Insurance & Commerce- House
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Bills discussed (41)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1424
Act 628
· 12 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 |
|
HB1300
Act 510
· 4 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 |
|
SB307
Act 373
· 4 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 |
|
HB1238
Act 306
· 3 mentions in transcript, chapter, agenda
Matched: “30. And this is just to concur on an amendment on HB 1238, which defines more of when a attorney fee may be awarded.…”
|
TO AUTHORIZE A MORTGAGOR TO RECOVER FEES IN CERTAIN CIRCUMSTANCES UNDER THE STATUTORY FORECLOSURE LAW. | Cavenaugh | Notification that HB1238 is now Act 306 |
|
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 |
|
HB1301
Act 511
· 3 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 |
|
HB1602
Act 633
· 3 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 |
|
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 |
|
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 |
|
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 |
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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…”
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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 |
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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 |
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If you have something on deferred that you really just do not plan to run, let me know at some point, 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, then let me know that also. We did get numerous fiscal impacts back, so we're making progress on that. Again, we're hoping to start cleaning up this agenda somewhat. 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. That's something that could take some time. And again, we are trying to kind of clean up our agenda. So next Monday after the House adjourns, we'll hear that one bill. 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 you have a concurrence.
Representative Frances Cavenaugh
Unverified
1:11
Thank you, Mr. Chair. Frank Kavanaugh, State Rep. District
30. And this is just to concur on an amendment on HB 1238, which defines more of when a attorney fee may be awarded. And with that, take any
questions. Okay. Representative Kavanaugh has explained the concurrence. She's open. Any questions? Are there any questions from the committee? Okay. Seeing no one.
Is there anyone in the audience who would like to speak against this? Anyone else
Representative Frances Cavenaugh
Unverified
1:49
like to speak for this? Would you like to close?
Thank you. I'm closed. I appreciate it. A good vote. Thank you. Representative Allen, you are recognized. We have a motion for concurrence on the Senate Amendment. All in favor, say aye. Aye. Any opposed, say no. Congratulations. You've passed your bill. Thank you, members.
Representative Johnson, I believe you have a few bills that you think will go fairly quickly, is my understanding. If you would, go to the end of the table and please identify the bill number you plan to start with. And again, members and people in the audience, we're trying to run through the bills beginning that aren't going to take too much time. So that's why we're jumping out of order. So Representative Johnson, you may
Representative Fred Allen
Unverified
2:44
proceed. Representative Lee Johnson, District 47, I'd like to present House Bill 1602, and I
Representative Lee Johnson
Unverified
2:48
have an amendment to that bill, if the staff could pass that amendment out.
Okay, members, staff is passing out the amendment. Representative Johnson, if you'd like to go ahead and start with the amendment. Yeah, this
Representative Lee Johnson
Unverified
3:19
amendment changes some language that was in the original bill around the licensure fee and also adds some language around protecting some of the data in the bill, and I'd be happy to answer any questions on the amendment. Any
Representative Les Warren
Unverified
3:32
questions on the amendment, members? Seeing none, 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. Aye. Any opposed, say no. Irv. Johnston, you recognize to proceed
Representative Lee Johnson
Unverified
3:51
with your bill as amended. Sure. Members, under the current PBM Licensure Act, I was reviewing that in the interim and came across the licensure fee. This act was passed back in 2017, and when it was passed, it was sort of first in the nation of its kind. We were a leader in this kind of bill around licensing PBMs. And the original fee was set at $1,000 with no renewal.
And that felt like a fee to me at this point with how PBMs have grown and how they've progressed that maybe needed a market adjustment. And so in addition to that, the way PBMs are structured, 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're 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 rate proposal. We have that money going directly back as special revenue to the AID for enforcement issues around PBMs. Because of the PBMs, we have 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 us understand better how PBMs are structured, help 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
Representative Jim Wooten
Unverified
5:41
anyone has any. Any questions from the members? Representative Wooten, you're recognized. Representative Johnson, what information do they have to give about their ownership in requesting a license?
Representative Lee Johnson
Unverified
5:54
So I would have to look 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
Speaker 34
6:10
the answer to that question. Thank you. Thank you. Representative Eubanks? Thank you, Mr. Chair. Representative Johnson, is it the
Representative Lee Johnson
Unverified
6:17
annual renewal? Did you get a doctor's note to be here, Representative Eubanks? Just out of curiosity,
I looked down there and I'm surprised to see you. Yes, it's an annual renewal.
Representative R. Scott Richardson
Unverified
6:25
Thank you, sir. Any other Representative Richardson? Representative Johnson, the $20,000 negotiated, what caused it to jump? Well, so again, it's hard to know how to
Representative Lee Johnson
Unverified
6:36
work backwards from a number and what's fair and what's not fair. I had originally looked at a rate of $50,000, and I was just trying to look proportionally based on what, like I know my licensure fee every year is about $500, and I know on average what a physician is going to generate in the way of income, and I'm just trying to look proportionally at what I thought was fair related to what PBMs generate and what there would be.
So that's based on the money that PBMs generate? It's a little bit based on pulled out of thin air, too, right? 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 myself, the people that I've discussed this with around the PBM space, and then also the pharmacist as something, and AID 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, Representative Richardson, is kind of having an idea of how much have we had to add in the way of cost at AID to
support some of the, 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. It generates around $800,000 a year, which is about what, you know, we're now incurring in increased costs. That's where the number came from.
any other questions from the committee okay saying none is there anyone in the audience who would like to speak against this bill okay president johnson you're recognized i'm making motion
Representative Lee Johnson
Unverified
8:18
uh make motion to pass acid as amended we have a
proper motion we have a motion do pass as amended. All in favor, say aye. Aye. Any opposed, say no. Congratulations. You passed your bill.
Representative Lee Johnson
Unverified
8:31
Thank you. If I may now, House Bill
Representative Lee Johnson
Unverified
8:46
Bill 1288. Members, this bill is about trying to expedite the credentialing process and make sure that once a physician has completed a certain part of their application, the payments can be made back retrospective to that date.
So sometimes there's a delay in processing a credentialing application with the payer, and that delay sometimes can result in a time period where a physician is practicing, seeing patients, but 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 CCVS, 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?
Okay. Seeing none, is there anyone in the audience that would like to speak against this bill?
Representative Johnson, you're recognized. I'm closed for my bill. Representative Johnson is closed for his
Representative Lee Johnson
Unverified
9:47
bill. Motion do pass. If a motion do pass, all in favor say aye. Aye. Any opposed, 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.
Speaker 51
10:12
Okay. The staff is passing out the amendment. You may proceed, Representative John. Proceed on
Representative Lee Johnson
Unverified
10:27
the amendment. Members, this amendment just changes some language in the original bill. This is a bill that's looking at the Prior Authorization Transparency Act. And, you know, there have been some, you know, opportunities for improvement around how we do prior authorizations. I think everybody would agree with that, both the payers and the providers.
