- Govt Affairs
|Notes from the Hill|
Notes from the Hill - 10/4/2016
"You hit home runs not by chance but by preparation." - Roger Maris
As October begins and APA District Meetings come to an end, I'm pleased to say that Scott and I met with 24 legislators as we traveled Arkansas. Some of these discussions involved the two Pharmacy Practice Act Interim Studies filed by Rep. Justin Boyd. House Rules mandate that any practice act changes must be preceded by an Interim Study of the proposed changes in Public Health Committee. We have been told to expect a physician dispensing ISP in response to these pharmacy practice act changes. Below are the ISP's:
ISP 2015-180 REQUESTING THE HOUSE COMMITTEE ON PUBLIC HEALTH, WELFARE, AND LABOR STUDY OTHER STATES REGARDING THE USE OF PHARMACISTS TO PROVIDE ACCESS TO CERTAIN MEDICATIONS, TO ADMINISTER MEDICATIONS, AND TO DEFINE PHARMACISTS AS HEALTHCARE PROVIDERS CONSISTENT WITH OTHER AREAS OF ARKANSAS LAW.
ISP 2015-181 REQUESTING THE HOUSE COMMITTEE ON PUBLIC HEALTH, WELFARE, AND LABOR STUDY STATES THAT HAVE A PRACTICE OF ALLOWING A ONE-TIME EMERGENCY REFILL OF A PRESCRIPTION BY A PHARMACIST.
The House and Senate will convene the 91st General Assembly on Monday, January 9, 2017. As a head-start on the process of formally adopting the rules that will govern the next General Assembly the House Caucus recently adopted the House Rules draft. The changes include:
The first week of Legislative Budget hearings will begin Oct. 11-13. They will focus on various professional licensing boards and commissions, and small research/promotion boards. Meetings resume Tuesday, Oct. 18, to complete work on those boards and commissions, then to hear budget requests in the afternoon from the Insurance Department, Workers' Compensation Commission, and the Bank Department.
IMPORTANT DATES AND DEADLINES FOR FILING AND REPORTING CERTAIN BILLS, etc.
91st General Assembly - 2017 - 2018
10/11/16 (Tues.) Budget Hearings Begin – Meet Tuesday’s through Thursday’s – 11/17/16
11/08/16 (Tues.) General Election
11/10/16 (Thurs.) Executive Balanced Budget: Prior to November 10, 2016
The Director of DFA is required to present the Official General Revenue Forecast and balanced budget no later than sixty (60) days prior to the beginning of the regular session.
11/11/16 (Fri.) House Caucus
House Rule 2; House Rule 54(a)(1); House Rule 54(b)(2); House Rule 80(a); and
House Rule 81(a)
11/15/16 (Tues.) Pre-filing of Bills and Resolutions.
House Rule 38; Joint Rule 23(A); (A.C.A. 10-2-112(a))
12/04 – 12/9/16 House Orientation (Legislative Institute)
(Sun. – Fri.)
12/9/16 (Fri.) Deadline for the Public Health, Welfare and Labor Committee to launch a
feasibility study of legislation affecting the licensure of health-care providers not currently licensed or expanding the scope of practice of health-care providers if such legislation is to be considered in the regular session. (Otherwise, consideration of such legislation requires a 2/3 vote of the membership of the Public Health, Welfare and Labor Committee.) House Rule 72) Thirty (30) days prior. (Whenever the filing deadline for any bill or resolution ends on Saturday or Sunday, the deadline is extended until the close of business the following Monday.)
01/9/17 (Mon.) 12:00 Noon – 91st General Assembly convenes. A.C.A. 10-2-101(a)(1)
Arkansas Constitution Article 5, Section 5
01/11/17 (Wed.) Rules Committee Report—Rule 65(a)(3) (third day after convening)
01/16/17 (Mon.) Celebration of Martin Luther King, Jr.'s and Robert E. Lee's Birthdays - State Holiday (A.C.A. 1-5-101) (must observe)
01/23/17 (Mon.) (15th day) No proposed legislation affecting the licensure of health-care providers not currently licensed or expanding the scope of practice of health-care providers may be filed after the 15th day unless introduction is first approved by a 3/4 vote of the full membership of each house of the General Assembly. Joint Rule 15
01/23/17 (Mon.) (15th day) No proposed legislation affecting any publicly supported retirement system or pension plan shall be introduced after the 15th day of a regular session unless introduction is first approved by a 3/4ths vote of the full membership of each house of the General Assembly. House Rule 38(o)(a)(b)(c) and Joint Rule 14(B)(2)(3); (A.C.A. 10-2-115)
01/31/17 (Tues.) Deadline to file STATEMENTS OF FINANCIAL INTEREST.
(A.C.A. 21‑8‑306(a) or A.C.A. 21-8-701(c)) (Whenever the filing deadline ends on Saturday or Sunday, the deadline is extended until the close of business the following Monday.)
2/7/17 (Tues.) Commencement of period to consider legislation affecting the licensure of health-care providers not currently licensed or expanding the scope of practice of health-care providers (15 days after the deadline for the filing of such legislation-1/23 deadline) Joint Rule 15(c)
02/8/17 (Wed.) (31st day) No resolution proposing a Constitutional Amendment shall be filed in the House of Representatives or the Senate after the 31st day of each regular session. House Rule 38(n); Joint Rule 19
02/20/17 (Mon.) President's Day (A.C.A. 1-5-101) (Legislature usually does not observe holidays while in session)
02/27/17 (Mon.) (50th day) No appropriation bill shall be filed and introduced in either the House of Representatives or the Senate later than the 50th day of a regular session except upon consent of 2/3rds of the members elected to each house. (Deadline fifteen (15) minutes before adjournment on Monday, February 27th.) House Rule 38(m)(a) and Joint Rule 14(B)(1)
03/06/17 (Mon.) And, no bill shall be filed for introduction in either the House of Representatives
03/04/17 (Sat.) or the Senate later than the 55th day of a regular session except upon consent of
(55th day) 2/3rds of the members elected to each house and no other bill or resolution except adjournment resolutions and resolutions requesting permission to introduce a bill or resolution except upon 2/3rds of the members elected to each house. House Rule 38(m)(a), Joint Rule 14(B)(1) (Whenever the filing deadline for any bill or resolution ends on Saturday or Sunday, the deadline is extended until the close of business the following Monday.)
