is 66% in the literature. I have not had a chance to review the Blue Cross data. It wasn't. I found out about this
Speaker 125
52:16
at 3 a.m. this morning. I was going to be speaking on this, so this is
Representative Jim Wooten
Unverified
52:20
the best expertise I can get. OK. So 66% of the other 33% that remains,
Or do, do they have a continuing cost relative to, is this when the shot comes into play or if, what,
how, how, what exposure do you have after they have the surgery, I guess is
Speaker 130
52:42
what I'm. Understood. OK, exposures after the
Chair
Unverified
52:45
surgery would be the potential for surgical complication that might require a reoperation which we would cover if the second operation was related to the first operation related to a complication thereof. Our policy does not cover at later time a bariatric surgery
currently if a previous bariatric surgery, historically has been performed and as far as ongoing costs, we do think at around 2 years some of the associated costs with the chronic conditions, and not every condition is improved. The idea that everyone's blood pressure gets better, everyone's diabetes gets better. That's not true, but the majority do. So then you have a patient who might be stumbling into recidivism who might then be placed on the injections to try to arrest that process. Before they regain all the weight, and that would be an associated cost, and we would
only pay for that in our plan currently with injections if the relationship was related to diabetes, we would not pay for the GOP ones currently for obesity only. All right.
Representative Les Warren
Unverified
53:39
Thank you. Thank you, doctor. Thank you. I don't see
Representative Matt Brown
Unverified
53:44
any other questions from the committee. So anyone else who would like to
Representative Lee Johnson
Unverified
53:49
speak? Against this bill. OK. The Represent a lady in
like for DHS to come up if anyone from DHS is
in the room. Members, let's do try to move this along the best we can. We have a lot of members who want to run their bills today.
Representative Lee Johnson
Unverified
54:18
If you would introduce yourself and you may proceed with
Speaker 132
54:21
your testimony. Yes, sir. Thank you, Janet Mann, Deputy Secretary of DHS and Medicaid Director. Um, I don't know that I have a testimony. Uh, I thought there were questions.
Representative Jack Ladyman
Unverified
54:34
Reverend Weidman, thank you, Mr. Chairman. Uh, you know, I just in this bill, uh, On the first page it says the Arkansas Medicaid program shall reimburse for the treatment of diseases and conditions caused by severe obesity. Uh, I thought we already did that. Yes,
Speaker 135
54:50
sir, we do, um, and working with, um, Representative Johnson, the criteria will not have any impact on us. It's, so we will keep our current procedure in place for prior approval if we perform the surgery or pay for it, excuse me. I'm just curious, why are we
Representative Jack Ladyman
Unverified
55:05
putting in this bill if it's already done. I
Speaker 135
55:09
think there's protection for the Medicaid program's criteria, so that it doesn't get lowered and that we have to cover any anymore without using our clinical criteria, so it's just clarification, is that right? All right, thank you. I think
Representative Lee Johnson
Unverified
55:21
if I may, I think some of the issue is just clarifying like we don't inadvertently with this bill since it's going to be the most recent bill passed, exempt them from what they already cover, so I think it's just trying to clarify that they're going to cover under the parameters they
cover now, and then The bill, the rest of the parameters will keep them from having any extra if I
understand the amendment correctly. Thank you, Representative Weidman. Any other questions for
Representative Jim Wooten
Unverified
55:54
DHS? It represent Whitney very quickly. You, you heard the testimony from Doctor Bledsoe. Relative to, uh, he didn't
perform them because of the cost it had on the hospital and that y'all and it was because of the amount of money that you paid, is any of that going to change with this bill? And, and how I don't understand why one hospital would take Medicaid. And another one would deny it. I mean, I understand their cost procedure or what they look at, but um, um, um, I'm
Representative Lee Johnson
Unverified
56:38
confused and I don't know that Director Mann was here for the testimony that Dr. Bledsoe had, but the testimony was that
some providers take Medicaid and will do the surgery at some hospitals, other hospitals don't take Medicaid based on reimbursement.
Speaker 135
56:53
That's what he's refer. Yes sir, I will try to answer your question, Representative Whitton. It is true we have different reimbursements for different sizes of hospitals. So hospitals have to make individual decisions if they will cover that surgery or not,
Speaker 134
57:09
so I can't speak to each individual hospital's
Representative Jim Wooten
Unverified
57:11
decision. Oh So it's a hospital's choice. Yes, sir,
a hospital and a clinician. Yes those on staff or that, that work out of that hospital. Yes, sir. All right. Thank you. Thank you, Mr. Chair. Thank you, Represent. Any other questions? Saying no,
there's no one else who has signed up to speak for or against this bill, Representative Johnson, you were recognized. Members again, I appreciate everyone's questions.
