SB104 amends the Arkansas Pharmacy Benefits Manager Licensure Act to impose new rules on pharmacy benefits managers (PBMs), healthcare payors, and their affiliates. The bill’s stated purpose is to protect patients’ rights and access to medications by preventing practices that steer enrollees to affiliated pharmacies, limit pharmacy choice, or obscure available options. It adds definitions for terms such as “ghost network,” “carve-out network,” “affiliate,” and “self-administered prescription drug,” and it creates new prohibitions on deceptive or restrictive PBM practices.
The bill bars PBMs and payors from using ghost networks or carve-out networks, from requiring use of affiliated entities in ways that restrict access, and from sharing or using enrollee-identifiable prescription information for marketing without written consent. It also requires clearer disclosure of appeal and exception procedures, mandates accurate and updated provider directories, and requires reasonable access to in-person pharmacy services in Arkansas. The Insurance Commissioner is given rulemaking and enforcement authority, including the ability to establish penalties of up to $100,000 per violation, and violations are treated as unfair and deceptive acts under the Deceptive Trade Practices Act. The bill also declares that the statutory definition of “self-administered prescription drug” controls over contrary plan or PBM classifications.
In practical terms, SB104 would significantly expand state oversight of PBM business practices and strengthen protections for patients and independent pharmacies. It would affect healthcare payors, PBMs, PBM affiliates, pharmacies, pharmacists, and enrollees in health benefit plans, while expressly limiting how PBMs can structure networks, direct prescriptions, and communicate with patients. The bill also states that it does not require self-funded health plans to alter covered benefits or underlying plan terms, though it applies to PBM administration to the extent not preempted by federal law.
The overall sentiment around the bill appears strongly favorable. The bill passed third reading in both chambers unanimously, with recorded votes of 27-0, 96-0, and 32-0, indicating broad bipartisan support and little visible opposition in the available record. The emergency clause further suggests lawmakers viewed the issue as urgent, particularly regarding timely access to prescription medications.
The main points of contention implied by the bill’s structure are the scope of PBM and payor restrictions, the treatment of affiliated pharmacies, and the extent of state authority over plan administration versus federal preemption. The bill specifically targets practices that may be used to steer patients or limit pharmacy access, while also preserving some plan-design cost-sharing changes and acknowledging limits for self-funded plans. No committee testimony is available in the record provided, so the specific arguments for or against the bill are not documented here.
SB104 would amend Arkansas Code Title 23, Chapter 92, Subchapter 5, by adding new definitions, prohibitions, disclosure requirements, network adequacy rules, and enforcement provisions governing PBMs and healthcare payors. It would make a wide range of PBM and payor conduct subject to the Arkansas Deceptive Trade Practices Act, authorize the Insurance Commissioner to promulgate implementing rules, and allow the Attorney General to use DTPA remedies and penalties. The bill also creates explicit protections for pharmacy choice, patient privacy, appeals and exceptions, and access to in-person pharmacy services, while limiting PBM attempts to redefine “self-administered prescription drug” or to rely on ghost/carve-out network structures.
The available voting history shows overwhelming support for SB104, with unanimous third-reading votes in the Senate and House and no recorded nays. That pattern suggests the bill was broadly viewed as a patient-access and consumer-protection measure rather than a partisan or highly divisive proposal. The emergency clause reinforces the sense of urgency around prescription access and pharmacy network practices.
The bill’s likely points of contention are the new limits on PBM network design, affiliate steering, and prescription routing, which could affect vertically integrated pharmacy and insurance business models. PBMs and healthcare payors may object to the breadth of the “ghost network” and “carve-out network” prohibitions, the restrictions on affiliate use, and the enforcement/penalty framework. Another possible area of dispute is the bill’s interaction with self-funded plans and federal preemption, since the act expressly preserves some plan terms while still regulating PBM administration to the extent allowed by law.