Arkansas Rule 128 (Rule 128) is a transparency rule that requires group health plans providing prescription drug benefits to report information about pharmacy benefit manager (PBM) reimbursements to pharmacies within the state. Arkansas made Rule 128 permanent in December 2024, and the rule is intended to help the state determine whether reimbursements to Arkansas pharmacies and pharmacists are “fair and reasonable.”
The next reporting deadline is July 1, 2025, and covers the period from January 1, 2025, through June 30, 2025. Insurance carriers are responsible for reporting for fully insured plans. The reporting requirement generally belongs to the plan sponsor/plan administrator for self-insured plans. The rules allow PBMs to report on behalf of self-insured plans, and self-insured employers should work with their PBMs to determine whether their PBM will report on their behalf or provide the necessary data to the employer enabling it to complete the reporting. It is not clear that ERISA preemption will apply to the Arkansas Rule 128 reporting requirement.
This alert is relevant for any employers sponsoring group health coverage providing prescription drug benefits administered by a PBM to Arkansas residents.