Representative Lee Johnson
Unverified
57:40
I think this is a really good bill with really good opportunity to make a positive impact, you know, to say that there aren't still opportunities to improve and amend this bill would be to do it a disservice in the process. I think you heard testimony from payers in addition to providers. This is something that I'm committed to continue to work on. I think in I would ask the members to pass this out of committee today and give us the opportunity to continue to work on this on the Senate side as we move towards the end of session, and I'd be make a motion to do pass. Appreciate a good vote. We have
Speaker 12
58:12
a motion to pass. That's a proper motion. Is there any discussion on this motion? Seeing none, all
in favor say aye. Any both say no. Congratulations you passed your bill. OK, members, we're gonna try to keep moving. I know some of you do have um other committees you're gonna have to go to soon, but we're
going to keep going and try to make some progress on our agenda today. Repent McAlinden, I believe we skipped you inadvertently, um. I think it was. No comment.
Representative Lee Johnson
Unverified
58:43
It's This is 1307, a concurrence. Is that correct? OK. You may proceed. Thank you, Mindy
Representative Mindy McAlindon
Unverified
58:55
McAlinden House District 10. So this is, um, just a concurrence with the Senate amendment. We had an engrossing error, and um a couple of lines, the line proceeding on your amendment, the line proceeding the line and line after the line were both duplicated in the bill that went to the Senate, we decided to fix
that on the Senate side, and, um, bring it back here. So happy to answer any questions, but It's just in the grossing error
Representative Robin Lundstrum
Unverified
59:27
motion to adopt pass it proper motion to adopt and pass at
Representative Lee Johnson
Unverified
59:31
the proper time. OK. Any other questions from the committee? OK, seeing none, we have a motion to concur
Speaker 23
59:36
in the Senate amendment. All in favor say aye. You say no. Congratulations, you passed your amendment. Thank you, committee. Thank you, Chairman. Thank you, Representative
Re Allen, you're recognized. We are on HB 1316 members. Representative Allen, if you would, um, introduce yourself and proceed to do this testimony. Uh, state
Representative Fred Allen
Unverified
1:00:01
representative Fred Allen District 77. I feel that I'm introducing today's House Bill 1316 to mandate coverage for lung cancer screenings, as you all know, I'm a, I'm a cancer survivor and I'm very passionate about this. This
bill is, well, it's the American Cancer Society bill, uh, lung cancer is one of the leading causes of death in Arkansas. It kills over 2000 Arkansans annually more than brass colorectal cancer, prostate cancer, and all cancers. Uh, smoking is the key driver, 90% of lung cancer cases are caused by smoking, and Arkansas has the 2nd highest smoking rate in the nation with even higher rates In rural Arkansas, um, what does
this bill do? It expand access in rural areas, help Mokansas, especially in healthcare desert get screened earlier. And it saved lives. Economic benefits, early detection reduce expenses, uh, late stage treatments keeps people in the workforce and lowers Medicaid and disability costs. I'd be happy to take any questions. Are there any questions from the committee? See none. Motion.
Representative Trey Steimel
Unverified
1:01:19
All right, I, well, you want to close for your bill? I'm closed. All right. We're, we're working fast today. Appreciate that, Representative Allen. All right, I have a motion to oh. All right. You're
Representative Les D. Eaves
Unverified
1:01:33
recognized representative. Um Oh Sorry, I should have read this beforehand. Was there a Um, fiscal impact on this bill? 0. OK.
How does this affect, um, EBD, is there no impact at all? No. you then. OK. You mean just
if you don't care, just give me a second. Time's up a minute.
Well, I think I'm getting information a little bit too late. There seems to be maybe that Siegel missed a cost impact on the bill that there may be a cost shift. Um By not allowing cautioning with EBD, but if
that's the case, I think we can address it. Maybe on the Senate side, if they, if Siegel has missed something, if you would commit to looking at that. I will. OK, thank you. All right. Thank you, Representative Eaves. Any other questions from the committee?
