Bill > HB1602

This bill amends the Arkansas Pharmacy Benefits Manager (PBM) Licensure Act to establish new definitions, licensing requirements, and reporting obligations for pharmacy benefits managers. The legislation introduces precise definitions for terms like "clean pharmacy claim", which refers to a pharmacy claim without defects that can be processed electronically in real time, and establishes unique identifiers such as pharmacy claims bank identification numbers, group numbers, and processor control numbers. The bill mandates that PBMs obtain a license from the Insurance Commissioner, with an initial application fee of $20,000 and an annual renewal fee of the same amount, though the commissioner has discretion to reduce fees for PBMs experiencing financial hardship. Additionally, PBMs must now report detailed information about their pharmacy claims at the time of license renewal, including the specific identification numbers they use, the estimated number of covered lives for each claims combination, and the types of plans they serve (such as employer-sponsored, fully-insured, self-funded, government, and various public sector plans). The legislation aims to increase transparency and standardize reporting in the pharmacy benefits management industry, providing more insight into how these managers process pharmacy claims across different types of healthcare plans.

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https://arkleg.state.ar.us/Bills/Detail?id=hb1602&ddBienniumSession=2025%2F2025R