Prior to Adjourning Select non-voting members to Standing Committees.
03/06/17 (Mon.) Notice to reconsider can not be given within three days of the scheduled
(57th day) adjournment of a regular session. (after the 57th day) House Rule 27(a)
03/9/17 (Thurs.) 60th day
Floating Deadline - No new bill shall be introduced into either house during the last three (3) days of the session.
(Arkansas Constitution, Article 5, Section 34)
Notes from the Hill: 2016 Fiscal Session - May 6, 2016
We expect the Revenue Stabilization bill (RSA) to be placed on the desks of legislators next week, signaling the end of the Fiscal Session. By law, legislators must have three days before a vote to review the RSA, which is essentially finalizes what gets funded.
The 90th General Assembly officially adjourned “sine die,” on Wednesday after 81 days of session and three weeks of recess. "Sine die,” is the formal adjournment that prevents the 90th General Assembly from reconvening until the next fiscal session in February 2016 or for a special session called by the governor. Rumors are rampant of some sort of special session or even multiple sessions later this year to address Medicaid funding, highways and prisons.
The newest member of the legislature was sworn in Wednesday, State Sen. Greg Standridge, a Republican from Russellville, who will represent District 16. He was the victor of a special election in January to fill the seat vacated by former Sen. Michael Lamoureux, R-Russellville. Lamoureux resigned to serve as chief of staff for Gov. Hutchinson.
Also of note this week, Senators passed a rule change that will allow a Senator President Pro Tempore to serve more than one term. This means current Senate President Jonathan Dismang, R-Searcy, could continue in his powerful position for a second two year term. Dismang has said that he has not decided yet if he will seek another term as Senate President. However, House Speaker Jeremy Gillam, R-Judsonia, has declared he will run for the speaker’s post for the 2017 session.
"Perseverance is the hard work you do after you get tired of doing the hard work you already did." -Newt Gingrich
The 90th General Assembly kept to their schedule and ended their session on Thursday, April 2 after 81 days. The last week was not particularly pretty as far as these things go, but they got their work done, balanced their budget and left on time - for that we are all grateful.
On Monday and Tuesday of the final week the Revenue Stabilization Act, RSA, passed with ease. It appeared that only a few minor legislative matters remained at that point. For one, Governor Hutchinson pushed to have 2 constitutional amendments referred to the people. The first would amend the constitution to allow an Arkansas governor to retain his powers when out of the state, Senate Joint Resolution 3. The second removed the cap on bonds that the state could issue to bring in new industries, Senate Joint Resolution 16. The Governor had indicated for some weeks that the two amendments should be presented in the next election while House and Senate leadership had made it clear that no amendments were warranted. A third constitutional amendment, House Joint Resolution 1027, would increase the terms of county officials from two to four years. This was clearly a win for the Governor and another piece of his economic development goals.
Most of the energy and publicity this last week centered on HB 1228, the Religious Freedom Restoration Act sponsored by Rep Ballinger, R-District 97. The bill was viewed by many in the state as a way for businesses to discriminate against the LGBT community. Governor Hutchinson had given early indications that he would sign the bill if it got to his desk. After some consideration and after hearing from Wal-Mart, Axiom and other corporate entities in the state, the Governor back tracked. Finding himself in much the same situation as the Indiana governor he made it clear that a new bill, in line with the federal Religious Freedom Restoration Act, must be written. With only days to spare, a shell bill was used to accommodate the new language (SB975) and a likely veto was averted. In fact the House went into recess for about 45 minutes, just long enough to accommodate a bill-signing ceremony for SB975. The new bill will give more protection to the rights of all citizens including the LGBT community.
By late Thursday afternoon the House and Senate had gaveled out of session with plans to return May 8 to adjourn sine die. As they did so most observers and clearly most members believed they had completed a productive and business-like legislative session, the dust-up over the Religious Freedom bills notwithstanding.
The 90th General Assembly in concert with our new Governor was successful on several fronts. For starters they passed a middle class tax cut of over $100 million. They extended the Private Option until 2016 with the promise of changing the program. Those changes will come through the recommendations of a legislative task force that was also set up this session (You might recall that Representative Justin Boyd secured a coveted spot on the task force). Several bills were passed to increase funding for job training and education. Finally, $36 million was set aside for prison and parole reform that is a solid first step in controlling prison overcrowding and recidivism.
As usual, a goodly amount of time was taken up with abortion laws, gun rights and more. One pundit characterized it as the God, guns and gays portion of the session. The truth is that these issues come up in every session and will in all likelihood never go away.
Pharmacy had a successful session, although nail biting at times. APA passed a strengthened MAC Bill, a Patient’s Bill of Rights, and a bill giving the Arkansas Insurance Department oversight of PBM's doing business in Arkansas.
Here are a few take-aways from this session. For one, Governor Asa Hutchinson is an intelligent and resourceful leader that has every intention of leading from the center and occasionally a little right of center. It also appears to us that the Governor plans to build coalitions on his big issues through use of task forces or work groups. Witness the Medicaid expansion task force and the task force to study Common Core. Also, we have heard that the Governor plans on selecting a work group to look at highway funding just as soon as they adjourn. We expect to see this leadership group tackle their big issues early on in the session just as they did with the tax cut and the Private Option. Finally, we expect to see continued close working relationships between the third floor (House and Senate members) and the second floor (Governor’s office).
March 23, 2015
"It ain't over till the fat lady sings." Unknown
Last week it was evident that the leadership on both ends were sticking to their schedule to adjourn the 90th General Assembly by the first week of April. The House and Senate worked through long agendas every day. The House even worked into the afternoon on Friday. That’s rare. The Senate finished Thursday as usual.