We've been working on that for several sessions. This
is another attempt to try to both clean up and clarify some issues around prior authorization. And this amendment is just some negotiated language from the original bill based on meetings with payers and providers. And I'd be
happy to answer your questions on the amendment itself. Questions on the amendment, members? Seeing none. Make a motion to adopt
the amendment. I have a motion to adopt the amendment by version of Eubanks. All in favor say aye. Any opposed say no. You may proceed with your bill as amended.
Representative Lee Johnson
Unverified
11:16
Members, as I mentioned, this is an effort to try to clarify some things around the Power Authorization Transparency Act. There's a lot of parts to 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. It 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
Representative Robin Lundstrum
Unverified
12:01
anyone has any. Members, any questions? Representative Lundstrom, you're recognized. Could you give me the three big points
Representative Lee Johnson
Unverified
12:05
of the bill where we're going with this? I'm going to have someone come to the table with me because I could certainly try. Well, let me try to give you the big points. One of the things we're doing with this is we are creating a fund to go back to 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 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.
There are other things in the bill, but those are the main things that we're trying to do there. I could go through it sort of line by 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 just want to
Representative Robin Lundstrum
Unverified
13:39
make sure I get the big, where we're going. Yeah,
those are the big pictures, I would say. Okay, thank you. Thank you, Representative Lundstrom. Any other questions from the committee? Okay. Seeing none, is there anyone in the audience who would like to speak against this bill? Anyone who would like to speak for this bill?
Representative Lee Johnson
Unverified
14:00
Okay, Representative Johnson, you're recognized. I'm closed for the bill. I'm
Representative Les Warren
Unverified
14:05
making a motion to do pass as amended. I apologize. We're
Representative Les D. Eaves
Unverified
14:07
going to back up, and we're going to let Representative Eves ask a question. You're
Representative Lee Johnson
Unverified
14:13
establishing a new fund, is that right? Correct. And how is it being funded? It would be funded through fines as related to prior authorization. So if someone has an issue and AID 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 them. Do you
Representative Les D. Eaves
Unverified
14:28
have any idea how much we can expect to be in that fund?
Representative Lee Johnson
Unverified
14:32
I don't. I'd have to ask someone from AID 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 also understand that there has to be some sort of 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 a process if you're going to have a rule or
law and it's violated that there should be some kind of penalty imposed,
and that's the design. Thanks. Thank you, Representative Eaves. You'll recognize for your motion, Representative Johnson. I'll make a motion and do pass as amended.
Representative Les D. Eaves
Unverified
15:11
Okay. We have a motion to do pass as amended. All in
Representative Lee Johnson
Unverified
15:16
favor, say aye. Aye. Any opposed, 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 gold card 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 go-kart. 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 all people involved in the law. This amendment is an amendment to the bill that's been negotiated in agreed-upon language. I don't think there's anyone with
any opposition to the amendment. And I'd be happy to take any questions on the amendment.
Thank you, Representative Johnson. Questions from the committee? Seeing no, is there anyone else who'd like to
Representative Lee Johnson
Unverified
16:21
speak against this bill? Representative Johnson, you're recognized. So, members, this bill, one of the things we did not do
last session when we passed this legislation, we actually did not include a definition of gold card. And what that means, that's a term we used a lot around the legislation, as you recall. That's a process. Let me interrupt you. I apologize.
Someone came up and talked to me and got me. It's all good, Mr. Chan.
Off my game. Anyway, I believe we need to, I don't believe we adopted the amendment. Make a motion
Representative Les D. Eaves
Unverified
16:47
we adopt the amendment. We have a motion to adopt the amendment. Okay. All in favor of the motion to adopt the
Representative Lee Johnson
Unverified
16:54
amendment, say aye. Aye. Any opposed, say no. Okay. So, members, as you recall, GoCard is a process where we reward providers that are exhibiting quality choices in around when they order tests, you know, and 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 a prioritization for that procedure for a period of time. Conceptually, what we did last session is we forgot to define GoCard, so that's one of the things it does. Again, 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 GoCard, moving to the state and new, for people that are needing renewals, for people that maybe have been denied a GoCard.
And so we're just better defining that process and switching mainly from a retrospective to a prospective look and then clearing up some clerical things that came up in the interim around executing the process for both the payers and the providers. Again, this is a negotiated and agreed to bill, and I'd be
happy to answer any questions on it. Thank you, Representative Johnson. Any questions from the committee? Okay. Seeing none. Is there
anyone in the audience who would like to speak against this bill? Representative Johnson, you're recognized. I'm closed for
Representative Lee Johnson
Unverified
18:15
the bill. Make a motion do pass as amended.
Representative Les D. Eaves
Unverified
18:17
We have a motion do pass as amended. All in favor say aye.
Representative Lee Johnson
Unverified
18:23
Aye. Any opposed to say no. You have passed your bill. Members, this will be my last one. I appreciate everyone's
patience. House Bill 1424, and if I could, Mr. Chairman, I'd like to have Dr. Sam Bledsoe come to the table
with me to speak to this bill. Yes, just have your guest introduce himself and who he's with, and then you all can proceed with your testimony. Good morning.
Speaker 72
18:49
My name is Dr. Sam Bledsoe. I'm from the Arkansas Heart Hospital. I'm
Speaker 75
18:57
Dr. Eric Paul from Baptist Health Medical Center. I'm a bariatric surgeon.
Representative Lee Johnson
Unverified
19:01
Members, I think we all know the problems with obesity we have in this country, in this state in particular, and the challenges that presents from a healthcare perspective. There 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 am 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 and questions. Thank you, committee.
Sam Bledsoe
Unverified
19:27
My name is Dr. Sam Bledsoe. I'm a general and bariatric surgeon over at 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.
Three 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 measured expansion that 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. Arkansas, as you know, is one of the sicker states in the nation. The latest CDC data shows that we rank third 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 Act 109's passage, the Siegel Group, acting as outside consultants, identified four major cost drivers of Arkansas's EBD health plans.
Number one was diabetes. Number two is cardiovascular disease. Number three was cancer. And number four were the orthopedic issues, all of which will positively benefit from bariatric surgery. And, of course, cost concerns will arise, and appropriately so. You are stewards of the state's resources, but the language contained in Act 109 I think tells a really good story. And Act 109 says this, quote, payers can rely on bariatric surgery paying for itself through decreased comorbidities within two to four years. Act 109 also documented the Siegel finding
of a reduction of 45% in medical costs per member per month. 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. These are Arkansas numbers showing real savings for Arkansas taxpayers. Bariatric surgery addresses these economic realities in two ways. Number one, curing current disease, and number two, preventing future ones. Curing disease saves dramatically, but prevention yields even bigger savings.
