The Arkansas Legislative Council voted to make permanent Rule 128, requiring PBMs to reimburse pharmacies at “fair and reasonable” rates. This decisive vote came just one day after the Legislative Council’s Administrative Rules subcommittee rejected the proposal. It is exceedingly rare for a subcommittee to be overruled.
Rule 128 was approved in September as a temporary emergency rule because the Insurance Commissioner found that a public emergency existed that required changes to pharmacy reimbursement standards to ensure “reasonably sustainable network adequacy for pharmacy services” in the state. Please recall that Arkansas law has required the use of NADAC for product reimbursement, but did not address a professional dispensing fee, resulting in negligible reimbursement.
Rule 128 requires PBMs to submit their dispensing fee reimbursement methodology to the Insurance Commissioner, and the Commissioner is authorized to review and either approve or deny cost-to-dispense calculations. To implement, the Commissioner is required to issue a bulletin with procedures, timing, and other needed information. NCPA salutes the Arkansas Pharmacists Association’s unwavering advocacy on this issue.