Representative Trey Steimel
Unverified
1:03:05
See now, is there anyone here to speak for or against this bill? See none. I have a motion to
pass. All those in favor say aye. I was supposed to say no. I just have it. Congratulations, Representative Allen, you passed your bill. Up next, we're going to hear House Bill 1320 without objection, if you would. Representatives go to the end of the table. Recognize yourself and you're allowed to present your bill. Thank you, Mr.
Speaker 162
1:03:39
Chair. Thank you committee. Jeremy Wooldridge, State Representative, District one.
Speaker 152
1:03:48
Yeah House Bill 1320, correct? House Bill 1320, yes, sir. You have your fiscal impact. It
Speaker 162
1:03:57
came back, it was up in the uploads and it came back no impact. Representative Woolridge, you're going to
Representative Trey Steimel
Unverified
1:04:05
have to wait 2 days. My understanding. OK,
Speaker 158
1:04:07
so with that, that's no problem. We'll try again. All right, thank you.
Representative Dwight Tosh
Unverified
1:04:55
Go ahead and introduce yourself and proceed with your bill. I'm District 38. You may proceed, OK. Colleagues, many states have already updated their storage facility laws, this bill, um, Does place, as you'll read through it as I read through it with you, it does place a greater requirement on our storage facilities here in Arkansas, but however, I want to make sure you understand this bill was brought to me by the
storage facility association, and all they're wanting to do is to bring the current law up to the industry's industry standards, and let me just go through this and tell you some of the things this bill does. It expands the operator's lean search. It establishes a standardized termination process which requires self storage operators to give tenants at least 15 days' notice. It also modernizes notification messages now, the only way they can sign a lease
agreement is in person and in writing. This expands that to electronic notifications. It improves lienholder transparency. It requires a tenant to list. are disclose any existing liens on stored property and mandates that that facility operators verify that. It also reduces uh, it should reduce legal disputes by standardizing rental agreements. This should minimize
court cases and unnecessary litigation. Colleagues, this bill will also address a growing industry concern. Many of our storage facilities today. They operators face challenges with signed agreements, unclear termination procedures and abandoned property. This bill will modernize outdated regulations to reflect, as I said earlier, current industry practices. This is also a bill that enhances consumer
protections, uh, by allowing these operators to check for those lien holds and uh also promote that business. So, As we move through this, the bill seeks to strengthen legal clarity, modernize notifications, and standardized termination policies within the self storage industry. That's what this bill does. And these updates are important because they create more methods in which a storage facility owner could possibly find an occupant
before legally removing the property in inside inside that unit. It requires an document to disclose any lien holders, as I stated earlier this condition is being added to help facility owners have a better chance of finding these lien holders if the time comes for them to begin the process of legally removing property from the unit. Colleagues, to be clear, There is a legal process found in this statute that a facility owner must follow before
removing property from the unit, but we are not changing any of those policies here. We are just adding that occupants' needs to disclose any lien holders of property held in the unit. So, uh, currently our current law Our law requires a facility owner to check for liens and the only requirements that the current law requires of those facility owners is that they check with the circuit clerk. Uh, this added language will add
those facility owners to look elsewhere for any liens, which I think is extremely important and they can do that through websites and vendors who do keep track of these things and we are just allowing those facility owners the ability to perform a better search. The surrogate clerks, as I said, are the only place they have to check now under the old law and the clerks association has no issues with these changes, uh, the commercial real estate transaction industry I've been
told has extremely increased over the past 5 years as new owners come in, they review mental agreements and records and records don't match unit numbers. Uh, they are out of day a real agreements have been lost or not updated under current Arkansas law. So getting current tenants to sign a rental agreement protects the tenant and the operator. Colleagues, as I've already stated, this section creates a uniform policy for dealing with
these situations. This is good for both the faculty, the facility owner, and the occupant creating a balanced legal framework and hopefully reduces legal disputes. The occupant will still be allowed or is going to be allowed 14 days from delivery of the notice to remove their property. This notice will be delivered by hand, first class. male or for the last known address or by email. That's everything that this
legislation, uh, that I can, that it does, it is a balanced approach to protecting property, uh, protecting the consumers who use these facilities and it's also protects lien holders of the property held within. And with that, I'd take any questions. Thank you Tash. Questions from the committee. saying none to anyone who would like to speak against this bill?
