reglab/housing_qa huggingface dataset:
AR Code § 23-99-511 (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|§ 23-99-511. Enforcement

 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 § 23-99-512 (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|§ 23-99-512. Out-of-network providers

 In the case of a health benefit plan that provides both medical benefits and mental illness benefits, if the health benefit plan provides coverage for medical benefits provided by out-of-network providers, the health benefit plan shall provide coverage for mental illness benefits provided by out-of-network providers pursuant to this subchapter.
AR Code § 23-99-601 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-601. Short title

 This subchapter shall be cited as the “Dental Point of Service Act”.
AR Code § 23-99-602 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-602. Legislative findings

 The General Assembly finds that the quality of dental care is improved through patient choice among dentists and that utilization of dentists varies less than utilization of other providers. Patients should have the freedom to go to dentists outside their managed care network when the carrier is not required to pay the dentist more than it pays in-network dentists. Therefore, health carriers should be required to offer a point-of-service option for dental care.
AR Code § 23-99-603 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-603. Definitions

 As used in this subchapter:   (1) “Commissioner” means the Insurance Commissioner;  (2) “Covered person” means a person covered by a health plan including an enrollee, subscriber, policyholder, beneficiary of a group plan, or individual covered by any other health plan;  (3) “Dentist” means a person licensed under the Arkansas Dental Practice Act, § 17-82-101 et seq.;  (4) “Healthcare service” means that service offered or provided by the healthcare providers within the scope of their practice and relating to the prevention, cure, or treatment of illness or disease;  (5) “Health carrier” means any insurance company, health maintenance organization, or hospital and medical service corporation as defined in § 23-75-101, subject to the following laws:  (A) The Arkansas Insurance Code;  (B) Provisions pertaining to health maintenance organizations, § 23-76-101 et seq.; and  (C) Any successor laws of the foregoing; and    (6) “Health plan” means any policy, contract, or agreement offered by a health carrier to provide, reimburse, or pay for healthcare services except the following:  (A) Workers' compensation coverage;  (B) Self-funded or self-insured health plans, unless the plan is established or maintained for employees of a governmental entity; and  (C) A policy, contract, or agreement that limits coverage for dental services in connection with the treatment of a covered accidental injury or the treatment of a nondental physiological condition.
AR Code § 23-99-604 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-604. Coverage for out-of-network dentists

 (a) Every health plan which provides dental benefits issued, renewed, extended, or modified by a health carrier shall also include a point-of-service option which provides benefits to covered persons through dentists who are not members of the health carrier's provider network.  (b)  (1) The benefits offered under this option shall be the same as those offered through the network.  (2) The rate of reimbursement for out-of-network dentists may differ from the rate of reimbursement for noncapitated dentists in the network but by no more than ten percent (10%).  (3) The copayment, coinsurance, and other cost-sharing features may differ between the use of in-network and out-of-network dentists but by no more than twenty-five percent (25%).    (c) The out-of-network dentist may bill the patient for the balance of any charges which are not otherwise reimbursed by the health carrier. However, if after a request by the covered person in advance of treatment the provider fails to disclose a reasonable range of the total of charges for nonemergency services to be provided, the covered person shall not be liable for such additional charges.  (d) The health carrier shall fully disclose to the covered person, in clear, understandable language, the terms and conditions of this option. This requirement may be satisfied by the health carrier's providing to the employer or other purchaser of the health plan presentation materials for dissemination to covered persons.
AR Code § 23-99-605 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-605. Rules

 Within one hundred twenty (120) days of July 30, 1999, the Insurance Commissioner shall promulgate necessary rules for carrying out this subchapter, giving maximum possible effect to the General Assembly's intent to promote quality medical care through increased choice.
AR Code § 23-99-606 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-606. Insurance Commissioner's enforcement authority

 The Insurance Commissioner shall enforce this subchapter, using the powers granted to the commissioner elsewhere in the Arkansas Insurance Code.
AR Code § 23-99-607 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-607. Duty of Attorney General to defend