As the Segal 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 said another way, what is the cost savings of a heart attack that never happened? 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 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
Speaker 77
23:01
1424 and make Arkansas healthier for all of us. Thank you for your time. Just to piggyback on what Dr. Bledsoe just said, this is a disease of ongoing -- and
I'm blanking of course, I'm sorry. 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. What I do is something that is, it is a benefit to not only the patient themselves, but to their families. And we touch so many people by our science, our art.
And I would also like to ask that you please give this bill careful consideration because as we are always in the top five states in obesity in this country, I would like to help as many people as possible.
Speaker 79
24:01
Thank you. Thank you for that testimony. If you think every one of us in here hasn't blinked at the microphone at
Representative Lee Johnson
Unverified
24:10
some point, you just watch us because it happens to all of us. Members, we'll be happy to answer
any questions. Let's bill if anybody has any. There are questions in the queue.
Representative Eves, I believe you're first. Thank you. Any idea what this is going to cost, the
Speaker 84
24:30
Medicaid program? I may be wrong, but I don't think
Representative Lee Johnson
Unverified
24:34
Medicaid is included in this bill. I don't think DHS is included in this bill. There's no fiscal impact to DHS. And one more question.
Representative Les D. Eaves
Unverified
24:51
There's a page one. And it does not require Arkansas Medicaid programs 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 taking that? So that language came
Representative Lee Johnson
Unverified
25:04
directly from DHS. So, you know, 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 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 injectables. Okay. So you're
Representative Les D. Eaves
Unverified
25:29
adding the coverage, though, but we don't know who's paying for the coverage? The
Representative Lee Johnson
Unverified
25:34
coverage would be specific to commercial payers in the
Representative Les D. Eaves
Unverified
25:38
marketplace. It says the Arkansas Medicaid program shall reimburse for the treatment of diseases and conditions caused by severe obesity, and you've got bariatric surgery in there. I don't
Representative Lee Johnson
Unverified
25:48
know if anyone's here from DHS right now,
Speaker 89
25:51
Dr. Blitzer, you can speak to that? I do. Medicaid already covers it, but very few people avail themselves
Sam Bledsoe
Unverified
26:01
of it because of the reimbursement rates to the hospitals, and so that shouldn't change anything. To my understanding, any further expansion to Medicaid or DHS was carved out, and so this should go directly to the commercial payers and to people who have commercial
Speaker 89
26:17
insurance. Currently, we estimate there's upwards of 500,000 people who, in the state of Arkansas, who do not have bariatric surgery coverage, which is...
You're saying the Medicaid already covers bariatric surgery? Correct. Medicaid already covers bariatric surgery, yes, sir. And so this would not be an expansion of anything in the Medicaid realm. And I think there's
Representative Lee Johnson
Unverified
26:35
some things in here, including 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 the intention
Representative Les D. Eaves
Unverified
26:52
of the language. So both of you guys do bariatric surgery? Yes, sir. Do you take Medicaid patients?
Speaker 89
26:59
No. Why is that? They don't fit enough? Exactly. You know, it's very, very difficult to – you lose money on every single case. And I'm not talking about me
Sam Bledsoe
Unverified
27:09
personally. I would do it, but the hospitals can't afford to do it because you lose money on every single case, and it's hard to cover your expenses when that happens. And so it's a very difficult thing to do. I would do it myself, but it's a different animal when you start talking to hospitals. And that, by the way, is
Speaker 89
27:25
very consistent across the state of Arkansas. But there would be a cost to the private insurance companies.
Representative Les D. Eaves
Unverified
27:31
Yes. And then, I guess, potentially your insurance rate might go up because it's being covered. Yeah, I would. We've
Representative Lee Johnson
Unverified
27:37
got too many mics. I can turn your mic.
Yes, Representative Eves. I mean, and that's consistently the conversation at these committee meetings, right? I mean, this is a risk-reward payoff. Anytime we come in here and have a coverage mandate, the idea is to improve health care of Arkansans, and the idea is that they 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 cost, it solves the problem of obesity for many patients with many 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 probably would
Representative Les D. Eaves
Unverified
28:43
be cost savings down the road for people that get this. I'm just kind of, if we're going to force insurance companies to cover bariatric
surgery, I mean, but we're excluding these new, what do you call them? You're a doctor. Injections. Yeah. We're specifically excluding those? Is that what we're doing? Or just not including them in the bill? In this bill specifically,
Sam Bledsoe
Unverified
29:01
we were advised 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 $10,000, $15,000 a year on average for these injectables. The surgery is a one-time $10,000 to $15,000 cost. And so the economics of it is very different, and we thought it would be better for you all to be
Representative Jim Wooten
Unverified
29:27
considering the economics of it on an individual basis. Thank you. Yes, sir. Representative Wooten, you are next. Thank you. Dr. Bledsoe, explain the difference again relative to the injection and the surgery.
Would some people prefer to have the surgery versus the shot, or does the shot come into play after the surgery if they have a problem?
No, very good question. I see these as complementary. There are some
Speaker 89
29:57
people who would better benefit from the shots. There are some people who would better benefit from the surgery, and there are some people who would better benefit from both. And so these things are just complementary. I use them in my own practice. There are some people who are
Sam Bledsoe
Unverified
30:13
very, very overweight who they're going to 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 carve-out for car wrecks. So why do we have a carve-out for 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 are cardiac disease, orthopedic issues, diabetes, high blood pressure, sleep apnea, and all these other things that contribute to early
Representative Jim Wooten
Unverified
31:03
mortality rates and costs to the system. So this bill covers both, requires, it does not? It does not cover 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 at
Representative Lee Johnson
Unverified
31:23
a later date? Representative Wheaton, I do think there's a bill out there that I've seen that's been filed by
Representative Jim Wooten
Unverified
31:31
a different legislator around injectables, but that's separate and apart from this bill. Okay. All right. One more question. So
if they have the surgery, then long-range, their medical costs to the insurance companies will be reduced. So you want to respond?
Speaker 89
31:53
Sure. Yes, sir. So that is what happens over time. Usually takes about, depending on which surgery you have, let's say two
Sam Bledsoe
Unverified
31:59
years to recoup costs. When the Siegel Group looked at it, they saw a 45% decrease in medical costs per member per month. And so that is in Arkansans who are being followed by the pilot program that we had for about 10 years here in the state of Arkansas. The catch is that it takes two 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 I think that's part of the problem is that since the cost savings are recouped over time,
Speaker 72
32:28
that's part of the issue as to why that was a carve-out on the front end, is that the cost savings are over time versus immediate. Thank you. Thank you, Mr. Chairman.
Speaker 101
32:38
Representative Lightyman. You're recognized. Thank you,
Representative Jack Ladyman
Unverified
32:46
Mr. 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, we passed a bill for state employees, correct?