Representative Lee Johnson
Unverified
1:10:35
Anyone else who'd like to speak for this bill? There's Natasha
Representative Dwight Tosh
Unverified
1:10:40
Regnost. Thank you, Mr. Chair, and I'm closed with the bill, and I make
Speaker 66
1:10:44
a motion to pass. We have a motion do pass, all in favor say aye. Any opposed say no. You congratulations, you've
Representative Lee Johnson
Unverified
1:10:50
passed your bill. Thank you, Chair. Thank you. Thank you. Retamo you right now to go to the end of the table. What's the?
Speaker 172
1:11:09
Thank you, Mr. Chair. Now this is Senate Bill 276. If y'all want to take a look at
Representative Trey Steimel
Unverified
1:11:14
276 right quick. It's Mhm It's a pretty simple bill. Here and uh y'all want to take just a second to look at it. I mean, I think you're going to find it's uh It's just going to be some clarifying language for these non-admitted, so. Everyone have that pulled up. OK. So we've worked with surplus
lines earlier this this session and clarifying some language and we're just going to clarify, uh, this little piece here where it's gonna require it to go to a an eligible, we're changing that language. It's a very simple change that just will bring us in line and uh with that, I'll be happy to take any questions. They
Speaker 172
1:11:58
represents Donald. Any questions from the committee? OK, seeing none, there's who
would like to speak against this bill. Does anyone who likes to speak for anyone else who I can speak for this bill.
Speaker 172
1:12:21
Revers you recognize. To close for your bill. I am close for my bill. I'll make a motion to pass. Of a motion do
Speaker 23
1:12:27
pass, all in favor say aye. Any post say no. Congratulations, you passed your bill. Thank you, Mr. Chair. Thank
Representative Lee Johnson
Unverified
1:12:32
you committee. Acer, you are recognized, and when you get to the end of the table, please identify which bill it is that you are going to run. Go some
Speaker 174
1:12:42
Yeah. Try my bet. Are you coming back?
Speaker 12
1:12:51
I am. OK. Please introduce yourself for the record, and you can
Representative Sonia Eubanks Barker
Unverified
1:12:56
proceed with your testimony. Thank you, Mr. Chairman. Thank you committee. Representative Baker, District 71. I'm presenting House Bill 1700. Uh, this bill is a provider of privacy protection bill and essentially what this Aims to do is to preserve the integrity of a negative ruling
by a physician who works for a prior authorization company. Um, the reason for this is that what we found is that these providers don't have the rapport or the access or the established relationship with the patient. And so what we're trying to do is they cannot assess the patient's mental status. They can't assess their financial status, and what we'd prefer is for those conversations to happen between the prescribing physician and the patient. So this would prevent an automatic release of the name of the
physician who ruled against a prior authorization, but all that information is still available via the provider who issued the prescription or the order. And with that, I'll take questions. Questions from the committee. seeing none. Is there anyone
Representative Lee Johnson
Unverified
1:14:00
in the audience who'd like to speak against this bill? Resin maker, you're working to clothes for your bill. Thank you
Representative Sonia Eubanks Barker
Unverified
1:14:06
committee. I would like to close by saying this might be the only bill where the insurance companies and the hospitals support one of my bills, so I
would appreciate a compassionate and good vote, and I close for my bill and make a motion to pass. OK, we have a motion to
Speaker 23
1:14:23
pass. All in favor, say I. Can you post say no? Congratulations,
you have passed your bill. It was close, Reverend Baker. Members, we are waiting on, uh, represent Beatty, um, He's going to run his bill today. I think he's stuck in another committee. Is there
other business before the committee, um, at this stage that we can that we can talk through that we can that we can do. OK, seeing none at this time. We're not going to adjourn, but we are going to um take a, take about, hopefully about a 5 minute break.
Speaker 23
1:26:52
Representative Beatty, it's my understanding that you actually have 3 bills you'd like to present. Yes, sir.
And if you would identify the first one that you would like to start with, sir. I, I think the first bill
Representative Howard M. Beaty, Jr.
Unverified
1:27:03
would be Senate Bill 240. Senate Bill 240. Yes, sir. On the first page.
You may proceed, you know, it's a simple bill because it's a Ricky Hill
bill, so Century, uh, Senate bill, Representative Howard Beatty District 95 here to present Senate Bill 240. Uh, it's basically to amend the credit reporting Disclosure Act of 1989 to clarify the content required for a notice of adverse action. And basically it is striking the requirement that the Social Security number of the consumer, um, Has to be given to the user on the Consumer Report contained in
and received from a consumer reporting agency, so it removes that Social Security number requirement from the notice. And with that, I'd entertain any questions. Thank you, Reverend.