 In any legal proceeding in which the validity of this subchapter is challenged, the Attorney General shall defend the subchapter regardless of the state agency or official named as an official party.
AR Code § 23-99-608 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 6 - Dental Point of Service Act|§ 23-99-608. Applicability of subchapter

 This subchapter applies to health plans issued, renewed, extended, or modified by a health carrier on or after July 30, 1999. “Renewed, extended, or modified” shall include a change in premium or other financial term.
AR Code § 23-99-701 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems|§ 23-99-701. Legislative findings

 The General Assembly finds and declares the following:   (1) The State of Arkansas has an interest in protecting its citizens and in pursuing reasonable means to improve the quality of life and health of those citizens;  (2) In the healthcare field, the State of Arkansas has traditionally regulated utilization review as well as the quality of care provided by healthcare providers, insurance companies, and organizations which assume the risk of providing healthcare services for citizens of this state, such as health maintenance organizations; and  (3) Dynamic changes in how health care is delivered to citizens of this state require the state to oversee the quality of healthcare processes and outcomes resulting from health carriers and networks.
AR Code § 23-99-702 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems|§ 23-99-702. Definitions

 As used in this subchapter:   (1) “Commissioner” means the Insurance Commissioner;  (2) [Repealed.]  (3) “Healthcare services” means any services included in the furnishing to any individual of medical or dental care, hospitalization, or services incident to the furnishing of care or hospitalization, as well as the furnishing to any person of any and all other services or goods for the purpose of preventing, alleviating, curing, or healing human illness or injury;  (4) “Health carrier” means any person who undertakes to provide or arrange for one (1) or more managed care plans;  (5) “Managed care plan” means any arrangement whereby a health carrier undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any healthcare services, and at least part of the arrangement consists of arranging for or the provision of healthcare services as distinguished from mere indemnifications against the cost of the healthcare services on a prepaid basis through insurance or otherwise; and  (6) “Network” when used to describe a provider of health services, including, but not limited to, a hospital, physician, home health agency, pharmacy, etc., means that the provider has a participation agreement in effect with a health carrier, directly or through another entity, to provide health services to covered persons.
AR Code § 23-99-703 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems|§ 23-99-703. Grievance system

 (a) All health carriers and networks shall make arrangements for handling and resolving grievances.  (b) Each health carrier and network shall:  (1) Maintain records of grievances filed with the health carrier and network concerning the quality of healthcare services; and  (2) Submit in the form and manner prescribed by the Secretary of the Department of Health a periodic report which shall include:  (A) A written description of the processes and procedures for resolving grievances; and  (B) The total number of grievances handled through the grievance system, including a compilation of the dates of the grievances, the reason for the grievances, and resolutions of each grievance.      (c) In consultation with the Insurance Commissioner, the secretary may promulgate rules in accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq., to carry out the provisions of this subchapter to enable the state to be properly informed of quality issues within the state and to adequately respond to any quality concerns expressed through grievances.
AR Code § 23-99-704 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems|§ 23-99-704. Quality assessment and improvement systems

 (a) Each health carrier and network shall:  (1) Make arrangements for measuring and improving the quality of healthcare services;  (2) Maintain quality assessment and improvement programs and records measuring the outcomes of healthcare services; and  (3) Submit to the Secretary of the Department of Health in the time, manner, and form prescribed the following information:  (A) A written description of any quality assessment and quality improvement systems; and  (B) Findings of relevant quality data as determined by the secretary.      (b) In consultation with the Insurance Commissioner, the secretary may promulgate rules in accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq., to carry out the provisions of this subchapter to enable the state to be properly informed of quality issues within the state and to adequately respond to any quality concerns found through the outcome data.  (c) The provisions of § 16-46-105 and § 20-9-501 et seq. shall apply to all records maintained pursuant to this subchapter.
AR Code § 23-99-705 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems|§ 23-99-705. Applicability and scope

