The Arkansas Insurance Department (AID) issued a report summing up its activities ensuring fair and reasonable reimbursement under the state’s Rule 128. Arkansas previously required a minimum of NADAC for product reimbursement plus a fair and reasonable professional dispensing fee but issued a report in March 2026 specifying that a fair and reasonable professional dispensing fee must be at least $10.50. The new report outlines the many actions AID has taken to ensure the current reimbursement standard is met, including sending Rule 128 orders to 32 PBMs and the 1,600 plans represented by these PBMs.
The report said the following consent orders and penalties were issued in August:
- $60,000 was entered against Scriptclaim Systems, L.L.C., for unlicensed PBM operations.
- $20,000 was entered against OptumRx for reimbursements below NADAC.
- $200,000 was entered against SavRx, L.L.C., for reimbursements below NADAC. A corrective action plan was also implemented as part of this Order.
- $1,000 was assessed against TrueRx Management Services for a pharmacy reimbursement below NADAC.
- $2,500 was assessed against Prime Therapeutics for a prescription reimbursement below NADAC.
- $2,500 was assessed against ProCare Pharmacy Benefit Manager for a prescription reimbursement below NADAC.
- $2,000 was assessed against LucyRx Health Solutions for a prescription reimbursement below NADAC.
Below are the consent orders and penalties AID issued previously in the calendar year.
- MedOne: $50,000 for operating without a license
- PillowPH: $100,000 for operating without a license
- CapitalRx: $4,000 for claims reimbursed below NADAC
- Prime Therapeutics: $100,000 for claims reimbursed below NADAC
- RxAdvance: $220,000 for operating without a license
- WellDyneRx, LLC: $30,000 for claims reimbursed below NADAC
- Rightway Healthcare: $20,500 for claims reimbursed below NADAC
- LucyRx: $90,000 for operating without a license
- Sav-Rx Prescription Services: $200,000 for claims reimbursed below NADAC
- ScriptClaim: $60,000 for operating without a license
- OptumRx: $20,000 for claims reimbursed below NADAC
In addition, AID is in protracted proceedings to address concerns with Navitus, which did not cooperate with an investigation by providing reimbursement data for plans otherwise subject to ERISA. AID issued an Order to Cease and Desist that requested Navitus withdraw its objection. After a hearing, AID stood firm in its authority to request the information, arguing that the data sharing was not preempted by ERISA. Navitus has appealed to the Pulaski County Circuit Court.
NCPA salutes AID for the rigor of its PBM regulation enforcement, an exemplary program that we hope inspires other states to similar action. The Arkansas program reflects the strong support of the state’s elected leadership and the outstanding advocacy of pharmacy stakeholders in the state. Sound policy and strong enforcement will ensure patients can access the health care they need from community pharmacies.