Representative Lee Johnson
Unverified
1:28:04
Any questions from the committee? But seeing none, is there anyone in the house you'd like to speak against this bill? Represent Beatty, you're recognized
Representative Howard M. Beaty, Jr.
Unverified
1:28:13
the cloth for your bill. Uh, Mr. Chair, I'm closed, and I would appreciate a motion due pass and a good vote from the committee. Reverend Warren, you're recognized? Motion to pass by Representative
Speaker 23
1:28:26
Warren all in favor say aye. Any both say no, you passed your bill. Thank
Representative Howard M. Beaty, Jr.
Unverified
1:28:34
you, Mr. Chair. Thank you. And which bill will you proceed with next, sir? The next bill would be Senate Bill 242,
Representative Lee Johnson
Unverified
1:28:46
another Senator Hill Bill. Representative Beatty, Beatty, um, I've had a couple of members ask if you would
go ahead and jump to 1509 because they have to leave and they would like to do, they would
like to hear that one. So could
Representative Lee Johnson
Unverified
1:29:00
you do that? I apologize. Absolutely. Well, I have some members who, well, strike that. um. You may proceed with
Representative Howard M. Beaty, Jr.
Unverified
1:29:21
Members representative Howard Beatty District 95 here today to present House Bill 1509, uh, to
create the Second Amendmentancial Privacy Act prohibit financial institutions from using certain discriminatory practices. Basically, um, this bill, uh, that's related to firearms retailers and customers. A summary of the bill, the bill provides definition divines various terms related financial transactions, firearms, financial institutions to provide care, uh, clarity on the scope of what's covered in the act, uh, prohibited conduct in the bill
is more related to the merchant category code, uh, the Act prohibits payment card networks from requiring the use of specific merchant codes that would distinguish firearm retailers from other retailers. Uh, under the Financial Transaction outlines restrictions on assigning merchant category codes to firearms retailers and transactions involving firearms, accessories, or ammunition And also, uh, on data collection prohibits the keeping of lists, records, or registries of
privately owned firearms or their owners with the exceptions to maintaining personal list or law enforcement purposes, uh, under enforcement, it has enforcement authority under the Attorney General and in power the Attorney General, uh, to enforce and investigate any violations of the act, investigation penalties or procedures outlined for investigations and violations, uh, providing. proper notice and imposing penalties on non-compliance, including civil penalties for continued violations, does have
confidentiality included, uh, that covered entities are not compelled to disclose confidential information pri privilege data unless required by law, uh, the Act does prevent, um, uh, under exceptions prevent uh responsible actions related dispute processing, the normal operations fraud management, customer protection, loyalty program. and legal requirements that that banks would and financial institutions would have to provide, um, under civil
proceedings, um, uh, individuals and entities can defend civil proceedings by demonstrating a good faith belief that their actions were required based on applicable law. And overall, this, this act basically seeks to protect the financial privacy and rights of firearm retailers, owners from preventing discriminatory. practices by financial institutions and safeguarding against unauthorized data collection related firearm ownership. And with that, I'll, you know,
entertaining questions. Thank you, Representative Beatty. Representative Wootten,
Speaker 14
1:32:10
I believe you had a question. Thank you.
Representative R. Scott Richardson
Unverified
1:32:13
uh, Representative Richardson. Thank you. So The purpose of this bill is
Representative Howard M. Beaty, Jr.
Unverified
1:32:19
what? What, what got us to to create this. Well, what led to this, I think was the creation of an ISO merchant code associated with the firearm industry. Uh, I think that was done back in 20022, um, and, and
that, that, that ISOO was more or less, uh, to involve tracking and categor categorization so that the government could see, you know, if you purchased a firearm and they could
Representative R. Scott Richardson
Unverified
1:32:43
segregate and have that information for tracking. purposes, OK, and this negates that negates that and says you can't do that. So if you can't do that, does, does it make it more Would it, would it make it easier for individuals Who aren't supposed to purchase firearms to purchase them. This
Representative Howard M. Beaty, Jr.
Unverified
1:33:06
would have nothing to do with the restrictions of, of, if you're authorized or you're allowed to purchase. This is strictly in the payment processing side, kind of like a a retail merchant would have a code that, you know, a convenience store may have a code that designates it in the network as a convenience store. This would designate these folks as firearm dealers or retailers. Uh, we firearms or ammunition or accessories are sold thus identifying all those transactions that come through. Uh, as to that location, and I
Representative R. Scott Richardson
Unverified
1:33:34
think I heard right in terms of
uh The difference between the banks that are identified here right between community and national banks. There was, there was some difference that
Representative Howard M. Beaty, Jr.