Yes, sir. 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?
Speaker 89
33:12
Not that I'm aware of. 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 I heard
Representative Jack Ladyman
Unverified
33:24
you say that in two years we should be able to see some savings. We've had this more than two years.
Sam Bledsoe
Unverified
33:30
It started, it was passed in 2022, and it went into effect in 2023.
Representative Jack Ladyman
Unverified
33:34
Okay. Well, I know private insurance, you know, is the one that's going to pay this, But my concern is, will this raise rates for everybody, people that are not affected by this? And I understand what you're trying to do, and I agree with that. But, you know, are rates going to go up? Where are the insurance companies on this? Are they opposing this? Are they for it? Are they neutral? I think there will be someone coming
Representative Lee Johnson
Unverified
34:02
to the table 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
Representative Robin Lundstrum
Unverified
34:15
listen to them. Thank you. Representative Lundstrom, you're recognized. 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 save? Well,
Sam Bledsoe
Unverified
34:28
the data I would go back to is what we got through the Siegel Group with the EBD program, which is consistent with what we see nationally, too.
You get the savings after about two years, and, of course, it depends on the patient and how much medical savings you get individually. But we expect about a 40% to 50% savings reduction on individual patients across the board. On
Representative Robin Lundstrum
Unverified
34:47
that 40% or 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 it. I think you'll hear
Representative Lee Johnson
Unverified
35:05
that they are looking at it when they come to the table.
I think it's something they're looking at. And it's something
that I guess we're just a different opinion on when to take action. We feel like it's time to take action now. We feel like 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
as the savings come in, that should translate back. Having more at some point accountability around premiums, why 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.
Representative Robin Lundstrum
Unverified
35:40
I'm a little concerned. If they could save a buck, I'm confident they would save a buck. So I'm a little concerned. I want to go back to page one. I think Representative Eves made this comment on line 22. It says, Arkansas Medicaid program shall reimburse for the
treatment. So this is Medicaid paying for it. Or what am I
Representative Lee Johnson
Unverified
36:03
missing? Again, and 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,
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, and I'm happy to try to do that for you. Okay, thank
Representative Robin Lundstrum
Unverified
36:26
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
Sam Bledsoe
Unverified
36:36
what this is going to actually cost. Our estimates would be usually about 1% to 2% of people who qualify would take advantage of it. And so of 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 would probably be in the neighborhood of a few thousand people that would take advantage of this. Okay. And that would be on an annual basis. All
Representative Jon S. Eubanks
Unverified
37:05
right. All right. Thank you. I'll step out. Representative Eubanks, do you have a 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 curious if the long-term benefit
Speaker 75
37:31
is actually there. Well, I would say in my practice, our recidivism rate is possibly
Speaker 77
37:38
around 30%, which is significantly better than, say, diet and exercise, which is close to 98%. It all depends a lot on the patient themselves,
the program that they're participating with. Our program provides an exorbitant amount pre-operative education and post-operative 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
Sam Bledsoe
Unverified
38:18
piggyback on that as well,
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 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. Any other
questions, members? Okay, thank you. Is there anyone in the audience
who would like to speak against this bill? Just come, just introduce yourself for the records, sir, and you may
Representative Lee Johnson
Unverified
39:18
proceed with your testimony. Yeah, this is the right time.
Speaker 122
39:22
Sure. Absolutely. Just introduce yourself. Hi, David
Speaker 123
39:26
Manns with Arkansas Blue Cross. I'm the Senior Vice President for Policy.
Chair
Unverified
39:31
I'm Dr. Mark Jansen. I'm Chief Medical Officer of Arkansas Blue
Speaker 123
39:36
Cross, Vice President. And I'll be honest with you, I wasn't clear if I wanted to, if I needed to come up for opposed or for support because we're kind of in between, but I just wanted to kind of provide some perspective for you. So we have been working with Representative Johnson on language and really appreciate his willingness to work with us. We have been working on some amendments. We
haven't really kind of gotten through that process yet, and it's our fault. We have been working to try and identify exactly what the cost will be for our policyholders. We have some numbers, 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. Also, you know, as has been discussed, there are long-term benefits, short-term costs, and so forth, and just trying
to make sure that we get that balance and that we fully understand it. We have been running internally with Blue Cross, an employee bariatric surgery pilot program for years, and so it's something that we've been experimenting with, trying to find the right answer to that question, and I'll let Dr. Jansen 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've been having with Representative Johnson is just overall with mandates and just trying to figure out, you know, is there an overarching, I guess, 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.
And, you know, those did increase costs for a while, you know, and then they kind of grow from there. But, you know, it's just, you know, 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. But, you know, overall, you know, our state and federal policymakers are really managing a health care system that is headed for destruction.
And, you know, it's really a question of what that what that trajectory looks like. Is the trajectory going to be steeper, or are we going to bend it down a little bit? But we see an affordability issue for policies, especially in small business. The small business groups that we ensure, more and more of them are stretching, taking on a lot more risk.
And that's a troubling trend. But I'll go ahead and let Dr. Jansen speak for a couple minutes about the medical side. I appreciate the time compression. I'll be as quick as I can on what
Chair
Unverified
43:07
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, associate professor. I was also chief medical officer of the regional programs, which we all really know as AHECS. They put all the primary care doctors. So I did that for six years. I'm now in my sixth 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 commercial. 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 at Arkansas Blue Cross that bypass surgery is a legitimate approach to an individual who is properly selected. But that's critical that, and you saw two experts up here from Baptist and from Encore,
and what they have in their program is a program that properly selects patients. It makes sure that they go through all of the priming that's required to understand what the surgery is going to involve. And then, as Representative Eubanks 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% cited. 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 centers of excellence that are recognized by the American Society of Bariatric and Metabolic Surgery or the American College of Surgery, performing these surgeries. You've got to have a lot of ancillary support. You just don't do the surgery, send somebody home and say, hey, go eat less and you'll be fine. 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 who's on a certain plan who gets the surgery done is paid for by that plan. If you see the return, if you will, in two years, is that person having the financial return two years later. But we do not oppose this legislation. Members,
Representative Lee Johnson
Unverified
45:57
I do have DHS here if there's questions of 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 is 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.
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
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 if it's
Speaker 34
47:00
okay with the chair, I'll have questions to these guys. Yes. Reverend Eubanks. Thank
Representative Jon S. Eubanks
Unverified
47:05
you, Mr. Chair. 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 have a high probability of success? So the qualifications to have the
Chair
Unverified
47:22
surgery 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 one, class two, class three obesity. Class three is a BMI of 40 or above, two is 35 to 40, and number one is 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 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 GLP-1s, and, you know, that's a thing. I think you're seeing fewer surgeries done because of GOP-1s. But everybody in the U.S. wants an easy answer to everything. Let me get this surgery, and I'm done. Let me 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 if 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
Representative Jim Wooten
Unverified
49:46
I want to follow up on Representative Eubanks' questioning. 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? My second question along with that would be, what is the success rate that your company has relative to your people who you cover? What is their success rate? I'd have to look at the statistics. I
Speaker 128
50:19
just looked in general as far as the success rate of the surgery long term. And again, if we
Chair
Unverified
50:28
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, your wiring has been changed forever inside. And 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 is a thing.
