Insurance & Commerce - Senate

I don't know about all that right. Where are y'all at all. I saw your name on there. It's not good for my bills for me to go down there but Boyd can be own worst enemy. Hey Howard, you coming Where are y'all at all. I saw your name on there. It's not good for my bills for me to go down there but Boyd can be own worst enemy. Hey Howard, are you coming, I'm just gonna wait on you because we just got two deals. Yeah. She. Oh. Yeah, uh, I don't know what right, see you. 171, yeah. I'm, I'm gonna run penzo. He's got a bill for you, so alright, see you, bud bye. Senate state insurance commerce come to order. I almost did it again. So Senator Penzo, you want to do Senate Bill 257. 257. Thank you, Mr. Chair. I've got Simon here to present with me. I'll let him introduce himself. My name is Simon De Britsov, Highlands Oncology Group where a oncology clinic in Northwest Arkansas. Go ahead, Senator. Go ahead. Uh, thank you for having me, uh, Chairman and committee members. This bill is about changing some of the timelines in the Medicaid appeals process. Currently it affords 35 days for providers to provide a response, so when Medicaid makes the decision to deny a claim. They send a letter and then the practice, it comes into the practice and there's a bunch of letters that come in. We have about 100 letters from different insurance companies that come in every day. And so we're trying to keep up with the volume and this changes it just from 35 days to 65 days in order to afford us time to respond coherently and investigate the reason and also when there are emergencies in Arkansas such as tornadoes or anything like that. There have been occasions where by the time we opened up the letter, it has already expired the timeline to me this is an administrative simplification because we do have workarounds to reopen the claim. But I believe that creates extra work on the state side. Additional phone calls and additional work for the practice all to end up at the same goal of affording a little bit of extra time to reopen the claim and appeal it. The second part of this bill requires that information, protocols and policies be published online and available for providers, and that's just like laws in order for us to comply with the requirements of DHS, whatever they may be, we to be able to read them and adhere to them and make sure that we're educated on them. So this is strictly by mail, no electronic movement of these documents. The documents are available on the portal, but if you have a large practice with multiple clinics, you have to currently go to every single one manually and pull them up, so it is a very prohibitive in terms of time for the staff to go to the portal, log in, go to each practice, and reconcile what they have already pulled in and what they have not because there's not like a tracker mechanism that says You've already read this one or you haven't. It's basically start, start fresh, so any other questions from members? Senator Boyden. Thank you, Mr. Chair. Um, Can I call you Simon? um. This sounds like a lot of bureaucracy. Do you have any idea how much this bureaucracy costs the average clinic to have to deal with all of this. I mean, are we, it sounds like we're, you're having to spend a lot of money and efforts on bureaucracy rather than taking care of patients, so any, any ideas just out of curiosity, yes, sir, just, just for Medicaid alone, most practices have about 2 dedicated reps for a larger practice just working these on the back office side, and I would say that There's also additional burden at the state level because we're calling them and you know that's obviously something that this body pays for. We're calling them to discuss it. We're calling them to appeal it. We're calling them to reopen claims and so I would imagine there's there's waste on both sides, OK, and you don't have to, you might not want to answer this specific to Medicaid, but if you want to, that's fine with me. Uh, I mean, do you even get your costs really reimbursed overall with, with Medicaid. I mean, like that's a a lot of bureaucracy, right? Unfortunately, not all services and not all specifically for us drugs and medications, they don't all reimburse acquisition costs. There's, I think, about 30% of drugs that we dispense that are below cost, so but you know it's part of serving Arkansans and so, uh, better recover some if possible, then take the full hit. Thank you. I appreciate your testimony. Senator Johnson Thank you, Mr. Chairman. Uh, Simon or Senator Penzo, I don't care who answers, um, are we changing is this uh this 35 day thing is this in rural or is it in statute. Yeah, it's currently in rural, I believe we're mandating the agency to change their rule to 65 days. Uh, yes, sir, it has come up for comment before and practices have submitted comments, I believe, and unfortunately through that process nothing, there was no feedback, so I'm not quite sure. OK, well, I have no problem, you know, telling agencies what to do, you know, I mean we set policy and they carry it out. So if we're changing that, then that's fine, but I didn't know if we were, it would still require them to they would they would be now mandated by the General Assembly to mend their rule. Am I reading that right, OK, that answers it. Thank you, Mr. Chairman. Thank you. Thank you. Is there any other questions? See none, uh, Simon, you're the only one that signed up to be for uh are you good? Is there anybody in the audience would like to speak for or against this bill. Seeing none, you want to close for your bill. I would like