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An act TO MANDATE THE USE OF BIOSIMILAR MEDICINES 10 UNDER HEALTH BENEFIT PLANS, the official text

Shown verbatim: the complete text as captured from the official PDF posted by the Arkansas General Assembly, fetched 2026-07-23. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
Stricken language would be deleted from and underlined language would be added to present law.

1 State of Arkansas         As Engrossed: S2/5/25 S3/10/25
2 95th General Assembly
                                     A Bill

3 Regular Session, 2025                                            SENATE BILL 140

4

5 By: Senator J. Boyd

6 By: Representative Achor

7

8                           For An Act To Be Entitled

9   AN ACT TO MANDATE THE USE OF BIOSIMILAR MEDICINES

10  UNDER HEALTH BENEFIT PLANS; TO REQUIRE A HEALTHCARE

11  PROVIDER TO PRESCRIBE BIOSIMILAR MEDICINES; TO

12  IMPROVE ACCESS TO BIOSIMILAR MEDICINES; AND FOR OTHER

13  PURPOSES.

14

15

16                               Subtitle

17                       TO MANDATE THE USE OF BIOSIMILAR

18                       MEDICINES UNDER HEALTH BENEFIT PLANS; TO

19                       REQUIRE A HEALTHCARE PROVIDER TO

20                       PRESCRIBE BIOSIMILAR MEDICINES; AND TO

21                       IMPROVE ACCESS TO BIOSIMILAR MEDICINES.

22

23 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

24

25  SECTION 1. Arkansas Code Title 23, Chapter 79, is amended to add an

26 additional subchapter to read as follows:

27

28  Subchapter 29 -- Mandate for Use of Biosimilar Medicines

29

30  23-79-2901. Definitions.

31  As used in this subchapter:

32  (1) "Beneficiary" means an individual who is entitled to receive

33 healthcare services under the terms of a health benefit plan;

34  (2) "Biosimilar medicine" means a biological product that is:

35                       (A) Licensed under 42 U.S.C.� 262(k), as it existed on

36 January 1, 2025; and

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1               (B) Not listed as discontinued in the United States Food

2 and Drug Administration's Database of Licensed Biological Products, commonly

3 known as the "Purple Book";

4               (3) "Brand drug" means a drug product for which an application

5 has been approved under 21 U.S.C. � 355(c), as it existed on January 1, 2025,

6 or a biological product, other than a biosimilar medicine, that is licensed

7 under 42 U.S.C. � 262(a), as it existed on January 1, 2025;

8               (4) "Formulary" means:

9               (A) A list of prescription drug products and biological

10 products that is developed by a pharmacy and therapeutics committee or other

11 clinical and pharmacy experts; and

12              (B) Represents a health benefit plan's prescription drug

13 products and biological products approved for use;

14              (5) "Generic drug" means a drug product:

15              (A) For which an application has been approved under 21

16 U.S.C. � 355(j), as it existed on January 1, 2025; and

17              (B) That has been listed in the United States Food and

18 Drug Administration's Approved Drug Products with Therapeutic Equivalence

19 Evaluations, commonly known as the "Orange Book" as therapeutically

20 equivalent to a reference listed drug, even if the manufacturer of the drug

21 product applies a trade name to the drug;

22              (6)(A) "Health benefit plan" means an individual, blanket, or

23 group plan, policy, or contract for healthcare services offered, issued,

24 renewed, delivered, or extended in this state by a healthcare insurer.

25              (B) "Health benefit plan" includes:

26              (i) Indemnity and managed care plans; and

27              (ii) Nonfederal governmental plans as defined in 29

28 U.S.C. � 1002(32), as it existed on January 1, 2025, including plans

29 providing health benefits to state and public school employees under � 21-5-

30 401 et seq.

31              (C) "Health benefit plan" does not include:

32              (i) A plan that provides only dental benefits or eye

33 and vision care benefits;

34              (ii) A disability income plan;

35              (iii) A credit insurance plan;

36              (iv) Insurance coverage issued as a supplement to

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1 liability insurance;

2                        (v) A medical payment under an automobile or

3 homeowners insurance plan;

4                        (vi) A health benefit plan provided under Arkansas

5 Constitution, Article 5, � 32, the Workers' Compensation Law, � 11-9-101 et

6 seq., or the Public Employee Workers' Compensation Act, � 21-5-601 et seq.;

7                        (vii) A plan that provides only indemnity for

8 hospital confinement;

9                        (viii) An accident-only plan;

10                       (ix) A specified disease plan;

11                       (x) A long-term-care-only plan; or

12                       (xi) The Arkansas Medicaid Program;

13  (7)(A) "Healthcare insurer" means an entity subject to the

14 insurance laws of this state or the jurisdiction of the Insurance

15 Commissioner that contracts or offers to contract to provide health insurance

16 coverage, including without limitation an insurance company, a hospital and

17 medical service corporation, a health maintenance organization, or a self-

18 insured governmental or church plan in this state.

19  (B) "Healthcare insurer" does not include:

20                       (i) An entity that provides only dental benefits or

21 eye and vision care benefits; or

22                       (ii) The Arkansas Medicaid Program;

23  (8) "Healthcare provider" means a type of provider that renders

24 healthcare services to patients for compensation including a doctor of

25 medicine or another licensed healthcare professional acting within the

26 provider's licensed scope of practice;

27  (9) "Limited distribution drug" means a prescription medication

28 that is restricted by a pharmaceutical manufacturer to a limited number of

29 specialty pharmacies due to the prescription medication's:

30  (A) Complex use, including special handling, monitoring,

31 or administration;

32  (B) High cost; or

33  (C) Safety concerns;

34  (10) "Reference listed drug" means the listed drug product

35 identified by the United States Food and Drug Administration as a drug

36 product upon which an applicant relies in seeking approval of the applicant's

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1 application submitted under 21 U.S.C. � 355(j), as it existed on January 1,

2 2025;

3               (11) "Reference product" means a single biological product that

4 is licensed by the United States Food and Drug Administration under 42 U.S.C.