But we look for those qualifying conditions and the medical records
Representative Jim Wooten
Unverified
51:41
to justify the surgery before it's done. Follow-up, if I may. So you're saying 33% of your clientele that is covered, that they are successful? No, sir. What I'm saying is the
Chair
Unverified
51:58
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. I found out about this
at 3 a.m. this morning. I was going to be speaking
Representative Jim Wooten
Unverified
52:15
on this, so this is the best expertise I can get. So 66%. Of the other 33% that remains, do they have a continuing cost relative to, is this when the shot comes into play, or what exposure do
you have after they have the surgery, I guess, is what I mean.
Speaker 130
52:37
Understood. Okay, exposures after the surgery
Chair
Unverified
52:40
would be the potential for surgical complication that might require a re-operation, 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 a later time a bariatric surgery currently if a previous bariatric surgery historically has been performed. And as far as ongoing cost, we do think at around two 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 GLP-1s currently for
Speaker 128
53:34
obesity only. All right. Thank you. Thank you, Dr.
Representative Matt Brown
Unverified
53:39
Thank you. I don't see any other questions from the committee. Um, is there
anyone else who would like to speak against this bill? Okay.
Representative Leidemann would 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.
If you would introduce yourself, and you may
Speaker 132
54:16
proceed with your testimony. Yes, sir. Thank you. Janet Mann, Deputy Secretary of DHS and Medicaid Director. I don't know that I have a testimony.
Representative Jack Ladyman
Unverified
54:27
I thought there were questions. Representative Lightyman. Thank you, Mr. Chairman. Janet, in this bill, on the first page, it says, the Arkansas Medicaid program shall reimburse it for the treatment of diseases and conditions caused by severe obesity.
Speaker 135
54:42
I thought we already did that. Yes, sir, we do. In working with Representative Johnson, the criteria will not have any impact on us. So we will keep our current procedure in place for prior approval if we perform the surgery, or pay for it,
Representative Jack Ladyman
Unverified
54:59
excuse me. I'm just curious, why are we putting in this
Speaker 135
55:04
bill if it's already done? I think there's protection for the Medicaid program's criteria so that it doesn't get lowered and that we have to cover any more without using our clinical criteria.
Representative Lee Johnson
Unverified
55:14
So it's just clarification, is that right? Yes, sir. All right, thank you. I think, if I may tell you, 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 this other bill, the rest of the parameters will keep them from having any extra, if I understand the
amendment correctly. Thank you, Representative Leitman. Any other questions for DHS?
Representative Jim Wooten
Unverified
55:48
Representative Witten, you recognize me. Very quickly. You heard the testimony from Dr. Bledsoe relative to he didn't perform them because of the cost it had on the hospital and that you all, and it was because of the amount of money that you paid. Is any of that going to change with this bill? 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 I'm confused.
Representative Lee Johnson
Unverified
56:30
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. That's what he's referring to. Yes,
Speaker 135
56:48
sir. I will try to answer your question, Representative Wheaton. 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. So I can't speak to each individual
Speaker 134
57:04
hospital's decision. So it's a hospital's choice? Yes,
Representative Jim Wooten
Unverified
57:06
sir, a hospital and a clinician. And what
they'll let those on staff that work out of that hospital? Yes, sir. Thank you. Thank you, Mr. Chair. Thank you, Representative Wooden. Any other questions? Okay. Seeing none, there's no
one else who has signed up to speak for or against this bill.
Representative Lee Johnson
Unverified
57:30
Representative Johnson, you are recognized. Members, again, I appreciate everyone's questions. I think this is a really good bill with a really good opportunity to make a positive impact. 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. And 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 make a motion to do pass. I appreciate a good vote.
Speaker 12
58:06
All right, we have a motion due passed. That's a proper motion. Is there any discussion on this motion? Okay, seeing none, all in
favor say aye. Aye. Any opposed, say no. Congratulations, you've passed your bill. Okay, members, we're going to try to keep moving. I know some of you do have other committees you're going to have to go to soon,
Representative Les D. Eaves
Unverified
58:24
but we are going to keep going and try to make some progress on our agenda today. Representative McElindon, I believe we skipped you inadvertently.
No comment. This is 1307, a concurrence? Is that correct? Correct. You may proceed. Thank
Representative Mindy McAlindon
Unverified
58:50
you. Mindy McElindon, House District 10. So this is just a concurrence with the Senate amendment. We had an engrossing error and a couple of lines, the line proceeding on your amendment, The line preceding the line and the 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 bring it back here. So, happy to answer any questions, but it's just an engrossing error. Motion to adopt and do pass
Representative Robin Lundstrum
Unverified
59:22
at the proper time. Representative Lundstrom, you're right now. Motion to adopt and
do pass at the proper time. Okay. Any other questions from the committee? Okay. Seeing none, we have a motion
Representative Les Warren
Unverified
59:31
to concur in the Senate amendment. All in favor, say aye. Any opposed to say no. Congratulations. You have passed your amendment. Thank you, committee. Thank you, Chairman.
Thank you, Representative McElwinder. Representative Allen, you're recognized. We are on HB 1316. Members, Representative Allen, if you would introduce yourself and proceed to your
Representative Fred Allen
Unverified
59:56
testimony. State Representative Fred Allen, District 77. The bill that I'm introducing today is House Bill 1316 to mandate coverage for lung cancer screenings. As you all know, I'm a cancer survivor, and I'm very passionate about this.
This bill is the American Cancer Society bill. Lung cancer is one of the leading causes of deaths in Arkansas. It kills over 2,000 Arkansans annually, more than breast, colorectal cancer, prostate cancer, and all cancers. Smoking is the key driver, 90% of lung cancer cases are caused by smoking and Arkansas has the second highest smoking rate in the nation, with even higher rates in rural Arkansas. What does this bill do?
It expands access in rural areas, helps more Arkansas, especially in healthcare deserts, get screened earlier, and it saves lives. Economic benefits, early detection, reduced, expensive, 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
Representative Trey Steimel
Unverified
1:01:14
All right. Well, you want to close for your bill? I'm closed. All right. We're working fast today. Appreciate that, Representative Allen. All right. have a motion to? Oh, all right.
Representative Les D. Eaves
Unverified
1:01:28
You're recognized. Sorry, I should have read this beforehand. Was there a fiscal impact on this bill? Zero.