The Speaker and Pro Tem receptions and dinners were held Thursday night of this week. That is just one more sign that the end is near. It is usually a pleasant evening probably because most of the spouses attend. We even ran into former Governor Beebe and first lady Ginger Beebe at the Senate soiree. They looked happy and content and glad to be out of the business of politics after eight years as Governor, eight years as Attorney General and 20 some odd years in the Senate. It was announced some weeks ago that he was associating with the Mike Roberts Group but he advised that he would mostly be consulting and playing a lot of golf.
From sources in the Governor’s office we hear that the budget team is rapidly finishing up their final items on the budget. We still anticipate that the RSA will be on members’ desks by the end of next week. Remember the rules require that RSA must be on members’ desks a full 3 business days before a vote can be taken.
As they near the end of this session a few things have become clear. First and foremost Governor Hutchinson has a clear grasp of how a session should operate and how he can best mold the Assembly to follow his agenda. And he seems to know which battles to fight and which are best left alone.
It is also clear that the nexus between Speaker Gilliam, Pro Tem Dismang and Chief of Staff Lamoureaux is a key component of the success of this session. Their close relationship has practically eliminated any real legislative battles, at least publicly, between houses and members. For the most part that is a good thing, particularly when your client’s interests have been protected. When deals get made without consideration of your interests, that is another matter altogether. It can be very troubling when you know you have your votes to pass your bill but the leadership for whatever reason have decided otherwise.
Another hopeful trend in this session is the number of bills filed. By the March 9 deadline to file a bill only 2037 bills had been filed. That is the smallest number of bills filed since 1997 when only 1840 bills were filed. The statistic that interests me regarding bills is how many of those filed are ultimately passed and signed into law. So far this session the Governor has not vetoed any bill and we don’t expect he will due to the working relationship noted above.
Pro Tem Dismang announced once again that he didn’t believe any of the 41 Constitutional amendments filed, Senate or House Joint Resolutions, should be put on the ballot. Contrary to what we wrote last week it appears that there may not be a House or Senate Resolution referred to the General Election ballot. That final discussion will take place this week in committee.
The House and Senate did pave the way to receive their salary increases this week. Part of the recommendation of the task force to study the state’s salaries required that the roughly $15,000 office expense that all members received tax free would have to be repealed first before the higher salaries could go into effect. Two bills to do just that passed by large margins in the House and Senate last week.
We believe we can hear a rather corpulent young lady warming up her voice in the distance.
March 16, 2015
"When you reach the end of your rope, tie a knot in it and hang on." -Franklin D. Roosevelt
Another piece of the biennial session puzzle was put into place this past week. On Friday the House State Agencies Committee voted on 5 proposals to recommend to the joint committee with the Senate. The Senate State Agencies Committee chose not to cull their proposals and will have their list of 16 constitutional amendments to discuss at their March 23rd meeting. Every regular session the members get to pick 3 constitutional amendments to put on the next general election ballot. This year there have been at least 40 such Joint Resolutions, JR. The proposals include a new voter ID amendment, a response to the Arkansas Supreme Court over turning the voter ID law passed in 2013. One proposal, HJR1005, by Representative Matthew Shepherd, R-El Dorado, would end the election of judges and in its place implement a “merit-based” system. Another proposed amendment, by Senator Hester, R-Cave Springs, SJR9, caught our attention and may be the first issue we lobby for passage, pro bono. The amendment would reduce the number of days the legislature would be in session while repealing the fiscal session altogether. It’s got merit but it is doubtful that this body will vote for something that reduces their work load fresh off the extension of their term limits and raises. The level of frustration and exhaustion was apparent when one member suggested that it would be novel for the legislature not to offer any constitutional amendments for a change. We cannot remember a session in which the General Assembly did not offer up at least 1 amendment for the ballot.
Much of the political theater at the Capitol this week centered on Rep Justin Harris and his “re-homing” of his adopted children. The specifics of the case are only now fully coming to light but there appears to be plenty of blame to go around from Representative Harris to the Department of Human Services. What is clear is that the Democratic Party has used the tragic situation to raise doubts about Harris’ ability to do his job and call for his resignation. The Governor has already responded to the issue by administratively making new rules in the department concerning adoption. Not to be outdone by the administrative branch the legislature has filed a number of bills dealing with adoption and the issue of
Our expectations are to see a host of bills die in committee in the remaining weeks of the session. Many of them have made it through one side of the Assembly and hopefully will die on the other. One such bill passed the Senate this week by a vote of 32-1 is SB 803. The bill would allow a candidate to run for more than one federal office simultaneously.
You know it’s time to send the legislature home when they start pushing this type of self-serving legislation.
February 20, 2015
"Even if you're on the right track, you'll get run over if you just sit there." -Will Rogers
The sixth week of the 90th General Assembly was bookended by snow days or threat thereof. Most legislators had made it back to Little Rock by Sunday night just ahead of the storm. By Monday morning it was clear that some legislators and most of the staff could not make it to the Capitol due to snow and ice. On Thursday when it appeared that another arctic blast was going to cover the state that night the Speaker cancelled the Friday morning session. The threat of severe weather did affect the Senate. They typically go home on Thursday after a short morning session.
As advertised, the final large and significant bit of legislation was put into play this week. A day after Governor Hutchinson held a press conference to outline his prison and parole reform plan, his nephew, State Senator Jeremy Hutchinson, R-Little Rock, filed SB 472. The legislation, known as the Criminal Justice Reform Act of 2015, attempts to reform both prisons and parole guidelines. It is designed to increase available prison beds, take pressure off county jails and fix parole rules as well as the Parole Board. It is believed that the new guidelines will ultimately reduce the number of inmates and recidivism. It also sets up the Legislative Criminal Justice Oversight Task Force, apparently a favorite tool of our new Governor. The Task Force will meet quarterly to monitor the success or failure of the reforms and make recommendations. Governor Hutchinson earmarked $32million for the reforms. This looks to be a slam dunk for the Governor and sponsors. The Governors’ House sponsor is Representative Matthew Shepherd, R-El Dorado. Both legislators are lawyers, Chairmen of the Judiciary committees in their chamber and well regarded by their peers. The bill will be heard in the Judiciary committee and nobody votes again their chairman as a rule.
