reglab/statecodes huggingface dataset:
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 13 - COVERAGE FOR PROSTATE CANCER SCREENING (§§ 23-79-1301 — 23-79-1303) › Section 23-79-1302 - Definitions

As used in this subchapter:
(1)
(A)
"Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by an insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan in this state.
(B)
"Health benefit plan" includes:
(i)
Indemnity and managed care plans; and
(ii)
Governmental plans as defined in
29 U.S.C. § 1002(32)
, as it existed on January 1, 2009.
(C)
"Health benefit plan" does not include:
(i)
Accidental injury insurance plans;
(ii)
Dental insurance plans;
(iii)
Vision insurance plans;
(iv)
Specified disease insurance plans;
(v)
Disability income plans;
(vi)
Credit insurance plans;
(vii)
Insurance coverage issued as a supplement to liability insurance;
(viii)
Medical payments under automobile or homeowners' insurance plans;
(ix)
Health benefit plans provided under 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.;
(x)
Insurance under which benefits are payable with or without regard to fault and the benefits that are statutorily required to be contained in any liability policy or equivalent self-insurance; and
(xi)
Plans that provide only indemnity for hospital confinement;
(2)
"National Comprehensive Cancer Network" means:
(A)
A not-for-profit alliance of twenty-one (21) of the world's leading cancer centers dedicated to improving the quality and effectiveness of care provided to patients with cancer; and
(B)
With the primary goal of improving the quality, effectiveness, and efficiency of oncology practice so that patients may live better lives; and
(3)
"Premature death" means a death that occurs before sixty-five (65) years of age.
Acts 2009, No. 75, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 13 - COVERAGE FOR PROSTATE CANCER SCREENING (§§ 23-79-1301 — 23-79-1303) › Section 23-79-1303 - Coverage for prostate cancer screening required

(a)
(1)
A health benefit plan that is offered, issued, or renewed in this state on or after January 1, 2010, and that provides coverage to men forty (40) years of age or older in this state shall provide coverage for screening for the early detection of prostate cancer in men forty (40) years of age and older according to the National Comprehensive Cancer Network guidelines, as in effect on January 1, 2009.
(2)
The coverage for prostate cancer screening required under subdivision (a)(1) of this section:
(A)
Is not subject to policy deductibles; and
(B)
Shall not exceed the actual cost of the prostate cancer screening up to the maximum allowable cost per screening.
(b)
The coverage for prostate cancer screening required under subsection (a) of this section shall be offered as follows:
(1)
The prostate cancer screening shall be performed by a qualified medical professional; and
(2)
(A)
The coverage shall provide at least one (1) screening per year for any man forty (40) years of age or older according to the National Comprehensive Cancer Network guidelines, as in effect on January 1, 2023.
(B)
If additional clinical recommendations for prostate cancer screenings are recognized by medical science to reduce the risk of prostate cancer diagnoses and are included in updated guidelines published by the National Comprehensive Cancer Network, then the Insurance Commissioner may adopt the updated guidelines by rule.
(c)
The coverage for prostate cancer screening required under subsection (a) of this section does not diminish or limit diagnostic benefits otherwise allowable under a health benefit plan.
(d)
If a medical practitioner recommends that an insured, a subscriber, or an enrollee undergo a prostate specific antigen blood test, coverage may not be denied on the ground that the insured, subscriber, or enrollee has already had a digital rectal examination and the examination result was negative.
Amended by Act 2023, No. 66,§ 1, eff. 8/1/2023.
Acts 2009, No. 75, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 14 - COVERAGE FOR HEARING AIDS (§§ 23-79-1401 — 23-79-1403) › Section 23-79-1401 - Definitions