Unverified
1:33:47
this bill kind of helps with. I think the point of contention in this bill, uh, basically is on page 4 of the bill, lines 14 through 16, 3 lines out of the bill that under 1509 state a payment card network does not include a financial institution that settles a credit, debit or
prepaid transaction directly with a retailer on behalf of the customer. So the bank is is strictly settling that, same as you walk in to cash a check, more or less. With the electronic side, you hand the check to the bank, the teller cash the check, gives you your money, and you go. Um, so it's just for settling and processing that transaction. The information comes to the bank and a digital format, and then to post to the account and settles and the money is sent back through, through your correspondent bank or the Fed to that merchant account and that retailer account hits their bank
account. So it would hold the banks, uh, basically would not apply to banks that are just settling those transactions. Thank you, Representative Burton.
recognized. I have a motion that the appropriate time.
Representative Matt Brown
Unverified
1:34:52
OK. Thank you, sir. We have some grandma, do you have a question? Yes. I I guess
Speaker 268
1:34:59
so how does the national bank operate differently than these community banks which are going to be exempt, like, I mean, I really just don't understand like what
specifically like, like, so you're saying community banks just operate just with the retailer and settle the transaction. National banks
Representative Howard M. Beaty, Jr.
Unverified
1:35:16
do something different. Well, I think the primary difference related to this bill without getting into a national bank and state bank or community bank. Um, I, I think related to this bill, I think the key is that most of the drinks in Arkansas, our community banks do not have their own payment processing group in bank. They're dealing with third-party payment processors that facilitate these
transactions, the banks don't set up a merchant code and input the merchant code and, and the processing code. I know, uh, when I was at the bank, sometimes you'd have information that you needed. It was all stored off site on the third party network. So these merchant codes and things along those lines would would be set. Uh, at the, at the third party payment. The banks do not establish those codes. Those are the codes that you have to live by more or less. So basically to hold a bank, uh, and, and pass
the liability to a financial institution for a code that's set by someone else is, I mean, I, I just don't see that. Uh, so these banks don't set the code, they don't establish the code, third party payment processor and that third party sets those codes. Some banks process their transactions maybe in-house and would have that, and they understand. that they would have the liability under, under this, um, it under the use of that merchant code. But make it clear, community banks in
Arkansas don't use this code and would not support identifying and tracking of, of merchant information related to firearms for our customers. It's Arkansas and um we we're
just not gonna do that. Just follow up. So you're saying it's a capacity issue in our community banks and that they're held because they don't
Speaker 268
1:36:56
have the capacity to do it. because they have a third party who forces them to do it a different way. I wouldn't say
Representative Howard M. Beaty, Jr.
Unverified
1:37:03
that it's a capacity. I would think that it's
a necessity, but basically because of the expense to create a a payment processing network and, and their industries established networks
that, that we all rely on and utilize to facilitate the, the electronic transactions and speed of of clearing that we all enjoy on, on our accounts with our deposits and other things. That's, that's the line of the game they're in. We're, we're more in debits and. credits and making sure what's in your account is correct, then, then the tracking of other information. We're taking care of the customer. All right, thank you. I
think there's some Gramlich. Any other questions from the committee? OK, saying
Representative Lee Johnson
Unverified
1:37:37
none. Is there anyone else in the audience who would like to speak against this bill?
Speaker 14
1:37:45
Seeing no one. Where Rep represent Beatty, would you like to close for your bill? I, I'm
Representative Howard M. Beaty, Jr.
Unverified
1:37:51
closed. I just want to, you know, again, make it clear that uh this, this bill, the, the main point is again on page 4 of those, those three lines. This doesn't completely exempt all banks, and it's not not like a big carve out. Uh, it simply says the banks aren't in control of that, uh, that portion and, and all we do is we settle those debits and
credits and posting on the account. And with that, I, I'm closed and I would appreciate a motion do pass and a good vote of the committee.
Thank you for your presentation, Representative Beatty. Representative and I believe you had a motion.
Representative Lee Johnson
Unverified
1:38:28
Motion to pass. We have a motion do pass, all in favor say aye, say no. Congratulations you have passed your bill.
Representative Howard M. Beaty, Jr.