APA expects to introduce legislation next week designed to reduce the power and dominance of PBMs through oversight and MAC pricing requirements. A bill exempting veterinarians from the Prescription Drug Monitoring Program sank in the Senate Agriculture Committee after a short sail through the House. A shell bill intended to increase the pharmacist to tech ratio was withdrawn after the Board of Pharmacy agreed to pursue a one to three increase. Legislation requiring the real time electronic logbook used to track pseudoephedrine sales should be provided free of charge made it out of the House Public Health committee despite an RFP being released the day before the sponsor presented the bill as a special order of business. We expect a bill to be introduced specifying that a consumer without an existing pharmacy-patient relationship may purchase pseudo ephedrine if they meet the other requirements to purchase.
HB 1158 by Representative Richard Womack continues to attract the interest of many licensed business in the state. The bill would allow certain jobs to be performed by unlicensed people as long as they had the ability to perform the service. The bill sponsor believes that his legislation is a much needed step to get government off the backs of the citizens and a means to put people to work. Needless to say health care professionals, contractors, engineers, lawyers, CPA's, surveyors, speech pathologists, barbers, plumbers, electricians, and just about every other licensed profession in the state sees it differently. The bill came out of the House Public Health Committee last week with a tie breaking vote made by the Chair, Representative Kelley Linck (R). By the time the bill made it to the full House this week many licensed interests had galvanized their members. The sponsor passed over the bill this week knowing that he did not have the votes for passage. The issue appeared to be dead but by the end of this week it appears the sponsors are working on some amendatory language that would satisfy some of the opposition.
We have heard from a number of incredulous legislators this week over some of the bad legislation that is being passed. Having watched this process up close and personal for years, our level of incredulity is low to non-existent. We expect it to get worse as they near the end.
February 16, 2015
"Unless someone like you cares a whole awful lot, nothing is going to get better. It's not." - Dr. Seuss
It's the fifth week of the session and the final pieces of this 90th General Assembly are falling into place. The final heavy lift will be prison and parole reform. There will be no easy fix but we are sure that the Governor and Assembly will not allocate $100 million for new prison beds. New sentencing guidelines and drugs courts will be a part of the plan. The focus will be on non-violent offenders receiving lighter sentences and drug and alcohol rehabilitation where appropriate. Like in the Governor’s other initiatives this session we expect to see a comprehensive plan for prison reform rolled out in the next few weeks.
Another sign that the legislature is rounding 2nd base on the way to 3rd is their consideration of Constitutional amendments. So far there have been 40 proposed constitutional amendments filed most of which are in shell bill form with nothing more than a title on it. The proposals range from how we select our State Supreme court Justices to tort reform to abolishing the office of Lieutenant Governor. We expect a battle over tort reform proposals.
The duel personality of the Assembly was also in evidence this week. Senator Bart Hester’s bill to bar cities and counties from passing anti-discrimination ordinances passed the House and is on the way to the Governor. The bill appears to be in response to a couple of cities in Arkansas, Fayetteville and Eureka Springs, passing the ordinances as a further protection for gay and lesbian rights. It seems that the Senator believes that the state should make such decisions for the local governments. We are puzzling over how it can be that local governments get to decide whether they can sell and serve alcohol but not pass other laws that they deem important to them. Go figure. The Governor has promised to let the bill become law without his signature in effect showing his doubts about the constitutionality of the law but honoring the will of the legislature. His veto might have sent a better message to people and businesses coming to the state. And his veto would have been the 1st public display of disagreement between the Assembly and Governor Hutchinson.
Another surprising bit of legislation that seems destined for easy passage is SB 7, by Senator Jimmy Hickey, R-Texarkana. The bill in effect eliminates the Arkansas Lottery Commission and places control and direction of the Scholarship Lottery under the Governor in the Department of Finance and Administration. Oh, and get this, the bill sets up another department in DF&A, the office of Arkansas Lottery. Whatever happened to the legislators who opposed growing government. Why the legislature and the Administration think they can do a better job than the nine commissioners that they appointed is beyond us. The lottery commission has had its problems but the main one was solved when the first director Ernie Passailaigue left the state. We are reminded of that old saw, be careful what you wish for because you might get it.
It seems that we have reached the part of the part of the session where much of the bad legislation is filed. One pundit has called this the part of the session in which guns, gays and abortions are dealt with. The truth is the state can get along just fine without passing many of these laws. The fact is they will be filed and much of it passed.
February 9, 2015
"Majority rule only works if you're also considering individual rights. Because you can't have five wolves and one sheep voting on what to have for supper." -Larry Flynt
It took only four weeks for the 90th General Assembly to polish off the big ticket items and campaign promises, although it was done with little fanfare. Governor Hutchinson signed the middle class tax cut bill in a signing ceremony on Friday. The Private Option funding bill and the bill that sets up the task force to study how best to proceed with the Private Option after 2016 passed easily and are now on their way to the Governor for his signature. It's expected that there will be far fewer legislators attending the signing ceremony and photo op for the Private Option than attended the tax cut ceremony on Friday.
During last session the Private Option funding bill passed by the slimmest of margins. This session with sizable Republican majorities, many of whom ran on their opposition to Obama Care, the bill passed easily: 29 to 2 in the Senate and 82 to 16 in House. What a difference a new Republican governor makes. It appears that the Private Option or a reasonable facsimile thereof is here to stay.
What's impressive about this Assembly is the business-like approach the members are taking to the legislation before them. Most of the bills and issues appear to be vetted and refined in their caucuses and smaller meetings, resulting in less dissension and prolonged debates. Sure the Governor and Chief of Staff Lamoureux have had an impact on the process. But most assuredly this session would not be going so well without the firm and steady hand of Speaker Gillam and Pro Tempore Dismang. The two leaders are keeping their members on their agendas, avoiding partisanship (as much as is possible in such an environment) and somehow keeping the usual competition between the House and Senate to a minimum. To be sure that is all subject to change as they near the end of the process and start truing-up the Revenue Stabilization Act.
With their agendas all but complete, Governor Hutchinson and Leadership could conceivably pass their budget bills over the next several weeks, shut-down this session and rightfully declare it a success. But that won’t happen until March 13th, the last day to file a bill.