As used in this subchapter:
(1)
(A)
"Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer in this state.
(B)
"Health benefit plan" includes:
(i)
Indemnity and managed care plans; and
(ii)
Governmental plans as defined in
29 U.S.C. § 1002(32)
, as it existed on January 1, 2009.
(C)
"Health benefit plan" does not include:
(i)
Accidental injury insurance plans;
(ii)
Dental insurance plans;
(iii)
Vision insurance plans;
(iv)
Specified disease insurance plans;
(v)
Disability income plans;
(vi)
Credit insurance plans;
(vii)
Insurance coverage issued as a supplement to liability insurance;
(viii)
Medical payments under automobile or homeowners' insurance plans;
(ix)
Health benefit plans provided under 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.;
(x)
Insurance under which benefits are payable with or without regard to fault and the benefits that are statutorily required to be contained in any liability policy or equivalent self-insurance; and
(xi)
Plans that provide only indemnity for hospital confinement; and
(2)
"Hearing aid" means an instrument or device, including repair and replacement parts, that:
(A)
Is designed and offered for the purpose of aiding persons with or compensating for impaired hearing;
(B)
Is worn in or on the body; and
(C)
Is generally not useful to a person in the absence of a hearing impairment.
Acts 2009, No. 1179, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 14 - COVERAGE FOR HEARING AIDS (§§ 23-79-1401 — 23-79-1403) › Section 23-79-1402 - Coverage for hearing aids required

(a)
A health benefit plan that is offered, issued, or renewed in this state shall offer coverage for a hearing aid or hearing instrument sold on or after January 1, 2010, by a professional licensed by the state to dispense a hearing aid or hearing instrument.
(b)
The coverage offered for hearing aids under this section:
(1)
Shall not be for less than one thousand four hundred dollars ($1,400) per ear for each three-year period;
(2)
Shall provide coverage of not less than one thousand four hundred dollars ($1,400) per ear beginning on the first day of coverage; and
(3)
Is not subject to policy deductibles or copayment requirements.
Acts 2009, No. 1179, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 14 - COVERAGE FOR HEARING AIDS (§§ 23-79-1401 — 23-79-1403) › Section 23-79-1403 - Rules

The State Insurance Department shall develop and promulgate rules for the implementation and administration of this subchapter.
Acts 2009, No. 1179, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 15 - COVERAGE FOR CRANIOFACIAL ANOMALY RECONSTRUCTIVE SURGERY (§§ 23-79-1501 — 23-79-1504) › Section 23-79-1501 - Definitions

As used in this subchapter:
(1)
"Craniofacial anomaly" means the abnormal development of the skull and face;
(2)
(A)
"Health benefit plan" means an individual, blanket, or any group plan, policy, or contract for healthcare services issued or delivered in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan in this state.
(B)
"Health benefit plan" includes:
(i)
Indemnity and managed care plans; and
(ii)
Plans providing health benefits to state and public school employees under §
21-5-401
et seq.
(C)
"Health benefit plan" does not include:
(i)
A disability income plan;
(ii)
A credit insurance plan;
(iii)
Insurance coverage issued as a supplement to liability insurance;
(iv)
Medical payments under an automobile or homeowners insurance plan;
(v)
A health benefit plan provided under 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.;
(vi)
A plan that provides only indemnity for hospital confinement;
(vii)
An accident-only plan;
(viii)
A specified disease plan; or
(ix)
A plan that provides only dental benefits or eye and vision care benefits; and
(3)
"Reconstructive surgery" means the use of surgery to alter the form and function of the cranial facial tissues due to a congenital or acquired musculoskeletal disorder, including surgery to alter the form and function of the skull and face.
Amended by Act 2021, No. 955,§ 4, eff. 4/27/2021.
Amended by Act 2021, No. 955,§ 3, eff. 4/27/2021.
Amended by Act 2021, No. 955,§ 2, eff. 4/27/2021.
Amended by Act 2015, No. 373,§ 1, eff. 7/22/2015.
Added by Act 2013, No. 1226,§ 1, eff. 8/16/2013.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 15 - COVERAGE FOR CRANIOFACIAL ANOMALY RECONSTRUCTIVE SURGERY (§§ 23-79-1501 — 23-79-1504) › Section 23-79-1503 - Rules - Report