Unverified
1:38:38
Thank you, Mr. Chair. And you have one more, I believe that should be a simple, a simple bill, uh, again, Representative Howard
Beatty, District 95, Senate Bill 242 to amend the law concerning loans involving the stock of a state bank, uh, primarily, um, You know, a bank cannot, could not loan money according to state law secured by their own bank stock. Uh, but sometimes through the acquiring of a financial institution, uh, this could happen. You, you acquire another institution that maybe had a loan secured by your bank
stock. So after, after you acquire that bank and you bring those assets into your institution, you, you realize, hey, we've got a loan secured by our bank stock. So Primarily that's what this bill would do is it would clear that uh from being a huge issue and provide some, uh, some direction on how banks can divest of that and move forward. Uh, and with that I would entertain any questions. Thank you, Beatty. Questions from the committee?
Speaker 14
1:39:47
Saying no one in the like to speak against this bill. Anyone else who likes to forward this bill
Representative Howard M. Beaty, Jr.
Unverified
1:39:53
represent by you break to close for your bill, Mr. Chair, again, I'm closed. I'd appreciate, uh, uh, a motion to pass and a good vote of the committee. OK Representative Warren,
Speaker 23
1:40:04
you're recognized. I have a motion to pass from Representative Warren. All in favor say aye. You say no. Congratulations,
Representative Howard M. Beaty, Jr.
Unverified
1:40:10
you passed your bill. Thank you committee and again sorry that I, that you had to take a recess there. We were
In the middle of state agencies, it's a wonderful committee. I'd encourage you to come down and
join us sometime. That's OK, um, and members, um, I wanna say I appreciate your patience, working, we got through a lot on the agenda today, but do remember, we are going to be Monday after the House adjourns to hear, um, that Senate bill that we discussed earlier. So Monday after session. Thank you. We are adjourned.
Agenda
CONCUR IN SENATE AMENDMENT
HB1238 Cavenaugh TO AUTHORIZE A MORTGAGOR TO RECOVER FEES IN CERTAIN CIRCUMSTANCES UNDER THE STATUTORY FORECLOSURE LAW.
HB1307 McAlindon TO ENSURE RESPONSIBLE FUND MANAGEMENT; AND TO AMEND THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT (2006).
REGULAR AGENDA
HB1316 F. Allen TO MANDATE COVERAGE FOR LUNG CANCER SCREENINGS.
HB1509 Beaty Jr. TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY ACT; AND TO PROHIBIT FINANCIAL INSTITUTIONS FROM USING CERTAIN DISCRIMINATORY PRACTICES.
HB1531 Achor TO PROHIBIT PHARMACEUTICAL MANUFACTURERS FROM RESTRICTING OR LIMITING PRESCRIPTION MEDICATIONS TO A LIMITED DISTRIBUTION NETWORK OF OUT-OF-STATE PHARMACIES.
SB229 J. Boyd TO CREATE THE DEPARTMENT OF FINANCIAL SERVICES WITHIN THE DEPARTMENT OF COMMERCE.
HB1547 L. Johnson TO AMEND THE WATER AUTHORITY ACT; AND TO AMEND THE DEFINITION OF "QUALIFIED CORPORATION" UNDER THE WATER AUTHORITY ACT.
SB240 Hill TO AMEND THE CREDIT REPORTING DISCLOSURE ACT OF 1989; AND TO CLARIFY THE CONTENT REQUIRED FOR A NOTICE OF ADVERSE ACTION.
HB1602 L. Johnson TO AMEND THE ARKANSAS PHARMACY BENEFITS MANAGER LICENSURE ACT; TO ESTABLISH FEES UNDER THE ARKANSAS PHARMACY BENEFITS MANAGER LICENSURE ACT; AND TO REQUIRE REPORTING OF CERTAIN INFORMATION BY A PHARMACY BENEFITS MANAGER.
SB237 J. Boyd TO AMEND THE LAW CONCERNING THE LICENSING AND REGULATION OF CAPTIVE INSURERS.
HB1652 Tosh T0 AMEND THE LAW CONCERNING SELF-SERVICE STORAGE FACILITIES; TO ENFORCE AN UNSIGNED SELF-SERVICE FACILITY STORAGE RENTAL AGREEMENT; AND TO CREATE A TERMINATION PROCEDURE FOR A SELF- SERVICE FACILITY STORAGE RENTAL AGREEMENT.
