reglab/housing_qa huggingface dataset:
AR Code § 23-99-401 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-401. Short title

 This subchapter shall be known and may be cited as the “Arkansas Health Care Consumer Act”.
AR Code § 23-99-402 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-402. Legislative findings and intent

 As the state's insurance sector becomes increasingly dominated by managed care features that include decisions regarding coverage and appropriateness of health care, there is a vital need to protect patients in this environment.
AR Code § 23-99-404 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-404. Benefits for mothers and newborns

 (a)  (1) Except as provided in subsection (b) of this section, a healthcare insurer may not restrict benefits for any hospital stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a normal vaginal delivery or to less than ninety-six (96) hours following cesarean section.  (2) A healthcare insurer may not require that a provider obtain authorization for prescribing any length of stay required under subdivision (a)(1) of this section.    (b) Subdivision (a)(1) of this section shall not apply if the decision to discharge the mother or her newborn child prior to the expiration of the minimum stay is made by the attending physician in consultation with the mother.
AR Code § 23-99-405 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-405. Mastectomies

 (a) Every health benefit plan providing mastectomy benefits and issued or renewed after July 16, 2003, shall conform with the requirements of the Women's Health and Cancer Rights Act of 1998, 42 U.S.C. §§ 300gg-6 and 300gg-52, as it existed on January 1, 2003.  (b) To the extent the requirements of this section do not conflict with federal law, rules, or regulations, each healthcare insurer providing mastectomy benefits in a health benefit plan shall provide, in a manner determined in consultation with the attending physician and the enrollee or insured:  (1) For medical and surgical benefits for any hospital stay in connection with a mastectomy for not less than forty-eight (48) hours unless the decision to discharge the patient before the expiration of the minimum length of stay is made by an attending physician in consultation with the enrollee or insured;  (2) The following medical and surgical benefits with respect to mastectomy coverage if an enrollee or insured receives benefits in connection with a mastectomy and elects breast reconstruction:  (A) Surgery and reconstruction of the breast on which the mastectomy has been performed;  (B) Surgery and reconstruction of the other breast to produce a symmetrical appearance; and  (C) Prostheses and coverage for physical complications at all stages of a mastectomy, including lymphedemas; and    (3) Written notice of the availability of coverage under this section to the enrollee or insured upon enrollment and annually thereafter.    (c) No healthcare insurer providing mastectomy benefits under this section shall:  (1) Deny an enrollee or insured eligibility or continued eligibility to enroll or renew coverage under the terms of the health benefit plan solely for the purpose of avoiding the requirements of this section; or  (2) Penalize, reduce, or limit the reimbursement of an attending provider or induce the provider to provide care in a manner inconsistent with this section.
AR Code § 23-99-406 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-406. Obstetrical and gynecological services

 (a) In order to ensure that healthcare benefits are safely and appropriately delivered to women, insurers which require the selection or assignment of a primary care physician shall allow each covered person who is a woman to select a participating obstetrician/gynecologist in addition to her primary care physician.  (b) If the woman chooses to make this selection, the insurer shall allow the woman to go directly to her selected obstetrician/gynecologist, without referral from her primary care physician, for obstetrical and gynecological services.
AR Code § 23-99-407 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-407. “Gag clause” prohibition

 No participating provider may be prohibited, restricted, or penalized in any way from disclosing to any covered person any healthcare information that the participating provider deems appropriate regarding the nature of treatment, risks, or alternatives thereto, the availability of alternate therapies, consultations, or tests, the decision of utilization reviewers or similar persons to authorize or deny services, the process that is used to authorize or deny healthcare services or benefits, or information on financial incentives and structures used by the insurer.
AR Code § 23-99-408 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-408. Continuity of care