Mr. Representative, how does this affect EBD? Is there no impact at all? No impact. Hang on a second. Give me
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 by not allowing cost sharing with EBD. but if
that's the case, I think we can address it maybe on the Senate side
if Siegel has missed something. If you would commit to looking at that. I will. Thank you. Thank you, Representative Eaves. Any other questions from the committee? Seeing none,
Representative Trey Steimel
Unverified
1:03:00
is there anyone here to speak for or against this bill? Seeing none, I have a motion to do pass. All those in favor say aye. All those opposed say no. Ayes have it. Congratulations, Representative Allen. You passed your bill. Up next, we're going to hear House Bill 1320 without objection. If you would, Representative Woodridge, go to the end of the table,
recognize yourself, and you're allowed to present your bill.
Representative Jeremy Wooldridge
Unverified
1:03:34
Thank you, Mr. Chair. Thank you, Committee. Jeremy Wooldridge, State Representative, District 1.
Speaker 152
1:03:47
Good to see you. House Bill 1320, correct? House Bill 1320, yes, sir. Do you
Representative Jeremy Wooldridge
Unverified
1:03:52
have your fiscal impact? It came back. It was in the uploads, and it came back no impact.
Representative Trey Steimel
Unverified
1:04:00
Representative Woolridge, you're going to have to wait two
days, is my understanding. Okay. So with that. That's no problem. We'll try again. All right. Thank you, committee. Reverend Tosh.
Representative Dwight Tosh
Unverified
1:04:46
Go ahead and introduce yourself and proceed with your bill. I'm Dwight Tosh, District 38. You may proceed. Okay. Colleagues, many states have already updated their storage facility laws. This bill 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 standards. And let me just go through this and tell you some of the things this bill does. It expands the operator's lien search. It establishes a standardized termination process, which requires self-storage operators to give tenants at least 15 days' notice. It also modernizes notification message now. The only way they can sign a lease agreement is in person and in writing.
This expands that to electronic notifications. It improves lien holder transparency. It requires a tenant to list or disclose any existing liens on stored property and mandates that that facility operators verify that. It also 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, the operators face challenges with unsigned 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 by allowing these operators to check for those lien holds and also promote that business.
So as we move through this, the bill seeks to strengthen legal clarity, modernize notifications, and standardize 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 inside that unit. It requires an occupant to disclose any lien holders. As I stated earlier, this addition is being added to help facility owners
have a better chance of finding these lien holders if a 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 need to disclose any lien holders of property held in the unit.
So 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. 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 circuit 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. The commercial real estate transaction industry, I've been told, has extremely increased over the past five years. As new owners come in, they review rental agreements and records, and records don't match unit numbers. They are out a day or rental 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 the property. This notice will be either delivered by hand, first-class mail,
for the last known address, or by email. That's everything that this legislation that it does. It is a balanced approach to protecting property, protecting the consumers who use these facilities, and it also protects lien holders of the property held within. And with that, I'd take any questions. Thank you, Representative Tosh. Questions from the committee?
Seeing none, is there anyone who would like to speak against this bill? Anyone else who would like to speak for this bill? Reverend Tosh, you're
Representative Dwight Tosh
Unverified
1:10:35
recognized. Thank you, Mr. Chair, and I'm closed with the bill, and I make
Representative Les Warren
Unverified
1:10:39
a motion due pass. We have a motion due pass. All in favor say aye. Any opposed, say no. Congratulations, you've passed
your bill. Thank you, Chair. Thank you, committee. Thank you, Reverend Tosh. Reverend Stommel, you're recognized to go to the end of the table.
Speaker 172
1:11:02
Thank you, Mr. Chair. Now, this is Senate Bill 276. If y'all want to take a
Representative Trey Steimel
Unverified
1:11:09
look at 276 right quick, it's a pretty simple bill here. And y'all want to take just a second to look at it. I mean, I think you're going to find it's just going to be some clarifying language for these non-admitteds. So, does everyone have that pulled up? Okay.
So we've worked with surplus lines earlier this session in clarifying some language, and we're just going to clarify this little piece here where it's going to require it to go to an eligible. We're changing that language. It's a very simple change that just will bring us in line. And with that, I'll be happy to take any
Speaker 172
1:11:53
questions. Thank you, Representative Stonnell. Any questions from the committee?
Okay. Seeing none, is there anyone who would like to speak against this bill?
Anyone else who would like to speak for this bill? Representative Stein, will you be recognized to close for your bill? I
Speaker 172
1:12:16
am closed for my bill. I'll make a motion to do pass. If a motion do pass, all in favor say
Representative Les Warren
Unverified
1:12:22
aye. Aye. Any opposed, say no. Congratulations, you have passed your bill. Thank you, Mr. Chair. Thank you,
committee. Representative Aker, 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.
Speaker 12
1:12:41
Please introduce yourself for the record, and you can proceed
Representative Sonia Eubanks Barker
Unverified
1:12:51
with your testimony. Thank you, Mr. Chairman. Thank you, committee. Representative Baker, District 71. I'm presenting House Bill 1700. This bill is a provider 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. 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? Okay, seeing none, is there anyone in the audience who would like to speak against this bill? Revenant Maker, you
Representative Sonia Eubanks Barker
Unverified
1:14:01
recognize to close for your bill. Thank you, committee. I would like to close by saying this might be the only bill where the insurance companies in the hospital 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 do pass. Okay, we have a motion to do pass. All in favor say aye. Aye.
Any opposed say no. Congratulations, you have passed your bill. It was close, Representative Baker. Members, we are waiting on Representative Beatty. He's going to run his bill today. I think he's stuck in another committee. Is there other business before the committee at this stage that we can talk to her, that we can do? Okay.
Seeing none at this time, we're not going to adjourn, but we are going to take hopefully about a five-minute break.
Speaker 177
1:17:21
So that's where you're going to get popped for the two and a half I don't know how to screen it.
Speaker 205
1:17:35
So it's very important. So if we can get that out of the
Speaker 186
1:17:45
bill, there's no problem with the pocket. Yeah, no, I mean,
Speaker 209
1:18:12
we talked about the work with, yeah. Thank you.
Speaker 203
1:18:19
And then we're already doing those things. So I know we've already got it now. Like we can kind of like do that. We would already know the cost. We're already doing
Speaker 205
1:18:39
it. We know where the cost is. Right. So now
Speaker 177
1:18:46
you can know where it is. It is very strict. Sure, sure, sure. I mean, is
Speaker 213
1:18:56
it really, really going down to not around us?
Speaker 177
1:19:04
Because they weren't, but that's just where you can get through that. Is
Speaker 205
1:19:13
there any possibility that people take now? Absolutely. I mean, yeah, you'll carve us out of that. Right. It's not just on this field. It's just like, you know, what you were talking about. It's going to have to go way too. It's going to carve us out.