(a)
The State Insurance Department shall develop and promulgate rules for the implementation and administration of this subchapter.
(b)
The State Board of Finance shall follow the rules promulgated by the department for administration of this subchapter for the plans providing health benefits to state and public school employees under §
21-5-401
et seq.
(c)
The department shall submit biannual reports to the Chair of the House Committee on Insurance and Commerce and the Chair of the Senate Committee on Insurance and Commerce.
Amended by Act 2021, No. 1004,§ 22, eff. 4/28/2021.
Amended by Act 2021, No. 955,§ 7, eff. 4/27/2021.
Amended by Act 2015, No. 373,§ 1, eff. 7/22/2015.
Added by Act 2013, No. 1226,§ 1, eff. 8/16/2013.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 15 - COVERAGE FOR CRANIOFACIAL ANOMALY RECONSTRUCTIVE SURGERY (§§ 23-79-1501 — 23-79-1504) › Section 23-79-1504 - Title

This subchapter shall be known and may be cited as "Wendelyn's Craniofacial Law - Craniofacial Coverage".
Added by Act 2021, No. 955,§ 1, eff. 4/27/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 17 - EMERGING THERAPY ACT OF 2017 (§§ 23-79-1701 — 23-79-1704) › Section 23-79-1701 - Title

This subchapter shall be known and may be cited as the "Emerging Therapy Act of 2017".
Added by Act 2017, No. 1089,§ 2, eff. 8/1/2017.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 17 - EMERGING THERAPY ACT OF 2017 (§§ 23-79-1701 — 23-79-1704) › Section 23-79-1702 - Definitions

As used in this subchapter:
(1)
"Board" means the State Board of Finance;
(2)
"Choosing Wisely initiative" means the initiative established by the American Board of Internal Medicine Foundation that seeks to advance a national dialogue on avoiding wasteful or unnecessary medical tests, treatments, and procedures;
(3)
"Emerging therapies" means therapeutic services that have not historically been covered but for which new evidence may demonstrate therapeutic enhancements or opportunities for cost avoidance, or both;
(4)
"Evidence" means peer-reviewed objective studies of emerging therapies; and
(5)
"Regenerative injection therapy" means a nonsurgical orthopedic treatment performed by injecting into a joint or soft tissue a substance that stimulates the growth of normal cells and tissues for the purpose of strengthening or repairing a painful or injured joint or connective tissue.
Amended by Act 2021, No. 1004,§ 23, eff. 4/28/2021.
Added by Act 2017, No. 1089,§ 2, eff. 8/1/2017.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 17 - EMERGING THERAPY ACT OF 2017 (§§ 23-79-1701 — 23-79-1704) › Section 23-79-1703 - State Board of Finance - Requirements

(a)
By the end of plan year 2017, the State Board of Finance shall explore the evidence supporting opportunities for benefit modification informed by:
(1)
The Choosing Wisely initiative;
(2)
Emerging therapies; and
(3)
Therapeutic alternatives to invasive surgical procedures, such as regenerative injection therapy.
(b)
By July 2018, the board shall:
(1)
Identify and consider implementation of pilot programs that include stepped therapy or center of excellence approaches, or both, for which evidence demonstrates cost savings to the plan; and
(2)
Identify opportunities to stimulate conversations between patients and providers about appropriate and necessary treatment, including treatment recommendations identified by the Choosing Wisely initiative.
Amended by Act 2021, No. 1004,§ 24, eff. 4/28/2021.
Added by Act 2017, No. 1089,§ 2, eff. 8/1/2017.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 17 - EMERGING THERAPY ACT OF 2017 (§§ 23-79-1701 — 23-79-1704) › Section 23-79-1704 - Legislative findings

The General Assembly finds that:
(1)
The State Board of Finance has a fiduciary obligation to explore cost-effective treatments for its members;
(2)
There are emerging technologies that could serve as cost-effective alternatives to surgical procedures; and
(3)
Clinical organizations are increasingly providing public guidance on quality treatment practices.
Amended by Act 2021, No. 1004,§ 25, eff. 4/28/2021.
Added by Act 2019, No. 391,§ 10, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 18 - COVERAGE FOR NEWBORN SCREENING FOR SPINAL MUSCULAR ATROPHY (§§ 23-79-1801 — 23-79-1802) › Section 23-79-1801 - Definitions