to add 11 little comment. All of their insurance companies customarily provide 90 days minimum, so this is still even below what the standard is for all other insurance companies, including the past programs, even for the past programs I have 120 days in my contracts for for the same process, so you know this is just 30 days just for traditional Medicaid. Thank you. We're closed. You want to make a motion, a motion to pass motion by Senator Penzo, seconded by Senator Boyd, uh, any discussion, all in favor say aye. I'll oppose like son. Thank you, Senator. You passed your bill. Thank you. Next is House Bill 1378. Representative Beatty, you just come down here. I can't even see you if you go all the way down to the other end. Yeah, it's a long ways. You got anybody that you need to come to the table with you. All right. Just recognize yourself and your you're welcome to proceed. Representative Howard Beatty, District 95. I'm here to present House Bill 1378. It's an agency bill. It's to amend the composition and meeting requirements for the state board of Finance and repeal the requirements of the employment of a chief compliance officer by the state board. This bill makes 4 updates to the state board of Finance. It lowers the required number of board members to make a quorum from 7 to 6 members. The board struggled in the past to reach a quorum because members have other important duties and responsibilities in the state. It replaces the Securities commissioner on the board with the secretary of TS&S, um, Act 475 of 23 transferred um The administrative duties of the state securities department to the state bank department and allowed the bank commissioner to act as the securities commissioner. This will ensure that they are too bored, that two board positions aren't held by one individual and it permits the governor's designee to serve on the board, and that would allow for flexibility in the event the governor's scheduled conflicts with meetings and prevents attendance at the meeting. And it eliminates the requirement that the chief compliance officer be employed by the board. Currently that compliance officer is a position that's authorized for the treasurer of the state. And it's not practical that a chief compliance officer be paid for or be an employee of the board so that the The treasurer's office is where that employee would be. And with that, I'll Entertaining questions. The question Senator Johnson. Thank you, Mr. Chairman. Representative Beatty, uh, I get the idea with what happened in the Securities department he had going under the bank department makes perfect sense, but why the secretary of transformation and shared services. Well, if you think back Employee benefits and and that world that they're over over those areas, so that was the That was the reason for transformation Shared Service. We can have someone from DFNA come and speak, and they might can address that concern a little bit better, but um that, that's what I remember, OK, and this is kind of a general question for the DFA people or anybody, really. Isn't there a bill somewhere I've seen recently that would change the name of TSS to you nodding, Mr. Chairman. So would we need to amend this bill to like that, or is there a in the additional bill, does it, would it clean this up as well in the language of that the bill that you're referencing is maybe 187. I don't know if that's the right 1. 187, 185. I won't hold you to that the language in that bill is a one-time language anywhere else in code that that that needs to be changed. It will change that, correct that in code. OK. And I would still want to hear the logic for TSS. Sure, Andy Babbitt with DFA. Basically the logic is Excuse me, uh, Part of the responsibility of Board of Finance is to oversee all contracts that are coming out of the EBD, so EBD falls under the Secretary of Transformation Shared Services, so that gives the direct line of review there and helps the board better understand the direction EBD's going and any effect it might have on on the calls to agencies for increases there. OK, well, that's it's gone out, uh, but now this does not allow uh the secretary of Department of Transformation and Shared Services to designate someone that the secretary would have to serve. OK, well, that's, that's good. It makes with EVD It it does make a lot of sense. Thank you, Mr. Babbitt. Represent. Thank you, Mr. Chair. Is there any other questions? Seeing none, uh, You want to close for your bill. I'm closed. I would, I would appreciate a motion due pass and a good vote and also appreciate y'all giving uh Senator Hill a little grief, uh, for hitting me this morning to come to committee, but I've enjoyed the time here. Thank you. Thank you have a motion motion by Senator Johnson, seconded by Senator Boyd, any discussion seeing none. What's the will of the committee, all in favor say aye. All opposed like sign. Thank you. Representative Beatty, you have passed your bill. We have no other business to come before the committee today, uh. I think We have A dinner tonight. Has anybody got a public health and insurance Public health and insurance and commerce, I think it's over at Capitol Hill. Is that tonight or tomorrow night? To that at 6 over to apartments because they had to have a bigger place, so. No, it's, it's, it's the apartments over here in the dining area, yeah. So It we have a, yeah, dinner. I have no idea what the what the meal is going to consist of, but if anybody can come, I, you know, appreciate it if y'all y'all are welcome. We are adjourned. Mr. Chair. Thank you. That was a long one.