Board discusses EBD legislative package, approves Segal MOU, Health Advantage extension and temporary $20 dispensing fee for COVID antivirals

Jake Lee, administrator for the Employee Benefits Division (EBD), told the State Board of Finance the division is working with the Bureau of Legislative Research on a package of bills (designated ANS 500 in BLR materials) that would change EBD governance, create two advisory subcommittees (for public-school and state employees), eliminate existing subcommittees and require fiscal-impact statements and funding-trigger mechanisms. Lee said those bills would require subsequent board actions and closer coordination between EBD and the board.

Lee described an MOU from the Bureau of Legislative Research that would allow EBD to use the Segal Group Inc. for assistance drafting RFPs and managing certain procurement work (Medicare Advantage and pharmacy benefits manager solicitations). "Those RFPs would still be the responsibility of EBD and would come before the Board of Finance for review and approval," Lee said. The board approved entering the MOU with the caveat it must follow state procurement law.

On contracting, Lee presented Milliman's market-check analysis and recommended extending the existing Health Advantage third-party administrator (TPA) relationship for calendar year 2023 with a proposed 5% administrative-fee increase to $23.64 per member per month (PMPM). Lee said Milliman found continuing with Blue Cross/Health Advantage likely to be the most cost-effective option given network effects and the administrative cost tradeoffs of changing TPAs; the board approved the extension by voice vote.

Lee also summarized a request from the Arkansas Pharmacists Association to temporarily increase the dispensing fee for certain federally supplied oral COVID antiviral drugs. Pharmacy representatives said the federal supply is free to pharmacists but dispensing these medications is labor intensive; one speaker said pharmacies estimated initial dispensing costs in the range of $30'$40 and noted many pharmacies would be unable to participate without a viable reimbursement model. EBD recommended a temporary $20 dispensing fee (up from $1.50), to be implemented after ALC and other required approvals. Board members asked about fiscal impact and availability of federal funds; Lee said attempts to locate federal funding had not succeeded so far. The board approved the $20 dispensing fee and asked staff to pursue any available federal revenue alternatives.

Jake Lee closed by saying EBD will continue to provide updates as legislative and procurement steps move forward.