As used in this subchapter:
(1)
(A)
"Health benefit plan" means:
(i)
An individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by an insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan in this state; and
(ii)
Any health benefit program receiving state or federal appropriations from the State of Arkansas, including the Arkansas Medicaid Program and the Arkansas Health and Opportunity for Me Program, or any successor program.
(B)
"Health benefit plan" includes:
(i)
An indemnity and managed care plan; and
(ii)
A nonfederal governmental plan as defined in
29 U.S.C. § 1002(32)
, as it existed on January 1, 2019.
(C)
"Health benefit plan" does not include:
(i)
A disability income plan;
(ii)
A credit insurance plan;
(iii)
Insurance coverage issued as a supplement to liability insurance;
(iv)
Medical payments under an automobile or homeowner's insurance plan;
(v)
A health benefit plan provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, §
11-9-101
et seq., or the Public Employee Workers' Compensation Act, §
21-5-601
et seq.;
(vi)
A plan that provides only indemnity for hospital confinement;
(vii)
An accident-only plan;
(viii)
A specified disease plan; or
(ix)
A long-term-care-only plan;
(2)
"Healthcare professional" means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of his or her profession; and
(3)
"Newborn" means a child who is twenty-nine (29) days of age or younger.
(4)
[Repealed.]
Amended by Act 2023, No. 490,§ 4, eff. 8/1/2023.
Amended by Act 2021, No. 530,§ 6, eff. on and after January 1, 2022.
Added by Act 2019, No. 58,§ 2, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 18 - COVERAGE FOR NEWBORN SCREENING FOR SPINAL MUSCULAR ATROPHY (§§ 23-79-1801 — 23-79-1802) › Section 23-79-1802 - Coverage for newborn screening

(a)
A health benefit plan that is offered, issued, or renewed in this state shall provide coverage for newborn screening for conditions as determined by the Department of Health under §
20-15-302
by a healthcare professional on or after January 1, 2020.
(b)
The coverage for newborn screening under this section:
(1)
Is not subject to policy deductibles or copayment requirements; and
(2)
Does not diminish or limit benefits otherwise allowable under a health benefit plan.
Amended by Act 2023, No. 490,§ 5, eff. 8/1/2023.
Added by Act 2019, No. 58,§ 2, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 19 - COVERAGE FOR SERVICES OF PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS AND PEDIATRIC ACUTE-ONSET NEUROPSYCHIATRIC SYNDROME (§§ 23-79-1901 — 23-79-1905) › Section 23-79-1901 - Findings

The General Assembly finds that:
(1)
Pediatric acute-onset neuropsychiatric syndrome, also known as "PANS", is a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms or eating restrictions, accompanied by two (2) or more symptoms of acute behavioral deterioration or motor and sensory changes, or both;
(2)
Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections, also known as "PANDAS", is a term used to describe a subset of children and adolescents within the broader PANS classification;
(3)
Some insurance companies are currently providing disparate insurance coverage for the treatment of PANS and PANDAS, including the State and Public School Life and Health Insurance Program, the University of Arkansas for Medical Sciences, Medicaid, and some insurance companies that serve the interests of Arkansans; and
(4)
However, not all insurance providers in Arkansas provide coverage or sufficient coverage for PANS and PANDAS, and those insurance companies that do should be consistent in coverage of treatment of PANS and PANDAS.
Added by Act 2019, No. 878,§ 1, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 19 - COVERAGE FOR SERVICES OF PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS AND PEDIATRIC ACUTE-ONSET NEUROPSYCHIATRIC SYNDROME (§§ 23-79-1901 — 23-79-1905) › Section 23-79-1903 - [Repealed]

Repealed by Act 2023, No. 876,§ 1, eff. 1/1/2024.
Added by Act 2021, No. 430,§ 1, eff. 3/24/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 19 - COVERAGE FOR SERVICES OF PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS AND PEDIATRIC ACUTE-ONSET NEUROPSYCHIATRIC SYNDROME (§§ 23-79-1901 — 23-79-1905) › Section 23-79-1904 - [Repealed]