HB1659 S. Meeks TO AMEND THE UNIFORM COMMERCIAL CODE; AND TO CLARIFY THE PRIORITY AMONG SECURITY INTERESTS AND ENTITLEMENT HOLDERS UNDER THE UNIFORM COMMERCIAL CODE.
HB1288 L. Johnson TO AMEND THE ARKANSAS HEALTH CARE CONSUMER ACT; AND TO REQUIRE A HEALTHCARE INSURER TO MAKE CERTAIN RETROACTIVE PAYMENTS TO A PROVIDER UPON CREDENTIALING OF A PROVIDER.
HB1424 L. Johnson TO MANDATE COVERAGE FOR SEVERE OBESITY TREATMENTS.
HB1426 L. Johnson TO AMEND THE HEALTHCARE CONTRACTING SIMPLIFICATION ACT.
HB1443 Pilkington TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY ACT; TO PROHIBIT FINANCIAL INSTITUTIONS AND PAYMENT NETWORKS FROM USING CERTAIN DISCRIMINATORY PRACTICES; AND TO PROVIDE FOR ENFORCEMENT OF VIOLATIONS.
HB1700 Achor TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT; AND TO EXCLUDE THE NAME OF A REVIEWING PHYSICIAN FROM DISCLOSURE IN AN ADVERSE DETERMINATION NOTICE UNDER THE PRIOR AUTHORIZATION TRANSPARENCY ACT.
recess
HB1703 L. Johnson TO PROVIDE A DRUG REIMBURSEMENT PROCESS FOR CERTAIN HEALTHCARE PROVIDERS.
SB242 Hill TO AMEND THE LAW CONCERNING LOANS INVOLVING THE STOCK OF A STATE BANK.
HB1297 L. Johnson CONCERNING ARTIFICIAL INTELLIGENCE, ALGORITHMS, AND OTHER AUTOMATED TECHNOLOGIES; AND TO REGULATE CERTAIN PRACTICES OF HEALTHCARE INSURERS.
HB1299 L. Johnson TO PROHIBIT HEALTHCARE INSURERS FROM EXERCISING RECOUPMENT FOR PAYMENT OF HEALTHCARE SERVICES MORE THAN ONE YEAR AFTER THE PAYMENT FOR HEALTHCARE SERVICES WAS MADE.
HB1300 L. Johnson TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT.
HB1301 L. Johnson TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT.
HB1314 L. Johnson TO AMEND THE LAW CONCERNING CERTAIN AUDITS OF HEALTHCARE PROVIDERS; AND TO CREATE THE ARKANSAS MEDICAL AUDIT BILL OF RIGHTS ACT.
SB276 B. Johnson TO AMEND THE LAW CONCERNING SURPLUS LINES INSURANCE; AND TO
CLARIFY THAT SURPLUS LINES INSURANCE IS ACCEPTABLE COVERAGE FOR FINANCIAL RESPONSIBILITY OF MOTOR VEHICLE INSURANCE COVERAGE.
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — INSURANCE & COMMERCE- HOUSE, Mar 12, 2025 | Agenda | 4 | Official source ↗ |
Speakers
Representative John Maddox Chair
Unverified
Representative Frances Cavenaugh
Unverified
Representative Lee Johnson
Unverified
Speaker 14
Speaker 23
Representative Jim Wooten
Unverified
Representative Jon S. Eubanks
Unverified
Representative R. Scott Richardson
Unverified
Speaker 44
Speaker 51
Representative Robin Lundstrum
Unverified
Representative Les D. Eaves
Unverified
Sam Bledso
Unverified
Speaker 75
Sam Blitz
Unverified
Speaker 77
Speaker 79
Speaker 84
Speaker 88
Speaker 50
Speaker 89
Speaker 101
Representative Jack Ladyman
Unverified
Speaker 123
Chair
Unverified
Representative Les Warren
Unverified
Speaker 125
Speaker 130
Representative Matt Brown
Unverified
Speaker 132
Speaker 135
Speaker 134
Speaker 12
Representative Mindy McAlindon
Unverified
Representative Fred Allen
Unverified
Representative Trey Steimel
Unverified
Speaker 162
Speaker 152
Speaker 158
Speaker 103
Representative Dwight Tosh
Unverified
Speaker 66
Speaker 172
Speaker 174
Representative Sonia Eubanks Barker
Unverified
Representative Howard M. Beaty, Jr.
Unverified
Speaker 268