Speaker 177
1:19:35
It's been a little bit too. Okay. Okay. I need to
Speaker 184
1:19:51
go back and look, because I think we were in
Speaker 205
1:20:07
Yes. Whoa. Okay. So that, yeah, because, again, I can just be right here. Okay. Okay. - Well, I'm not playing, I'll
Speaker 177
1:20:16
get back to the community. - Yeah, what are
Speaker 184
1:20:19
they doing here? - We're gonna have to go back for it. - Yeah, I'm two three, what was this year? Okay, are you eight three one, or are you six four seven? - Yeah, I'm two and
Speaker 177
1:20:31
six four seven. - Okay. - Okay, I'm gonna ask you guys AOC, thank you so much.
Speaker 222
1:20:42
- Thank y'all, again, I'm sorry. - No, no problem, thank y'all. I
Speaker 216
1:20:46
don't know, I'm just trying to do something different.
Speaker 205
1:21:41
you.
All right, I'll give you that one. Oh, thank you. No, I appreciate the help. Thank you.
Speaker 214
1:21:59
You're on our little hack office. Yes. Can we talk a little bit more about it? Yeah,
Speaker 228
1:22:06
she's day free right now. She's fine. Yeah, there we go. Yeah, that's the real conversation. Yeah. Yeah. Yeah. Yeah. Yeah. - Yeah.
Speaker 203
1:25:14
- Did I do any bills right here? - I know, well, let's have one room for the day. And he's gonna have the wrong number for the party. - I know. - And he's gonna have a
Speaker 198
1:25:22
plate. He's gonna have a plate, he's gonna have a plate. He's gonna have a plate. - He's gonna have a plate, he's gonna have a plate. - He's gonna have a plate. - Oh, sorry, are you gonna have a plate? - I'm gonna have a plate and a half. - Okay, let me see if I have a plate. - Okay, how are you today? You know Greg Linton, I'd like to see you all in your life.
Speaker 234
1:25:44
Do you want to go to the lead? Uh, yes, yes, sure. No, I'm not. I'll just talk to you in the right. I'll just talk to you in the right. I'll help you guys in the weekend, I think we'll get in the right and
Speaker 249
1:25:59
talk to you in the right. Absolutely, I want to feel a big thing in the right. You're doing all right? I'm good, how are you? All right. Yeah, I'm good, how are you? Great, how are you then?
Speaker 93
1:26:09
I'm glad to have a pleasure. Hey, Harry, good to see you, Rob. Good to see you here. Hey, no, no, no. I told them don't hold up.
Just tell me when you needed me. And I would show
Speaker 254
1:26:25
our way back to the table. Representative Beatty is here.
Representative Les Warren
Unverified
1:26:47
Representative Beatty, it's my understanding that you actually have three
bills you'd like to present? Yes, sir. And if you would identify the first one that you would like to start with, sir.
Representative Howard M. Beaty, Jr.
Unverified
1:26:58
I think the first bill would be Senate bill 240. Senate bill 240. Yes,
Speaker 254
1:27:13
sir. It's on the first page. You may proceed. You know, it's a
Representative Howard M. Beaty, Jr.
Unverified
1:27:20
simple bill because it's a Ricky Hill bill. So
Senator Hill. Senate bill, Representative Howard Beatty District 95 here to present Senate Bill 240. 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 has to be given to the user on a consumer report contained 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 Beatty. Any
questions from the committee? Seeing none, is there anyone in the audience who'd like to speak against this bill? Reverend Beatty, you are recognized to close for your
Representative Howard M. Beaty, Jr.
Unverified
1:28:08
bill. Mr. Chair, I'm closed, and I would appreciate a motion due passed and a good vote from the committee. Reverend Warren, you're recognized? Motion due passed. Motion due passed by Reverend Warren. All in favor say aye.
Representative Les Warren
Unverified
1:28:21
Aye. Any opposed to say no. You passed your bill. Thank you,
Representative Howard M. Beaty, Jr.
Unverified
1:28:29
Mr. Chair. Thank you, committee. And which bill will you guys proceed with next, sir? The next bill would
be Senate Bill 242, another Senator Hill bill. Representative Beatty, I've had a couple members
ask if you would go ahead and jump to 1509, because they have to leave, and they would like to hear that one.
So could you do that? I apologize. I'm here at the will of the committee. Absolutely. Well, I have some
Representative Howard M. Beaty, Jr.
Unverified
1:29:16
may proceed with 1509. Give me one second here. Members, Representative Howard Beatty, District 95, here today to present House Bill 1509. It's to create the Second Amendment Financial Privacy Act, prohibit financial institutions from using certain discriminatory practices.
Basically, this bill that's related to firearms, retailers, and customers, a summary of the bill. The bill provides definition, divides various terms related to financial transactions, firearms, financial institutions to provide clarity on the scope of what's covered in the Act. Prohibited conduct in the bill is more related to the merchant category code. The act prohibits payment card networks from requiring the use of specific merchant codes
that would distinguish firearm retailers from other retailers. Under the financial transaction outlines, restrictions on assigning merchant category codes to firearms retailers and transactions involving firearms, accessories, or ammunition, It also, on data collection, prohibits the keeping of lists, records, or registries of privately owned firearms or their owners, with exceptions to maintaining personal lists or law enforcement purposes.
Under enforcement, it has enforcement authority under the Attorney General and empowers the Attorney General to enforce and investigate any violations of the act, investigation penalties or procedures outlined for investigations and violations, providing proper notice and imposing penalties on non-compliance, including civil penalties for continued violations. It does have confidentiality included that covered injuries are not compelled to disclose confidential information privileged data unless required by law.
The act does prevent, under exceptions, prevent responsible actions related to dispute processing. the normal operations, fraud management, customer protection, loyalty programs, and legal requirements that banks and financial institutions would have to provide. Under civil proceedings, 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 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 to firearm ownership. And with that, I'll entertain any questions. Thank you, Representative Beatty. Representative Wooten, I believe you
had a question. I'll defer to
Representative Fred Allen
Unverified
1:32:05
the mic. Thank you. Representative Richardson.
Representative R. Scott Richardson
Unverified
1:32:08
Thank you. So the purpose of this bill is what?
Representative Howard M. Beaty, Jr.
Unverified
1:32:14
What got us to create this? Well, what led to this, I think, was the creation of an ISO merchant code associated with the firearm industry. I think that was done back in 2022. And that ISO code was more or less to involve tracking and categorization so that the government could see, You know, if you purchased a firearm, and
Representative R. Scott Richardson
Unverified
1:32:38
they could segregate and have that information for tracking purposes.
Okay, and this negates that? This negates that and says you can't do that. So if you can't do that, does it make it more, would it make it easier for individuals who aren't supposed to purchase firearms to purchase them?