Repealed by Act 2023, No. 876,§ 2, eff. 4/13/2023.
Added by Act 2021, No. 430,§ 1, eff. 3/24/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 20 - HEALTHCARE PAYOR IDENTIFICATION CARD ACT (§§ 23-79-2001 — 23-79-2003) › Section 23-79-2001 - Title

This subchapter shall be known and may be cited as the "Healthcare Payor Identification Card Act".
Added by Act 2019, No. 706,§ 1, eff. 4/4/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 20 - HEALTHCARE PAYOR IDENTIFICATION CARD ACT (§§ 23-79-2001 — 23-79-2003) › Section 23-79-2002 - Definitions

As used in this subchapter:
(1)
(A)
"Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare payor in this state.
(B)
"Health benefit plan" does not include workers' compensation plans, Medicaid, or a plan that provides only dental benefits or eye and vision care benefits;
(2)
(A)
"Healthcare payor" means an entity or individual that contracts, pays, or arranges for payment, in whole or in part, for the delivery of healthcare services or products that are covered by a health benefit plan administered, issued, or delivered by the entity or individual.
(B)
"Healthcare payor" includes a health insurance company, a health maintenance organization, a hospital and medical services corporation, and an entity that provides or administers a self-funded health benefit plan, including a governmental plan;
(3)
"Identification card" means a card or other technology that functions like a card issued by a healthcare payor to a subscriber or member and containing information related to the member's identity and health benefit plan;
(4)
"Member" means an individual enrolled or subscribed for healthcare services or products that are covered by a health benefit plan; and
(5)
"Short-term, limited duration insurance" means a health benefit plan that has an expiration date specified in the contract that is less than twelve (12) months after the original effective date of the contract and, taking into account renewals or extensions, has a duration of no longer than thirty-six (36) months.
Amended by Act 2023, No. 500,§ 2, eff. 8/1/2023.
Added by Act 2019, No. 706,§ 1, eff. 4/4/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 20 - HEALTHCARE PAYOR IDENTIFICATION CARD ACT (§§ 23-79-2001 — 23-79-2003) › Section 23-79-2003 - Identification cards

A healthcare payor shall issue an identification card to a member that provides an indication of whether the health benefit plan is insured, self-funded, or short-term, limited duration insurance.
Amended by Act 2023, No. 500,§ 3, eff. 8/1/2023.
Added by Act 2019, No. 706,§ 1, eff. 4/4/2019.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 21 - REGULATION OF STEP THERAPY PROTOCOLS (§§ 23-79-2101 — 23-79-2105) › Section 23-79-2101 - Legislative findings and intent

(a)
The General Assembly finds that:
(1)
Health benefit plans are increasingly making use of step therapy protocols under which patients are required to try one (1) or more prescription drugs before coverage is provided for a drug selected by the patient's healthcare provider;
(2)
Such step therapy protocols, if the step therapy protocols are based on well-developed scientific standards and administered in a flexible manner that takes into account the individual needs of a patient, can play an important role in controlling healthcare costs; and
(3)
Without uniform policies in the state for step therapy protocols, a patient may not receive the equivalent or most appropriate treatment.
(b)
It is the intent of the General Assembly that:
(1)
To require healthcare insurers to base step therapy protocols on appropriate clinical practice guidelines or published peer-reviewed data developed by independent experts with knowledge of the condition or conditions under consideration is a matter of public interest; and
(2)
Patients have access to a fair, transparent, and independent process for requesting a step therapy protocol exception when the patient's physician deems it appropriate.
Added by Act 2021, No. 97,§ 2, eff. 1/1/2022.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 21 - REGULATION OF STEP THERAPY PROTOCOLS (§§ 23-79-2101 — 23-79-2105) › Section 23-79-2103 - Clinical review criteria

