AR HB1804

Insurance Commissioner shall administer and enforce the Arkansas Pharmacy Audit Bill of Rights and promulgate rules to implement its purposes and requirements.

"Health benefit plan" definition amended to include individual, blanket, or group plans issued or delivered by a healthcare insurer payor in Arkansas.

"Healthcare insurer" definition repealed and replaced with new "healthcare payor" definition that includes health insurance companies, HMOs, hospital and medical services corporations, and entities administering self-funded health benefit plans including governmental plans.

Pharmacy benefits managers must report quarterly to Insurance Commissioner on rebates received and distributed, rebates passed to enrollees at point of sale, and amounts paid for pharmacist services itemized by pharmacy, product, and goods/services.

Insurance Commissioner must adopt rules requiring pharmacy networks maintain access standards: 90% of individuals in urban areas within 2 miles, 90% in suburban areas within 5 miles, and 70% in rural areas within 15 miles of a retail community pharmacy, aligned with Tricare or Medicare Part D standards as of January 1, 2021.