 (a) When healthcare insurers use participating providers, the healthcare insurers shall develop procedures to provide for the continuity of care of their covered persons. At a minimum, the procedures shall:  (1) Ensure that when a new patient is enrolled in a health benefit plan and is being treated by a nonparticipating provider for a current episode of an acute condition, the patient may continue to receive treatment as an in-network benefit from that provider until the current episode of treatment ends or until the end of ninety (90) days, whichever occurs first;  (2) Ensure that when a provider's participation is terminated, his or her patients under the health benefit plan may continue to receive care from that provider as an in-network benefit until a current episode of treatment for an acute condition is completed or until the end of ninety (90) days, whichever occurs first; and  (3) Explain how the covered person may request to continue services under subdivisions (a)(1) and (2) of this section.    (b) During the period covered by subdivisions (a)(1) and (2) of this section, the provider shall be deemed to be a participating provider for purposes of reimbursement, utilization management, and quality of care.  (c) Nothing in this section shall require a healthcare insurer to provide benefits that are not otherwise covered under the terms and provisions of the health benefit plan.
AR Code § 23-99-409 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-409. Prescription drug formulary

 When a healthcare insurer uses a formulary for prescription drugs, the insurer shall include a written procedure whereby covered persons can obtain, without penalty and in a timely fashion, specific drugs and medications not included in the formulary when:   (1) The formulary's equivalent has been ineffective in the treatment of the covered person's disease or condition; or  (2) The formulary's drug causes or is reasonably expected to cause adverse or harmful reactions in the covered person.
AR Code § 23-99-410 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-410. Grievance procedures

 (a) A healthcare insurer issuing or delivering a managed care plan shall establish for those managed care plans a grievance procedure which provides covered persons with a prompt and meaningful review on the issue of denial, in whole or in part, of a healthcare treatment or service.  (b)  (1) The covered person shall be provided prompt notice in writing of the outcome of the grievance procedure.  (2) In the event the outcome is adverse to the covered person, the notice shall include specific findings related to the grievance.
AR Code § 23-99-412 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-412. Provider input

 All healthcare insurers issuing or delivering managed care plans shall be required to establish a mechanism whereby participating providers provide input into the healthcare insurer's medical policy, utilization review criteria and procedures, quality and credentialing criteria, and medical management procedures.
AR Code § 23-99-413 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-413. Disclosure requirements

 Upon request, healthcare insurers must provide the following information in a clear and understandable form to all prospective policyholders, policyholders, and covered persons. Insurers shall notify policyholders and covered persons of their right to request the information, which must include:   (1) Coverage provisions, benefits, and exclusions by category of service and provider;  (2) A description of the prior authorization, precertification, and referral requirements;  (3) The existence of prescription drug formularies and prior approval requirements for prescription drugs;  (4) The name, number, type, specialty, and geographic location of participating providers; and  (5)  (A) Criteria by which providers are evaluated for network participation.  (B) Proprietary information shall not be disclosed.  (C) Criteria may include, but are not limited to, geographic limitations, geographic distribution of patients, specialty limitation, anticipated numbers and types of providers needed, and economic considerations. This information shall also be made available to providers upon request.
AR Code § 23-99-414 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-414. Rules

 The Insurance Commissioner may promulgate necessary rules for carrying out this subchapter.
AR Code § 23-99-415 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-415. Enforcement and penalties

 The Insurance Commissioner shall have all the powers to enforce this subchapter as are granted to the commissioner elsewhere in the Arkansas Insurance Code.
AR Code § 23-99-416 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-416. Application of subchapter

 This subchapter applies to all health benefit plans issued, renewed, extended, or modified on or after August 1, 1997. “Renewed, extended, or modified” shall include all health benefit plans in which the insurer has reserved the right to change the premium.
AR Code § 23-99-421 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 4 - Arkansas Health Care Consumer Act|§ 23-99-421. Pediatric dental benefits — Definitions

