Arkansas § 23-79-2303 Fairness in cost sharing

Arkansas Statutes

§ 23-79-2303 — Fairness in cost sharing

Arkansas § 23-79-2303

Title23

This text of Arkansas § 23-79-2303 (Fairness in cost sharing) is published on Counsel Stack Legal Research, covering Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ark. Code Ann. § 23-79-2303 (2026).

Text

(a)(1) When calculating an enrollee's contribution to any applicable cost-sharing requirement, a healthcare insurer shall include any cost-sharing amounts paid by the enrollee or on behalf of the enrollee by another person.

(2)The cost-sharing requirement under subdivision (a)(1) of this section does not apply for cost-sharing of a prescription drug if a name-brand prescription drug is prescribed and the prescribed drug:

(A)Is not considered to be medically necessary by the prescriber; and (B) Has a medically appropriate generic prescription drug equivalent.

(b)(1) Except as provided in subdivision (b)(2) of this section, this section applies to a health benefit plan that is entered into, amended, extended, or renewed on or after January 1, 2022.

(2)(A) Benefits offered through a heal

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(a) (1) When calculating an enrollee's contribution to any applicable cost-sharing requirement, a healthcare insurer shall include any cost-sharing amounts paid by the enrollee or on behalf of the enrollee by another person. (2) The cost-sharing requirement under subdivision (a)(1) of this section does not apply for cost-sharing of a prescription drug if a name-brand prescription drug is prescribed and the prescribed drug: (A) Is not considered to be medically necessary by the prescriber; and (B) Has a medically appropriate generic prescription drug equivalent. (b) (1) Except as provided in subdivision (b)(2) of this section, this section applies to a health benefit plan that is entered into, amended, extended, or renewed on or after January 1, 2022. (2) (A) Benefits offered through a health benefit plan under the Evidence-Based Prescription Drug Program of the College of Pharmacy of the University of Arkansas for Medical Sciences shall satisfy the requirements of this section beginning on and after January 1, 2024, if the Insurance Commissioner reports a failure to comply with this section to the Legislative Council. (B) (i) Beginning on January 1, 2022, the Director of the Evidence-Based Prescription Drug Program of the College of Pharmacy of the University of Arkansas for Medical Sciences shall report quarterly to the commissioner, Arkansas Legislative Audit, and the Legislative Council concerning details of plan savings and how the process that is used benefits an enrollee and the offered plan. (ii) The report described in subdivision (b)(2)(B)(i) of this section shall include the amount of enrollee savings, plan-specific data on the amount of manufacturer rebates received, and how the manufacturer rebates were applied in each plan for which the program is contracted to administer a prescription drug benefit. (c) The General Assembly intends for this section to regulate a healthcare insurer only to the extent permissible under applicable law.