February 2, 2015
"If you don't like something, change it. If you can't change it, change your attitude." Maya Angelou
In their third week the 90th General Assembly continued to followed the script written by Governor Hutchinson, Pro Tempore Dismang and Speaker Gilliam with barely a miscue.
On Tuesday Governor Hutchinson presented his $5.2 billion balanced budget. It includes increases for public schools, prisons, and the state Medicaid program. Most state agencies will get a 1% cut in their budgets. His budget also includes his $100 million middle class tax cut and a 1% cost-of-living increase for state employees. Overall, Hutchinson’s proposed budget would raise state spending by $149.5 million, or 3 percent. Funding for public schools will increase $50.9 million and for Medicaid by $80 million. The budget Chairs, Senator Teague and Representative Jean, gave their endorsement.
The funding bill for the Private Option, made it out of the Senate by the end of the week. By a vote of 29-2 it passed with the help of a number of Senators who voted against it in previous sessions. For these recently converted supporters, Senators Hendren, Clark, Bledsoe, Cooper, Hester and Irvin, it seems that Governor Hutchinson’s plan to push the final decision out to Dec.31, 2016, made the difference in their vote. The bill states that after Dec.31, 2016, the Private Option will not continue “without express legislative approval through a proper enactment of law.” Hmmm, sounds kind of like what they are doing already, voting to fund it every year. A Republican Governor who would have been looking at a $200 million hole in his budget may have had some impact on their votes as well.
The companion piece to The Private Option legislation also passed the Senate this week. The bill, sponsored by Hendren, R-Sulphur Springs, sets up a 16-member task force made up of 8 House members and 8 Senate members to study the Private Option and make recommendations for changing it. It passed by a vote of 27-7. Both bills were transmitted to the House and await the House members in their respective committees this week.
With the heavy lifting all but out of the way, some have suggested that this regular session may be over by Spring Break. There is talk about a Special Session for Highways to follow a few weeks after the end of the regular session.
It appears the Independent Citizens Committee, tasked to make recommendations regarding salaries for all constitutional officers and legislators, will more than double salaries for the House and Senate. Salaries for all of the other constitutional officers with the exception of the Lieutenant Governor will increase substantially as well. The public will have a 30 day comment period before the Legislature votes on the recommendations. The 30 day comment period may be a time when many voters come to understand what Amendment 3 was really all about: raises and extension of term limits.
Funny, the more things change, the more they stay the same.
Sine Die on May 17, 2013
The 89th General Assembly adjourned on Tuesday, April 23, but the session is not officially over until "sine die" adjournment. Today, the 89th General Assembly returned to the Capitol for Sine Die adjournment. Sine Die is Latin for “without day.” This means they will adjourn for an indefinite period of time or until fiscal session 2014.
100th Day of the 89th General Assembly
At exactly 100 days, this was the longest session since the 1920s. The first Republican majority since Reconstruction managed the House and Senate without a lot of party rancor or partisanship. All in all, the 89th Session looked a lot like every other Arkansas Legislative Session.
On April 23, the 100th and last day of the 89th General Assembly, Gov. Mike Beebe signed into law the Private Option Medicaid Expansion legislation. The Private Option is considered by many to be the biggest accomplishment of the session. This legislation was literally a whole session in the making. It was the primary impetus behind the passage and defeat of other related and non-related legislation during behind the scenes deals to garner enough votes for its passage. The Private Option will allow Arkansas to use federal Medicaid dollars to purchase private health insurance for thousands of low-income residents. Research suggests it will save the lives of 2300 Arkansans. The federal government must still officially approve Arkansas' plan, although federal officials have said the concept is consistent with Medicaid's requirements.
Tax cuts can also be considered an important accomplishment of this session. Out of the "trades" for Private Option votes came four tax cut bills and funding for the Big River Steel mill superproject. The four tax cut bills included income tax reform, capital gains taxes, the grocery tax reduction, and a sales tax on utilities for manufacturers. After the passage of the Private Option, tax cut bills were quickly passed and sent to Governor Beebe.
In total the bills add up to roughly $90 million in cuts in the 2014 and 2015 budgets. Not surprisingly, Speaker Carter got his capital gains tax cut, HB 1966. SB 791 by Senator Bill Sample passed 90-0 in the House. The bill gives relief to manufacturers in the state by reducing the sales tax on energy used for manufacturing. HB1832 by Representative Darrin Williams passed as well. The bill would use tax credits to encourage businesses to invest in poor communities. Governor Beebe’s tax cut on groceries, SB 135 by Senator Jason Rapert, passed 91-0. The bill would eventually lower the 1.5% grocery tax to .125%. HB 1585 by Representative Charlie Collins, passed easily as well. It would cut income tax rates by .1% over several years. The one tax increase bill, SB5, by Senator Sample, amounted to a self-imposed tax by the timber industry. The bill would raise the Fire Protection Tax from 15 cents an acre to 20 cents an acre. All-in-all it is an impressive tax cut package.
Arkansas lawmakers adjourned April 23 after approving the Revenue Stabilization Act (RSA), which lays out the state’s spending priorities. The $4.9 billion RSA contained $170 million in surplus funds and included increases for public education, Medicaid, and a 2 percent cost-of-living raise for state employees. The House approved the Revenue Stabilization Act on a 77-15 vote. The Senate approved it on a 28-6 vote.
Legislators will return May 17 to tidy up any unfinished business, correct any errors and officially adjourn the Regular Session of the 89th General Assembly.
Week 14 of the 89th General Assembly
All of our bills have been signed by the Governor and will take effect in July. They include:
SB 968 / Act 1169. Sen. Bruce Maloch (D-Magnolia). Authorizes the State Medical Board to continue to regulate physician dispensing of legend drugs. (Effective immediately)
1. If the appeal is upheld: a) make the change in the MAC; b) permit the challenging pharmacy to reverse and rebill; and c) change the MAC on the list effective for other pharmacies.
2. If the appeal is denied: a) provide the challenging pharmacy with the NDC number used as the basis for determining the MAC is reasonable; and, b) Permit the challenging pharmacy to reverse the claim and submit a new claim.