 (a) As used in this section:  (1) “Exchange” means a health benefit exchange that offers health benefits under a health benefit plan offered by a healthcare insurer in this state through a state-based health insurance exchange or a health insurance exchange operated by the federal government under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152;  (2) “Qualified dental plan” means a limited scope dental plan that has a certification that the qualified dental plan meets the criteria for certification under 42 U.S.C. § 18031(d)(2)(B)(ii), in effect on January 1, 2015; and  (3) “Qualified health plan” means a health benefit plan that provides healthcare coverage of essential health benefits under 42 U.S.C. § 18021(a), in effect on January 1, 2015.    (b) Beginning January 1, 2016, a qualified health plan offering healthcare coverage under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, satisfies the minimum essential pediatric oral health benefits under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, for health benefit plans offered through an exchange or outside an exchange that do not include the minimum essential pediatric oral health benefits if the healthcare insurer has reasonable assurance that the minimum essential pediatric oral health benefits are otherwise provided to the purchaser of the health benefit plan.  (c) The healthcare insurer shall be considered to have reasonable assurance that the minimum essential pediatric oral health benefits are otherwise provided to the purchaser of the health benefit plan if:  (1) At least one (1) qualified dental plan offers the minimum essential pediatric oral health benefits that are available to the purchaser of the health benefit plan; and  (2) A qualified health plan prominently discloses at the time of purchase on a form approved by the Insurance Commissioner that the qualified health plan does not provide the minimum essential pediatric oral health benefits.
AR Code § 23-99-501 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-501. Short title

 This subchapter shall be known and may be cited as the “Arkansas Mental Health Parity Act of 2009”.
AR Code § 23-99-502 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-502. Legislative findings and intent

 It is the intent of this state that if a health benefit plan provides insurance coverage for a mental illness or substance abuse disorder, the treatment of the mental illness or substance abuse disorder shall be as available as and at parity with that for other medical illnesses.
AR Code § 23-99-503 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-503. Definitions

 As used in this subchapter:   (1) “Carve-out arrangement” means an arrangement in which a healthcare insurer contracts with a separate person or entity to arrange for the delivery of specific types of healthcare benefits under a health benefit plan;  (2) “Commissioner” means the Insurance Commissioner;  (3) “Financial requirements” means copayments, deductibles, out-of-network charges, out-of-pocket contributions or fees, annual limits, lifetime aggregate limits imposed on individual patients, and other patient cost-sharing amounts;  (4) “Health benefit plan” means any group or blanket plan, policy, or contract for healthcare services issued or delivered in this state by healthcare insurers, including indemnity and managed care plans and the plans providing health benefits to state and public school employees pursuant to § 21-5-401 et seq., but excluding plans providing health care services pursuant to Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., and the Public Employee Workers' Compensation Act, § 21-5-601 et seq.;  (5) “Healthcare insurer” means any insurance company, hospital and medical service corporation, or health maintenance organization issuing or delivering health benefit plans in this state and subject to any of the following laws:  (A) The Arkansas Insurance Code;  (B) Section 23-75-101 et seq., pertaining to hospital and medical service corporations;  (C) Section 23-76-101 et seq., pertaining to health maintenance organizations; and  (D) Any successor law of the foregoing;    (6)  (A) “Mental illnesses” and “substance use disorders” mean those illnesses and disorders that are covered by a health benefit plan listed in the International Classification of Diseases manual and the Diagnostic and Statistical Manual of Mental Disorders.  (B) Unless specifically otherwise stated, “mental illness” includes substance use disorders;    (7) “Person” or “entity” means and includes, individually and collectively, any individual, corporation, partnership, firm, trust, association, voluntary organization, or any other form of business enterprise or legal entity; and  (8) “Small employer” means any person or entity actively engaged in business who, on at least fifty percent (50%) of its working days during the preceding year, employed no more than fifty (50) eligible employees.
AR Code § 23-99-504 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-504. Exclusions

