What you need to know
As previously communicated on Feb. 24, the Arkansas Pharmacy Benefit Manager Licensure Act provides the regulation of pharmacy benefit managers (PBMs) operating in the State of Arkansas. In 2024, the Arkansas Insurance Department (AID), which is responsible for administering this law, released regulations and guidance pertaining to pharmacy reimbursement practices and data reporting to AID.
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Action required by May 18, 2025 for July 1, 2025 submission deadline
As previously indicated, Prime Therapeutics (Prime) believes our approach is a reasonable one that should again satisfy AID. While you do not need to take any action at this time, certain proactive steps can be taken to ensure we are prepared for the July submission:

• If your plan does not want Prime to provide reporting to AID, please email GPReportingInquiries@PrimeTherapeutics.com by May 18, 2025.
• If your request to not submit is specific to a particular line of business (Fully Insured, ACA, Self Insured), please identify that in your request.
• If no request or direction is provided before the July 1 submission deadline, Prime will submit data on your plans’ behalf.

Background 
Arkansas Rule 128 and the Bulletin #18-2024 require that “health benefit plans” and “healthcare payors” submit various data to AID. Under Arkansas law, those terms include most types of prescription drug plans, including those offered by an insurer, a health maintenance organization (HMO) or any entity providing coverage on a self-funded basis (including governmental plans). They also expressly include any “group plan, policy, or contract for healthcare services issued outside [Arkansas] that provides benefits to residents of [Arkansas].” 

Questions? 
Please contact ClientCommunications@PrimeTherapeutics.com.