Arkansas Pharmacist's Ass'n v. Arkansas State & Public School Life & Health Insurance Board

98 S.W.3d 27, 352 Ark. 1, 2003 Ark. LEXIS 82
CourtSupreme Court of Arkansas
DecidedFebruary 13, 2003
Docket02-929
StatusPublished
Cited by3 cases

This text of 98 S.W.3d 27 (Arkansas Pharmacist's Ass'n v. Arkansas State & Public School Life & Health Insurance Board) is published on Counsel Stack Legal Research, covering Supreme Court of Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Arkansas Pharmacist's Ass'n v. Arkansas State & Public School Life & Health Insurance Board, 98 S.W.3d 27, 352 Ark. 1, 2003 Ark. LEXIS 82 (Ark. 2003).

Opinion

Tom Glaze, Justice.

This case requires us to determine stice. actions of the Arkansas State and Public School Life and Health Insurance Board constituted rule-making and whether those actions had to be taken in accordance with the Arkansas Administrative Procedures Act, Ark. Code Ann. § 25-15-201 et seq. (Repl. 2002).

Appellee State and Public School Life and Health Insurance Board (Board) is a statutorily created board that sets policy and selects plans and coverages for the state employee and public school personnel health and life insurance and self-funded medical programs. Ark. Code Ann. § 21-5-401 (Supp. 2001). Appellee AdvancePCS Health, L.P. (APCS) provides pharmacy benefits management services for health-benefit plans. The Employee Benefits Division of the Arkansas Department of Finance & Administration (the Division) contracts for health and life insurance coverage on behalf of state and public school employees; the Division also provides state and public school employees with prescription benefits through APCS.

On March 1, 2001, APCS’s predecessor, Advance Paradigm, entered into a contract with the Division to provide pharmacy benefits management services for State and public school employees. Under this benefit services contract, prescription drug purchases by state and public school employees are covered under the plan if the purchases are made at APCS network pharmacies. The network is a group of pharmacies that have contracted with APCS to provide pharmacy services to state and public school employees covered by the plans and to receive reimbursements according to a specific formula. The appellants in this case — the Arkansas Pharmacist’s Association, Sunnymede Pharmacy, Bryant’s Investments and Holding, Sims Drug, Inc., and Gary Fancher, P.D., d/b/a Flippin Pharmacy — alleged they were participating pharmacies in the APCS pharmacy network.

After reviewing various proposals regarding changes to the pharmacy benefit services agreement, the Board recommended two changes to the Division’s and APCS’s agreement at an October 17, 2001, board meeting. First, the Board passed a motion to recommend the implementation of an optional mail service to state and public school employees, whereby certain prescriptions could be filled through the mail. Second, the Board moved to recommend a change in the rate at which pharmacists were reimbursed. Discussions at the board meeting indicated that changing the reimbursement rate could save the State about $5 million annually. On January 17, 2002, the Division and APCS executed an amended agreement incorporating the Board’s recommended changes to the reimbursement rates and the mail-order service; the amended agreement also extended the term of the agreement until December 31, 2002.

The Arkansas Pharmacist’s Association, Inc., 1 and the pharmacies named above (collectively referred to as the Association) filed a declaratory judgment action against the Board and, by way of an amended complaint, included the Division and APCS as defendants. The complaint alleged that, in making the recommendations at the October 17 meeting, the Board engaged in rule-making within the meaning of the Arkansas Administrative Procedures Act, Ark. Code Ann. § 25-15-201 (Repl. 2002) (APA). Further, the complaint alleged that the Board failed to comply with the notice and hearing provisions of the APA, and as a result, the “rules” should be declared invalid.

The opposing parties filed cross-motions for summary judgment. After a hearing on May 16, 2002, the trial court granted the summary-judgment motion filed by the Board, the Division, and APCS, and denied the Association’s motion. The trial court held that the Board’s actions at its October 17 meeting, recommending the mail order provision and lower reimbursement rates, were not “rules” or “rule making” under the APA; it also determined the Division’s and APCS’s conduct in adopting these two recommendations by amending their contract did not constitute “rules” or “rule making.” From the trial court’s order granting summary judgment in favor of the Board, the Division, and APCS, the Association brings this appeal.

For its first point on appeal, the Association argues that the trial court erred in finding that the Board’s action did not constitute rule-making. Under the Administrative Procedures Act, a “rule” is defined as “any agency statement of general applicability and future effect that implements, interprets, or prescribes law or policy, or describes the organization, procedure, or practice of any agency and includes, but is not limited to, the amendment or repeal of a prior rule.” Ark. Code Ann. § 25-15-202(8)(A) (Repl. 2002). Moreover, the APA defines “rule making” as meaning an “agency process for the formulation, amendment, or repeal of a rule.” § 25-15-202(9). The Association asserts that the Board’s decision to amend the pharmacy benefit services agreement between the Division and APCS amounted to “rule making.”

In support of its argument, the Association asserts that the Board’s actions were indisputably of “future effect” and amounted to a prescribing of policy; the “only dispute,” according to the Association, is whether the Board’s actions were “of general applicability.” The Association insists that the Board’s decision was of general applicability, because the amendment 1) changed the reimbursement formula for all current and future pharmacies that provide services to plan members, and 2) offered the mail order benefit to all current and future members.

The Association is in error on this point. The only Arkansas case that discusses the meaning and import of “general applicability” within the framework of the APA is Eldridge v. Board of Correction, 298 Ark. 467, 768 S.W.2d 534 (1989). In that case, Steve Eldridge brought suit for declaratory and injunctive relief challenging the site selection for an adult detention facility by the Department of Correction; Eldridge claimed that the Department failed to comply with the notice and hearing provisions of the APA. The trial court granted summary judgment in favor of the Department, finding that the site-selection decision did not constitute the adoption of a rule. In affirming the trial court, this court held as follows:

Eldridge strongly argues that the decision by the Department of Correction to establish an adult detention facility is a statement of general applicability that implements the law authorizing the Department to establish such facilities. While this construction perhaps involves an interesting argument in semantics, the action of the Department was no more than the carrying out of legislatively mandated administrative duties under section 12-27-103 and not the adoption of a rule within the meaning of section 25-15-202(4) and (5).
Here, the term “rule” has been defined for us, and subsections (4) and (5) of section 25-15-202 were obviously drafted to address those instances in which an agency subject to the Act either formulates, amends, or repeals statements of general applicability and future effect which implement, interpret, or set out provisions having legal consequences, or which describe departmental policies, or explain the organization, procedure, or practice of an agency.

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Related

Brown v. Arkansas Department of Finance & Administration
180 F. Supp. 3d 602 (W.D. Arkansas, 2016)
Harris v. Altheimer Unified School District
227 S.W.3d 437 (Court of Appeals of Arkansas, 2006)
Opinion No.
Arkansas Attorney General Reports, 2003

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Bluebook (online)
98 S.W.3d 27, 352 Ark. 1, 2003 Ark. LEXIS 82, Counsel Stack Legal Research, https://law.counselstack.com/opinion/arkansas-pharmacists-assn-v-arkansas-state-public-school-life-health-ark-2003.