ARK LEG Drug Reimbursement Process

Published on: Apr 21, 2025

On Apr. 14, ARK LEG on bill re health care provider reimbursement.

  • ARK LEG approved HB 1703 re process for reimbursements for health care providers.
  • Adds ARK INS 23-99-1901 and ARK INS 23-99-1902 to Arkansas code to include definitions re the drug reimbursement process, health care and health benefit plans.
  • Drug Reimbursement Process
  • Contracting entity will provide administrative appeal procedure to allow a healthcare provider to challenge reimbursement for a specific drug, and include contact data.
  • If appeal is upheld, will make the change in the reimbursement rate to at least 110% of the healthcare provider’s drug acquisition cost, and reprocess the associated claim.
  • If the appeal is denied, will provide the challenging healthcare provider with the specific data re basis for the denial, including data to establish drug acquisition cost.
  • Legislative History
  • On Mar. 6, 2025, bill introduced in House; on Mar. 31, 2025, bill was passed in House.
  • On Mar. 31, 2025, bill delivered to Senate; on Apr. 8, 2025, bill was passed in Senate.
  • On Apr. 9, 2025, bill delivered to governor; on Apr. 14, bill HB 1703 became Act 570.
  • Effectiveness
  • Act effective 91 days after legislature adjourned sine die (May 5), so Aug. 4, 2025.
Regulators
ARK LEG
Entity Types
CNSM; Ins
Reference
PR, Act 570, HB1703, 4/14/2025; Citation: ARK INS 23-99;
Functions
Operations
Countries
United States of America
Category
State
N/A
Products
Insurance; Insurance-Health
Rule Type
Final
Regions
Am
Rule Date
Apr 14, 2025
Effective Date
Aug 4, 2025
Rule ID
251308
Linked to
N/A
Reg. Last Update
Apr 14, 2025
Report Section
US Insurance