Bill enforcement is by the Attorney General under the Deceptive Trade Practices Act. This final bill was agreed to by the PBM industry and will go into effect 90 days after the official end of the legislative session.
Week 12 of the 89th General Assembly
The race to the finish has begun! During the last two weeks, the 89th General Assembly has rounded the final corner and is sprinting to the finish line. In an effort to beat the April 19 deadline and save the taxpayers the cost for yet another extension, they worked into the afternoon last Saturday and there are whispers of a repeat this week. Only rarely has the Legislature chosen to work on Saturday and it is usually the last week of the session. On April 11, the Arkansas House of Representatives passed a bill that lays out the framework for the “private option” health insurance plan for Arkansans who earn up to 138% of the federal poverty level.
While the voting margins were more than the minimum 51 votes needed, they're still a ways away from the 75 votes required to pass the funding bill needed to implement the "private option.”
APA legislation awaiting Governor's signature:
Week 11 of the 89th General Assembly
SB 1138 Caldwell, Ronald (R-Wynne). Requires Pharmacy Benefits Manager to maintain a Maximum Allowable Cost List and make it accessible to pharmacists.
SB 878 Maloch, Bruce (D-Magnolia). Amends provisions of the Orthopedics, Prosthetics and Pedorthics Practice Act.
Week 10 of the 89th General Assembly
"In preparing for battle I have always found that plans are useless, but planning is indispensable." -Dwight D. Eisenhower
Week 9 of the 89th General Assembly
"A vote is like a rifle; it's usefulness depends upon the character of the user." -Theodore Roosevelt
Potential APA legislation includes a Maximum Allowable Cost (MAC) bill, a specialty drug bill, a fix for the physician dispensing issue, and a bill to deal with the sale of diabetic shoes. A complete list of bills we are tackling appears below. Monday, March 11, was the last day to file bills during the regular session of the 89th General Assembly. It resulted in the busiest filing frenzy of the session and a late night for lobbyists, with 664 bills being filed that day. Republicans filed 418 bills, while Democrats filed 246 pieces of legislation. The final bill count for the session comes to 1,300 House bills and 1,192 Senate bills for a grand total of 2,492 bills filed. There were 139 resolutions filed between the House and Senate.
This week the House Rules Committee ruled that a controversial bill requiring a photo ID to vote only needs a simple majority to pass the two chambers of the state legislature, not a super majority. The committee, which has 8 Republicans and 7 Democrats, appeared split along party lines, but the bill passed on a voice vote upon the ruling of the chair, Rep. Stephanie Malone (R-Fort Smith). Members of this committee are all appointed by the Speaker, Rep. Davy Carter (R-Cabot). The bill passed the House floor on a party line vote.
SB 878 Maloch, Bruce (D-Magnolia). Amends provisions of the Orthotics, Prosthetics and Pedorthics Practice Act.
SB 968 Maloch, Bruce ( D-Magnolia). Authorizes the State Medical Board to regulate physician dispensing of legend drugs.
SB 1138 Caldwell, Ronald (R-Wynne). Requires Pharmacy Benefits Manager to maintain a Maximum Allowable Cost List and make it accessible to pharmacists.
HB 1957 Wardlaw, Jeff (D-Warren). Limits Emergency Department Physicians prescribing authority.
SB 268 English, Jane (R-North Little Rock) Perry, Mark (D-Jacksonville). Requires active-duty military personnel identification cards to contain an ID photograph and the person's date of birth to be used to purchase pseudoephedine.
Week 8 of the 89th General Assembly
"Fools rush in where angels fear to tread." -Alexander Pope
The deadline for filing new legislation is Monday, March 11. The Session may come to a close April 15, leaving little time and lots of bills. APA is working to finalize the language on a Maximum Allowable Cost (MAC) pricing bill and Specialty Drug legislation. There could also be potential legislation to address physicians dispensing medications. A number of members have expressed concern about the recent court ruling striking down a portion of Arkansas law that will make it easier for physicians to dispense prescription medications. We are gathering information and trying to determine the most appropriate way to proceed. The AR HEALTH + AR JOBS Coalition hosted a rally on the Capitol steps March 7. They were there to support expanding access to affordable health care coverage for low-income Arkansans. Speakers included Gov. Mike Beebe and Senator Jonathan Dismang (R-Beebe). Until recently, the two were on opposite sides of the Medicaid expansion debate. Last week’s announcement that the Federal government will allow Arkansas flexibility to spend Medicaid expansion dollars on private insurance plans seems to have brought them closer to agreement.
Week 7 of the 89th General Assembly
"I never learn anything talking. I only learn things when I ask questions." -Lou Holtz
House Speaker Davy Carter (R-Cabot) made an appearance in House Public Health Committee Feb. 26 telling members that "halftime" is over and that the Session is at the “start of the third quarter.” He urged House members to take action on issues that would be “in the best interest of the state". In House Revenue and Tax Committee, Carter told members that he supported a $150 million tax cut package, which included a capital gains tax cut. He noted that it might start at $50 million and add $25 million in cuts per year in future years.
Governor Beebe’s meeting with U.S. Health and Human Services Secretary Kathleen Sebelius gave state lawmakers permission to explore additional options for Medicaid expansion. The new options would allow the anticipated 250,000 Arkansans that would be covered under Medicaid expansion to shop for subsidized health care plans in an open market system with private insurance carriers beginning in 2014. It could require subsidizing plans or creating co-pays for certain medical situations.
Week 6 of the 89th General Assembly (2/22/13)
To date, members of the 89th General Assembly have filed 418 House bills and 425 Senate bills. After passing both the Senate and House, Governor Beebe has signed 143 of those 843 bills into law.
Rep. Marshall Wright's (D-Forrest City) HB 1185 passed the full House on Feb. 18 and moved on to Senate Public Health Committee where it was presented by Senator Jonathan Dismang (R-Beebe). Harding University pharmacy students testified before committee in support of the bill. The bill received a "do pass" from committee members and is expected to be presented to the full Senate Monday. The Pharmacy Practice Act change will allow pharmacists to make therapeutic substitutes when indicated on the prescription by the prescriber. After counseling the patient on their options, the pharmacist can then substitute a product that lowers patient out-of-pocket costs (co-pays) and then notify the physician of any substitutions within 24 hours. The intent of this bill is to improve efficiency for pharmacists and patients along with maximizing cost savings.