 (a) This subchapter shall not apply to disability income, specified disease, Medicare supplement, hospital indemnity, accident-only policies, long-term care, short-term limited duration insurance, and all other supplemental insurance products issued by health carriers.  (b) In terms of the Secretary of the Department of Health's regulatory authority pursuant to §§ 23-99-703 and 23-99-704, such authority shall apply to the quality of care provided by health carriers and networks operating in this state and shall not apply to the benefits offered by any health carrier and network or to the administration of such benefits.
AR Code § 23-99-706 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems|§ 23-99-706. Enforcement and penalties

 The Secretary of the Department of Health shall have the power to implement and enforce this subchapter.
AR Code § 23-99-801 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 8 - Enforcement of any Willing Provider Laws|§ 23-99-801. Application and intent

 (a) The state's any willing provider laws shall not be construed:  (1) To require all physicians or a percentage of physicians in the state or a locale to participate in the provision of services for a health maintenance organization; or  (2) To take away the authority of health maintenance organizations that provide coverage of physician services to set the terms and conditions for participation by physicians, though health maintenance organizations shall apply the terms and conditions in a nondiscriminatory manner.    (b)  (1) The state's any willing provider laws shall apply to:  (A) All health insurers, regardless of whether they are providing insurance, including prepaid coverage, or administering or contracting to provide provider networks; and  (B) All multiple-employer welfare arrangements and multiple-employer trusts.    (2) This subsection shall apply only to the extent permitted by the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. § 1001 et seq.    (c)  (1) The state's any willing provider laws shall be construed to include within their provider definitions all those providers of the same class or classes who are:  (A) Practicing or operating within a border city in an adjoining state; and  (B) Licensed or authorized to practice or operate by the adjoining state, regardless of whether the provider is licensed or otherwise authorized to operate in Arkansas.    (2) As used in this section, “border city” means a city in a state adjoining Arkansas which adjoins the Arkansas state line and is not separated from an Arkansas city only by a navigable river.    (d)  (1) As clarification, nothing in the state's any willing provider laws shall be construed to cover or regulate healthcare provider networks offered by noninsurers.  (2) If an employer sponsoring a self-insured health benefit plan contracts directly with providers or contracts for a healthcare provider network through a noninsurer, then the any willing provider law does not apply.  (3) If a health insurer subcontracts with a noninsurer whose healthcare network does not meet the requirements of the any willing provider law, then the noninsurer may create a separate healthcare provider network that meets the requirements of the any willing provider law.  (4) If the noninsurer chooses not to create the separate healthcare provider network, then the responsibility for compliance with the any willing provider law is the obligation of the health insurer to the extent permitted by the federal Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. § 1001 et seq.    (e) Notwithstanding the provisions of subsection (d) of this section, the Patient Protection Act of 1995, § 23-99-201 et seq., and this subchapter apply to a health benefit plan provided by the State of Arkansas to state employees and public school personnel under § 21-5-401 et seq., whether self-funded or insured.
AR Code § 23-99-803 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 8 - Enforcement of any Willing Provider Laws|§ 23-99-803. Agency enforcement

 The Insurance Commissioner shall:   (1) Enforce the state's any willing provider laws using powers granted to the commissioner in the Arkansas Insurance Code; and  (2) Be entitled to seek an injunction against a health insurer in a court of competent jurisdiction.
AR Code § 23-99-804 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 8 - Enforcement of any Willing Provider Laws|§ 23-99-804. Health insurer — Healthcare provider contracts

 (a) A healthcare provider, including without limitation a physician, nurse, pharmacist, dentist, physical therapist, physician assistant, or any other healthcare provider licensed and in good standing with the state licensing board responsible for the licensing of the healthcare provider, shall not be excluded from contracting with a health insurer, third-party administrator, pharmacy benefits manager, or other entity that is subject to § 23-99-802, if the healthcare provider is permitted to participate in Medicare, Medicaid, or any other federal health benefit plan.  (b) This section does not preempt § 23-99-204 regarding the requirement that a healthcare provider accept a health benefit plan's operating terms and conditions, schedule of fees, covered expenses, and utilization regulations and quality standards to participate in that health benefit plan.
AR Code § 23-99-901 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 9 - Limitation on Financial Penalties in Alternative Payment Systems|§ 23-99-901. Legislative findings

