Skip to main content
Find a Lawyer

Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-79-2303. Fairness in cost sharing

Current as of March 28, 2024 | Updated by Findlaw Staff

(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.

Previous Part of Code Next Part of Code
Back to Chapter List

Cite this article: FindLaw.com - Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-79-2303. Fairness in cost sharing - last updated March 28, 2024 | https://codes.findlaw.com/ar/title-23-public-utilities-and-regulated-industries/ar-code-sect-23-79-2303/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

Was this helpful?

Welcome to FindLaw's Cases & Codes

A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.

Go to Learn About the Law

Latest Blog Posts

For Legal Professionals

Learn About The Law

Get help with your legal needs

FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.

Go to Learn About the Law

Need to Find an Attorney?

Search our directory by legal issue

Enter information in one or both fields (Required)

Copied to clipboard