Representative Howard M. Beaty, Jr.
Unverified
1:33:02
This would have nothing to do with the restrictions of if you're authorized or you're allowed to purchase. This is strictly in the payment processing side, kind of like a retail merchant would have a code.
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 where firearms or ammunition or accessories are sold, thus identifying all those transactions that come through as to that location.
Representative R. Scott Richardson
Unverified
1:33:29
And I think I heard right in terms of the difference between the banks that are identified here, right, between community and national banks, there was some difference that this bill
Representative Howard M. Beaty, Jr.
Unverified
1:33:42
kind of helps with immunity? I think the point of contention in this bill basically is on page four of the bill, lines 14 through 16,
three 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 strictly settling that. Same as you walk in to cash a check, more or less, without the electronic side. You hand the check to the bank. The teller casts a check, gives you your money, and you go. So it's just for settling and processing that transaction.
The information comes to the bank in a digital format, and then it posts to the account and settles, and the money is sent back through the correspondent bank or the Fed to that merchant account, and that retailer account hits their bank account. So it would hold the banks, basically would not apply to banks that are just settling those transactions. Thank you.
Representative Bruton, you're recognized. I have a motion
Representative Matt Brown
Unverified
1:34:47
at the appropriate time. Okay, thank you, sir. Representative Grammer, did you have a question?
Representative Zack Gramlich
Unverified
1:34:52
Yes, sir. I guess, so how does a 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, so you're saying community banks just operate just with the retailer and settle the transaction. National
Representative Howard M. Beaty, Jr.
Unverified
1:35:11
banks do something different? Well, I think the primary difference related to this bill, without getting into a national bank and state bank or a community bank, I think related to this bill, I think the key is
that most of the banks 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 the processing code. I know 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 be set 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 and pass the liability to a financial institution for a code that's set by someone else is, I mean, I just don't see that. So these banks don't set the code. They don't establish the code, the 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 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 merchant information related to firearms for our customers. It's Arkansas, and we're just not going to do
that. Just follow up. So you're saying it's a capacity issue on our community banks and that they're held because they don't have the capacity
Representative Zack Gramlich
Unverified
1:36:51
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
1:36:58
that it's a capacity. I would think that it's
a necessity, but basically because of the expense to create a payment processing network
and there are industry-established networks that we all rely on and utilize to facilitate the electronic transactions and speed of clearing that we all enjoy on our accounts with our deposits and other things. That's the line of the game they're in. We're more in debits and credits and making sure what's in your account's correct than the tracking of other information. We're taking care of the customer. All right, thank you.
Thank you, Representative Gramlich. Any other questions from the committee?
Okay, seeing none. Is there anyone in the audience who would like to
Representative Fred Allen
Unverified
1:37:41
speak against this bill? Seeing no one. Representative Beatty, would you like to
Representative Howard M. Beaty, Jr.
Unverified
1:37:46
close for your bill? I'm closed. I just want to, you know, again, make it clear that this bill, the main point is, again, on page four, those three lines, this doesn't completely exempt all banks, and it's not like a big carve-out. It simply says the banks aren't in control of that portion,
and all we do is we settle those debits and credits and posting on the account. And with that, I'm closed, and I would appreciate a motion due pass and a good vote of the committee. Thank you for
your presentation, Representative Beatty. Representative Wooten, I believe you had a motion. Motion due pass.
Representative Lee Johnson
Unverified
1:38:23
We have a motion due pass. All in favor say aye. Aye. Any opposed, say no. No. Congratulations. You have
Representative Howard M. Beaty, Jr.
Unverified
1:38:33
passed your bill. Thank you, Mr. Chair. And you have one more, I believe. One more that should be a simple bill.
Well, again, Representative Howard Beatty, District 95, Senate Bill 242 is to amend the law concerning loans involving the stock of a state bank. Primarily, you know, a bank could not loan money, according to state law, secured by their own bank stock. But sometimes through the acquiring of a financial institution, this could happen. and you acquire another institution that maybe had a loan secured by your bank stock.
So after you acquire that bank and you bring those assets into your institution, 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 from being a huge issue and provide some direction on how banks can divest of that and move forward. And with that, I would entertain any questions. Thank you, Representative Beatty. Questions from the committee?
Representative Fred Allen
Unverified
1:39:42
Seeing none, does anyone in the office like to speak against this bill? Anyone else would like to
Representative Howard M. Beaty, Jr.
Unverified
1:39:48
speak for this bill? Representative Beatty, you're recognized to close for your bill. Mr. Chair, again, I'm closed. I'd appreciate a motion due passed and a good vote of the
Representative Les Warren
Unverified
1:39:59
committee. Okay. Representative Warren, you're recognized. We have a motion due passed from Representative Warren. All in favor, say
Representative Howard M. Beaty, Jr.
Unverified
1:40:05
aye. Aye. Any opposed, say no. Congratulations to you. Passed your bill. Thank you, committee. And again, sorry 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 okay. And members, I want to say I appreciate your patience. We got through a lot on the agenda today. But do remember, we are going to meet Monday after the House adjourns to hear that Senate bill that we discussed earlier. So Monday after session. Thank you. We are adjourned. Thank you.
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 Fred Allen
Unverified
Representative Lee Johnson
Unverified
Representative Les Warren
Unverified
Representative Jim Wooten
Unverified
Speaker 34
Representative R. Scott Richardson
Unverified
Speaker 45
Speaker 51
Representative Robin Lundstrum
Unverified
Representative Les D. Eaves
Unverified
Speaker 72
Speaker 75
Sam Bledsoe
Unverified
Speaker 77
Speaker 79
Speaker 84
Speaker 89
Speaker 101
Representative Jack Ladyman
Unverified
Representative Jon S. Eubanks
Unverified
Speaker 122
Speaker 123
Chair
Unverified
Speaker 127
Speaker 128
Speaker 130
Representative Matt Brown
Unverified
Speaker 132
Speaker 135
Speaker 134
Speaker 12
Representative Mindy McAlindon
Unverified
Speaker 146
Representative Trey Steimel
Unverified
Representative Jeremy Wooldridge
Unverified
Speaker 152
Representative Dwight Tosh
Unverified
Speaker 172
Representative Sonia Eubanks Barker
Unverified
Speaker 179
Speaker 184
Speaker 195
Speaker 203
Speaker 177
Speaker 205
Speaker 186
Speaker 209
Speaker 213
Speaker 222
Speaker 216
Speaker 214
Speaker 228
Speaker 227
Speaker 234
Speaker 238
Speaker 211
Speaker 242
Speaker 244
Speaker 198
Speaker 249
Speaker 93
Speaker 19
Speaker 254
Representative Howard M. Beaty, Jr.
Unverified
Representative Zack Gramlich
Unverified