 The General Assembly finds that:   (1) Under an alternative payment system, a healthcare payor, when determining a healthcare provider's patient care costs, may use factors that are not under the control of the healthcare provider;  (2) A healthcare provider may not receive an appropriate share of savings or reduction in recoupment under an alternative payment system if the healthcare provider's patients have a higher cost of care; and  (3) A healthcare provider should not be penalized for higher patient care costs if any of the costs, or other factors determining reimbursement, are not under the control of the healthcare provider.
AR Code § 23-99-902 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 9 - Limitation on Financial Penalties in Alternative Payment Systems|§ 23-99-902. Definitions

 As used in this subchapter:   (1) “Alternative payment system” means a payment methodology used by a healthcare payor that includes a risk-sharing or gain-sharing component for a healthcare provider that participates in a plan, program, or network offered by the healthcare payor;  (2) “Gain-sharing payment” means an increase in a payment or additional payments made by a healthcare payor to a healthcare provider as a result of the achievement of identified benchmarks, including without limitation that patient care costs fall below cost thresholds of any form;  (3)  (A) “Healthcare payor” means an entity that reimburses a physician for the delivery of healthcare services that are covered by a plan administered, issued, or delivered by the entity.  (B) “Healthcare payor” does not include a provider-based network or system that utilizes risk-sharing including an accountable care organization or a clinically integrated network;    (4) “Healthcare provider” means any type of provider that renders healthcare services to patients for compensation, including:  (A) A doctor of medicine, a doctor of osteopathy, or another licensed healthcare professional acting within the professional's licensed scope of practice; or  (B) A healthcare facility, including a hospital, ambulatory surgery center, or other type of facility licensed in this state to provide healthcare services; and    (5)  (A) “Risk-sharing payment” means a reduction in a payment to or refund of a payment already made to a healthcare provider as a result of failure to achieve identified benchmarks, including without limitation that patient care costs exceed cost thresholds of any form.  (B) “Risk-sharing payment” includes the alternative payment method by gift card, credit card, or other type of electronic payment or virtual credit card as payment if the healthcare provider is given clear instructions about how to select an alternative payment method that does not result in the healthcare provider's being charged a service fee to process.
AR Code § 23-99-903 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 9 - Limitation on Financial Penalties in Alternative Payment Systems|§ 23-99-903. Physician penalties — Limitation

 (a) A healthcare payor doing business in this state, when determining any gain-sharing or risk-sharing for a healthcare provider, shall not attribute to a healthcare provider any costs that are a result of variations in the healthcare payor's freely negotiated contract pricing with other persons or entities outside the healthcare provider's practice if including the costs reduces a healthcare provider's gain-sharing amount or increases a healthcare provider's risk-sharing amount.  (b)  (1) When determining any gain-sharing or risk-sharing for a healthcare provider based on the achievement of or failure to attain certain benchmarks, a healthcare payor doing business in this state shall use clearly expressed and identifiable benchmarks.  (2) At least ninety (90) days in advance of implementation, the healthcare payor shall explain to the healthcare provider the applicability of the identifiable benchmarks.  (3) Any identifiable benchmarks shall be within the control of the healthcare provider to achieve or fail to attain.
AR Code § 23-99-904 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 9 - Limitation on Financial Penalties in Alternative Payment Systems|§ 23-99-904. Waiver prohibited

 (a) The provisions of this subchapter shall not be waived by contract.  (b) Contractual arrangements or actions taken in conflict with this subchapter or that purport to waive any requirements of this subchapter are void.
AR Code § 23-99-905 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 99 - Healthcare Providers|Subchapter 9 - Limitation on Financial Penalties in Alternative Payment Systems|§ 23-99-905. Enforcement

 (a) The State Insurance Department shall develop and promulgate rules for the implementation and enforcement of this subchapter.  (b) In addition to or as an alternative to any enforcement action by the department, a healthcare provider or an organization that represents healthcare providers may enforce this subchapter by filing suit against a healthcare payor in:  (1) Pulaski County Circuit Court; or  (2) The circuit court of a county in Arkansas in which one (1) of the healthcare provider claimants resides or does business.