As the sixth week of the 89th General Assembly draws to a close, APA is on the road to a productive Session.
Week 5 of the 89th General Assembly (2/15/13)
"Love conquers all things except poverty and toothache." -Mae West
Week 4 of the 89th General Assembly (2/8/13)
"Those are my principles. If you don't like them, I have others." -Groucho Marx
Last week, we learned that the state's Medicaid funding shortfall had shrunk from a November estimate of $138 million to just $61 million. This week, lawmakers and Arkansas Medicaid Director Andy Allison met to discuss the "good news". Allison had no real explanation for the drop, saying it was a bit mystifying.
The revised projection assumes lawmakers will approve the Governor’s proposal to address up the shortfall with $90 million in general revenue and $70 million in one-time surplus funds in the fiscal year that begins July 1, and with $222 million in general revenue and $70 million in surplus funds the following year. But the shortfall is still half what was predicted last November. The remaining $61 million is proposed to come from cuts that in the Governor’s proposed budget include skipping one year’s inflationary increase in Medicaid reimbursements paid to health care institutions and a 3 percent cut to providers. Auditors now say the Division of Legislative Audit report on the state’s Medicaid program may not be released for several weeks.
The Arkansas 89th General Assembly met in a “committee of the whole” for nearly three hours to discuss the $1.1 billion Big River Steel Mill, to be located near Osceola and provide 525 jobs. Securing the project will require legislators to approve a $125 million bond program to help with start-up costs. This is the first test of the state’s Amendment 82, passed by voters in 2004, which allows for state-supported bonds to help with economic development. In anticipation of the super project, 30 state Senators and House members have formed the Steel Caucus. Senator David Burnett (D-Osceola) and Rep. Monte Hodges (D-Blytheville) will co-chair the group.
Rep. Ann Clemmer (R-Benton) joined Senator Jason Rapert (R-Conway) to push forward a bill that would outlaw doctors performing abortions after the twelfth week of pregnancy. Rep. Rapert toned down his original bill that would not allow abortions after a hearbeat is detected using a vaginal probe at about six weeks. Although, the Governor believes the twelve week version may be unconstitutional, it is expected to pass the House and await his signature next week.
To date, the House has filed 280 bills and the Senate has filed 262 bills. None of our bills have been run yet but the action should pick up soon. These are our three major issues:
1. HB 1185 – Practice Act Change to allow limited therapeutic substitution: Our primary opposition will be PhRMA. The bill is designed to allow pharmacists to therapeutically substitute for a formulary drug when the physician indicates on the prescription that we can do so. After consulting with the patient about their options, the pharmacist can then substitute a product that lowers patient out of pocket costs (co-pays) and then electronically submit the choice to the physician. The intent of this bill is to shorten a process that now can take from hours to days to about 10 minutes. We are currently deciding on who the best lead sponsors are in the House and Senate and which day is best to run it.
2. HB 1184 – A bill that defines specialty drugs and requires the State Board of Pharmacy to adopt a list of drugs that fit the definition criteria. This list would govern what a PBM could classify as specialty drugs.
3. A bill concerning Maximum Allowable Cost (MAC) issues – Not yet filed. Just beginning to meet with the PBM folks to try to work out as much as we can before the fight ensues. We will be sending out more about this as we know more.
Bills APA is tracking in 89th General Assembly: Below is a list of bills APA is currently following during the 89th General Assembly. Click on the bill number to read the entire bill.
HB 1184 Wright, Marshall Requires the State Board of Pharmacy to prepare a list of specialty prescription drugs that require special handling, administration, inventory management, or patient support; provides regulations for pharmacy compliance.
SB 149 Files, Jake Allows pharmacists to dispense lower cost interchangeable biosimilar drugs in prescriptions for a biological product after first informing the prescription holder; requires notification to the prescribing physician of the substitution.
HB 1220 Joint Budget Appropriates funds to the Human Services Department - County Operations Division - Medicaid Expansion Program for fiscal 2013-14 operations.
SB 218 Irvin, Missy Requires the Insurance Commissioner to develop a uniform prior authorization form and requires health care insurers to use the form to request prior authorization for coverage of a prescription drug benefit.
Week 3 of the 89th General Assembly (2/4/13)
"We in America do not have government by the majority. We have government by the majority who participate.” -Thomas Jefferson
Week three of the Session was filled with news of Medicaid, economic development and abortion bills. January 28 was the last day for filing scope of practice bills and February 1 was the last day to file retirement related bills. To date, the House has filed 244 bills and the Senate has filed 232 bills. APA is currently tracking 15 bills.
New budget numbers say the Medicaid shortfall has been reduced to a managable $61 million. Medicaid Director Andy Allison attributed the reduction to the new episodic care delivery model instituted last October. Legislators on both sides of the aisle were skeptical of the reduction and the reason given for the reduction.
On February 1, the release of a special audit of the state Medicaid program was postponed. At the committee meeting, Joint Audit Co-Chairmen Sen. Bryan King( R-Green Forest), and Rep. Kim Hammer (R-Benton), announced that the Division of Legislative Audit was still reviewing its draft report with the Department of Human Services and the report presentation would be delayed. The report was originally scheduled to be presented in March; legislators had requested an earlier date. The audit comes during a session in which legislators are considering whether to expand the state Medicaid program under the federal Patient Protection and Affordable Care Act. Beebe favors expansion which would make Medicaid available to an additional 250,000 Arkansans, most of whom work but can’t afford coverage. Republicans in the Legislature have generally opposed the expansion.
The first of two economic development announcements began with the Governor’s announcement of the Big River Steel plant coming to Osceola. The construction phase of the plant will utilize up to 2000 workers and upon completion Big River Steel will employ 525 permanent workers with average salaries of $70,000. In a second announcement, Inuovo, Inc., an Internet marketing company is moving to Conway. The company will employ 30-50 people initially. The Governor’s Quick Action Closing Fund helped to secure both endeavors for Arkansas.