 This subchapter does not apply to:   (1) Dental insurance plans;  (2) Vision insurance plans;  (3) Specified-disease insurance plans;  (4) Accidental injury insurance plans;  (5) Long-term care plans;  (6) Disability income plans;  (7) Individual health benefit plans if the healthcare insurers offer individuals who satisfy the healthcare insurer's underwriting standards the option of purchasing a plan that, other than being optional, meets all the other requirements of this subchapter;  (8) Health benefit plans for small employers if the healthcare insurers offer purchasers the option of purchasing a plan that, other than being optional, meets all the other requirements of this subchapter; and  (9) Medicare supplement plans, as subject to section 1882(g)(1) of the Social Security Act.
AR Code § 23-99-506 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-506. Parity requirements

 (a) Except as provided in § 23-99-504, a health benefit plan that provides benefits for the diagnosis and treatment of mental illnesses shall provide the benefits under the same terms and conditions as provided for covered benefits offered under the health benefit plan for the treatment of other medical illnesses and conditions, including without limitation:  (1) The duration or frequency of coverage;  (2) The dollar amount of coverage; or  (3) Financial requirements.    (b) This subchapter does not:  (1) Require equal coverage between treatments for a mental illness with coverage for preventive care;  (2) Prohibit a healthcare insurer from:  (A) Negotiating separate reimbursement rates and service delivery systems, including without limitation a carve-out arrangement;  (B) Managing the provision of mental health benefits for mental illnesses by common methods used for other medical conditions, including without limitation preadmission screening, prior authorization of services, or other mechanisms designed to limit coverage of services or mental illnesses to mental illnesses that are deemed medically necessary;  (C) Limiting covered services to covered services authorized by the health benefit plan, if the limitations are made in accordance with this subchapter;  (D) Using separate but equal cost-sharing features for mental illnesses; or  (E) Using a single lifetime or annual dollar limit as applicable to other medical illness; and    (3) Include a Medicare or Medicaid plan or contract or any privatized risk or demonstration program for Medicare or Medicaid coverage.
AR Code § 23-99-507 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-507. Medical necessity

 (a) The criteria for medical necessity determinations for mental illness made under a health benefit plan shall be made available by the healthcare insurer in accordance with rules established by the Insurance Commissioner to any current or potential covered individual or contracting provider upon request.  (b) On request, the reason for a denial of reimbursement or payment for services to diagnose or treat mental illness under a health benefit plan shall be made available by the healthcare insurer to a covered individual in accordance with the rules of the commissioner.
AR Code § 23-99-508 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-508. Permitted provisions

 (a) A healthcare insurer may at the healthcare insurer's option provide coverage for a health service, such as intensive case management, community residential treatment programs, or social rehabilitation programs, that is used in the treatment of mental illnesses but is generally not used for other injuries, illnesses, and conditions if the other requirements of this subchapter are met.  (b) Healthcare insurers providing educational remediation may, but are not required to, comply with the terms of this subchapter in regard to the treatment or remediation.  (c) A healthcare insurer may provide coverage for a health service, including without limitation physical rehabilitation or durable medical equipment, which generally is not used in the diagnosis or treatment of serious mental illnesses but is used for other injuries, illnesses, and conditions if the other requirements of this subchapter are met.  (d) A healthcare insurer may utilize common utilization management protocols, including without limitation preadmission screening, prior authorization of service, or other mechanisms designed to limit coverage of service for mental illness to individuals whose diagnosis or treatment coverage is considered medically necessary although the protocols are not used in conjunction with other medical illnesses or conditions covered by the health benefit plan.
AR Code § 23-99-509 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-509. Applicability

 (a) On or after October 3, 2009, this subchapter shall apply to health benefit plans on the health benefit plans' anniversaries or start dates but in no event later than one (1) year after October 3, 2009.  (b) If a health benefit plan provides coverage or benefits to an Arkansas resident, the health benefit plan shall be deemed to be delivered in this state within the meaning of this subchapter, regardless of whether the healthcare insurer or other entity that provides the coverage is located within or outside Arkansas.
AR Code § 23-99-510 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 5 - Arkansas Mental Health Parity Act of 2009|§ 23-99-510. Rules

 The Insurance Commissioner shall enforce this subchapter and shall promulgate necessary rules for carrying out this subchapter.