5 � 262(a), as it existed on January 1, 2025, against which a proposed

6 biosimilar medicine or interchangeable biological product is compared and

7 listed as a reference product in the United States Food and Drug

8 Administration's Database of Licensed Biological Products, commonly known as

9 the "Purple Book"; and

10              (12) "Wholesale acquisition cost" means the same as defined in

11 section 1847A(c)(6)(B) of the Social Security Act, 42 U.S.C. � 1395w-3a, as

12 it existed on January 1, 2025.

13

14       23-79-2902. Formulary.

15       (a) A health benefit plan shall publish in a manner that is easily

16 accessible to a beneficiary, a prospective beneficiary, the state, and the

17 public an up-to-date, accurate, and complete list of all covered drug

18 products and biological products on the health benefit plan's formulary,

19 including without limitation:

20              (1) A tiering structure that has been adopted for the health

21 benefit plan; and

22              (2) Any restrictions on the manner in which a drug product or

23 biological product can be obtained.

24       (b) A formulary is easily accessible under subsection (a) of this

25 section if:

26              (1) The formulary can be viewed on the health benefit plan's

27 public website through a clearly identifiable link or tab without requiring

28 an individual to create or access an account or enter a policy number; and

29              (2) An individual can easily discern which formulary list

30 applies to which health benefit plan if a healthcare insurer offers more than

31 one (1) health benefit plan.

32       (c) If a change is made to the formulary of a health benefit plan

33 during the plan year, the easily accessible formulary shall:

34              (1) Be updated within thirty (30) calendar days; and

35              (2) Contain, in bold type, the date of the update, with the

36 updates clearly identifiable.

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1

2   23-79-2903. Generic drugs.

3   (a) If a generic drug is marketed pursuant to such approval, and has a

4 wholesale acquisition cost that is less than the wholesale acquisition cost

5 of the reference listed drug on the generic drug's initial date of marketing,

6 then a health benefit plan that provides coverage for the generic drug's

7 reference listed drug at the time of the generic drug's marketing date shall:

8             (1) Within a reasonable amount of time make the generic drug

9 available on the formulary with more favorable cost sharing, including

10 without limitation actual out-of-pocket costs, relative to the reference

11 listed drug; and

12            (2) Not impose:

13                   (A) A prior authorization, a step therapy requirement, or

14 other limitation on coverage of a generic drug for which formulary placement

15 is required under this section with the exception of limited distribution

16 drugs; or

17                   (B) A restriction on a pharmacy through which a

18 beneficiary may obtain the generic drug that makes it more difficult for the

19 beneficiary to obtain coverage of or access to the generic drug than to

20 obtain coverage of or access to the reference listed drug.

21  (b) This section shall remain in force as long as the wholesale

22 acquisition cost of a generic drug is lower than the wholesale acquisition

23 cost of the generic drug's reference listed drug.

24

25  23-79-2904. Biosimilar medicines.

26  (a) If a biosimilar medicine is marketed pursuant to such licensure,

27 and has a wholesale acquisition cost that is less than the wholesale

28 acquisition cost of the reference product of the biosimilar medicine on the

29 initial date of marketing, then a health benefit plan that provide coverage

30 for the biosimilar medicine's reference product at the time of the biosimilar

31 medicine's marketing date shall:

32            (1) Within a reasonable amount of time make at least one (1)

33 biosimilar medicine available on the formulary on a tier with more favorable

34 cost sharing, including actual out-of-pocket costs, relative to the reference

35 product; and

36            (2) Not impose:

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1                (A) A prior authorization, a step therapy requirement, or

2 other limitation on coverage of a biosimilar medicine for which formulary

3 placement is required under this section with the exception of limited

4 distribution drugs; or

5                (B) A restriction on an accredited pharmacy through which

6 a beneficiary may obtain the biosimilar medicine that makes it more difficult

7 for a beneficiary to obtain coverage of or access to the biosimilar medicine

8 than to obtain coverage of or access to the reference product.

9   (b) This section shall remain in force as long as the wholesale

10 acquisition cost of a biosimilar medicine is lower than the wholesale

11 acquisition cost of the biosimilar medicine's reference product.

12

13  23-79-2905. Purpose and construction of subchapter.

14  (a) A health benefit plan is not required under this subchapter to:

15  (1) Continue providing coverage for a brand drug after a generic

16 drug or biosimilar medicine is approved or licensed, as applicable, and

17 marketed; or

18  (2) Provide coverage for a brand drug, generic drug, biological

19 product, or biosimilar medicine if the pharmacy and therapeutics committee or

20 the clinical and pharmacy experts that develop the health benefit plan's

21 formulary determines that the brand drug, generic drug, biological product,

22 or biosimilar medicine is no longer medically appropriate or cost-effective.

23  (b) The application of this subchapter shall not interfere with or

24 prevent a pharmacy from the practice of pharmacy as defined in � 17-92-101.

25

26  23-79-2906. Rules.

27  (a) The Insurance Commissioner may promulgate rules necessary to

28 implement this subchapter.

29  (b) The State Board of Finance may promulgate rules necessary to

30 implement this subchapter that may apply to the State and Public School Life

31 and Health Insurance Program.

32

33  SECTION 2. DO NOT CODIFY. Effective date. This act is effective on

34 and after January 1, 2026.

35

36                                  /s/J. Boyd

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