Three abortion-related bills made it out of committees. Senator Jason Rapert’s bill, SB 134, would prohibit an abortion where the heart beat of the fetus has been detected, usually at about six weeks using a vaginal probe. The bill made it out of the Senate and is now in the House Public Health Committee. HB 1037 by Representative Andy Mayberry made it out of the House Public Health Committee and will be up for a House floor vote. The bill prohibits the abortion of an unborn child that is 20 weeks or older. HB 1100 by Butch Wilkins would prohibit Health Insurance Exchanges policies from covering abortions except through a rider. All three bills packed the committee rooms with supporters and opponents. They will continue their trek to the Governor's desk in the week to come.
As the fourth week begins, the 89th General Assembly, with its 44 freshman members feeling at little more at home in the state Capitol, it's full steam ahead.
2011 Notes From the Hill Retrospective
By Debra Wolfe, APA Director of Governmental Affairs
Some people think that lobbying is a four-letter word. However, lobbyists perform a critical role in shaping policies and laws that get enacted by the state. As one of the lobbyists for the Arkansas Pharmacists Association, I spend my days building relationships with the great men and women who serve the citizens of Arkansas in the Arkansas General Assembly.
I am happy to report that the relationships that the pharmacists of the state have with their legislators and the relationships that the APA has built and maintained with Arkansas legislators have made pharmacy a strong political force at the Arkansas State Capitol. This legislative session, pharmacy scored a number of key political victories in Little Rock. Here is a summary of our legislative successes and how they will impact the practice of pharmacy:
The Pharmacy Audit Bill of Rights – Senator Johnny Key (R - Mountain Home) and Representative Linda Tyler (D - Conway) co-sponsored a bill that protects community pharmacies from the unfair and predatory auditing practices of the Pharmacy Benefit Managers (PBMs). The new law includes provisions that require a PBM to allow a pharmacist to correct a claim before any money is recouped and any recoupment can only be for the amount in excess of the corrected claim. This provision will prevent PBMs from finding an insignificant error in a prescription and recouping the entire prescription amount from the pharmacy. In addition, random audits will be limited to two per year, and each random audit may only include 25 prescriptions. These provisions will limit the number of times each year that a PBM may conduct a random desk audit, and it places an important limit on the number of claims that they may audit. Many provisions of the bill become effective on July 1, 2011, with the full implementation occurring on January 1, 2012. Click here to read the PBM Audit Bill.
Senator Key also ran a separate bill for pharmacy that protects the pharmacist-patient relationship and prevents a PBM from interfering with this relationship.
Expansion of Pharmacists Ability to Immunize – Senator Percy Malone (D - Arkadelphia) authored a bill that permits Arkansas pharmacists to administer medications down to age seven. The previous age limit for pharmacists was 18. In addition, pharmacists may provide flu shots down to age seven under a general protocol. All other immunizations and medications will require a patient-specific prescription for ages seven to 17. This expansion of pharmacy practice opens up a new opportunity for pharmacists to provide immunizations to many children who currently go unvaccinated.
Pharmacist-Only Third Class of Drugs – Senator Malone and Representative Mark Perry (D – Jacksonville) co-sponsored a bill that creates the framework for a pharmacist-only third class of drugs. The new law maintains patients’ ability to access pseudoephedrine products from a pharmacist without a prescription, and it requires a pharmacist-patient relationship and the determination of a medical need by the pharmacist before a sale can be made.
In short, it prevents non-pharmacist store managers from forcing a professional pharmacist to sell these products and it allows the State Board of Pharmacy to discipline the pharmacy permit holder if someone attempts to force a pharmacist to make a sale. More importantly, the new law permits the State Board of Pharmacy to add new over-the-counter (OTC) products in the future that should require the specialized knowledge of the pharmacist before a patient may purchase them.
This bill drew many opponents, including the OTC manufacturers, the National Association of Chain Drug Stores, Walgreens, and Wal-Mart. However, pharmacists from all practice settings overcame this opposition by rallying at the State Capitol on March 15 to help ensure the bill’s passage.
Prescription Drug Monitoring Bill – Senator Malone also led the effort to create a statewide prescription drug tracking system. This electronic database will capture all Schedule II, III, IV, and V prescriptions that are filled in the state of Arkansas. The data will be housed at the Arkansas Department of Health and will be available as a tool for healthcare providers to use when making determinations about patient treatment. Pharmacists will have access to the system and the legislature hopes that the system will help reduce doctor and pharmacy shopping for controlled substances.
State Board of Pharmacy Appointment Bill – Representative Tommy Wren (D – Melbourne) and Senator Bill Sample (R – Hot Springs) co-sponsored a bill that codifies the long-standing tradition of the Governor receiving input from the Arkansas Pharmacists Association before making a pharmacist appointment to the Arkansas State Board of Pharmacy. Arkansas governors will now be required by law to appoint pharmacist members to the Board of Pharmacy upon the advice and consent of the APA.
Preserving the Professional Independence of a Pharmacist – Sponsored by Senator Johnny Key (R – Mountain Home) and Representative Fred Allen (D - Little Rock), this bill prohibits a third party from interfering with the pharmacists-patient relationship. It ensures that a pharmacist is not restricted when talking to a patient about their medical needs or options under any medical plan.
The 88th General Assembly was the most successful session for pharmacy in a long time, and I am particularly proud because it was productive for all of the different sectors of the profession. The APA is grateful to all of the legislators that helped us advance the profession of pharmacy and we are, most importantly, thankful to you the members for interacting with your legislators and letting them know the important role pharmacists play in today's healthcare team.
Judge Rules on PBM Lawsuit
District Judge Brian Miller has ruled on the lawsuit filed by PMCA in 2015. Read more about it in this note from APA Executive Vice President and CEO Scott Pace.
Community Pharmacy Enhanced Services Network
Arkansas CPESN has released its Participation Agreement.
Nominations are now open for APA Board of Directors and APA Annual Awards.
417 South Victory Street
Little Rock, Arkansas 72201