(a)
(1)
Clinical review criteria used to establish a step therapy protocol shall be based on clinical practice guidelines that:
(A)
Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:
(i)
(a)
Requiring members to disclose any potential conflicts of interest with entities, including healthcare insurers, health benefit plans, and pharmaceutical manufacturers.
(b)
A member shall recuse himself or herself from voting if the member has a conflict of interest;
(ii)
Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus; and
(iii)
Offering opportunities for public review and comments;
(B)
Are based on high-quality studies, research, and medical practice;
(C)
Are created by an explicit and transparent process that:
(i)
Minimizes biases and conflicts of interest;
(ii)
Explains the relationship between treatment options and outcomes;
(iii)
Rates the quality of the evidence supporting recommendations; and
(iv)
Considers relevant patient subgroups and preferences; and
(D)
Are continually updated through a review of new evidence, research, and newly developed treatments.
(2)
Peer-reviewed published medical literature may be substituted for clinical practice guidelines to establish clinical review criteria if the peer-reviewed published medical literature meets the requirements of subdivisions (a)(1)(B) and (C) of this section, when those requirements apply to the available peer-reviewed published medical literature.
(3)
If establishing a step therapy protocol, a utilization review agent shall take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.
(4)
A healthcare insurer, pharmacy benefit manager, or utilization review organization shall:
(A)
Upon written request, provide all specific written clinical review criteria relating to the particular condition or disease, including clinical review criteria relating to a step therapy protocol override determination; and
(B)
Make available such clinical review criteria and other clinical information on its website and to a healthcare professional on behalf of an insured upon written request.
(b)
This section does not require healthcare insurers, health benefit plans, or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.
Added by Act 2021, No. 97,§ 2, eff. 1/1/2022.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 21 - REGULATION OF STEP THERAPY PROTOCOLS (§§ 23-79-2101 — 23-79-2105) › Section 23-79-2105 - Applicability

This subchapter applies to a group health benefit plan or offered in connection with a group health plan that provides coverage of a prescription drug under a policy that meets the definition of a medication step therapy protocol whether or not the policy is described as a step therapy protocol.
Added by Act 2021, No. 97,§ 2, eff. 1/1/2022.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 22 - ARKANSAS COVERAGE FOR EARLY REFILLS OF PRESCRIPTION EYE DROPS ACT (§§ 23-79-2201 — 23-79-2203) › Section 23-79-2201 - Title

This subchapter shall be known and may be cited as the "Arkansas Coverage for Early Refills of Prescription Eye Drops Act".
Added by Act 2021, No. 357,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 22 - ARKANSAS COVERAGE FOR EARLY REFILLS OF PRESCRIPTION EYE DROPS ACT (§§ 23-79-2201 — 23-79-2203) › Section 23-79-2202 - Definitions

As used in this subchapter:
(1)
"Covered person" means a person who is and continues to remain eligible for coverage under a health benefit plan and is covered under the health benefit plan;
(2)
(A)
"Health benefit plan" means:
(i)
An individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer; and
(ii)
Any health benefit program receiving state or federal appropriations from the State of Arkansas, including the Arkansas Medicaid Program and the Arkansas Works Program, or any successor program.
(B)
"Health benefit plan" includes:
(i)
Indemnity and managed care plans; and
(ii)
Nonfederal governmental plans as defined in
29 U.S.C. § 1002(32)
, as it existed on January 1, 2021.
(C)
"Health benefit plan" does not include:
(i)
A disability income plan;
(ii)
A credit insurance plan;
(iii)
Insurance coverage issued as a supplement to liability insurance;
(iv)
A medical payment under automobile or homeowners insurance plans;
(v)
A health benefit plan provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, §
11-9-101
et seq., or the Public Employee Workers' Compensation Act, §
21-5-601
et seq.;
(vi)
A plan that provides only indemnity for hospital confinement;
(vii)
An accident-only plan;
(viii)
A specified disease plan;
(ix)
A long-term-care-only plan;
(x)
A dental-only plan; or
(xi)
A vision-only plan;
(3)
"Healthcare insurer" means an entity subject to the insurance laws of this state or the jurisdiction of the Insurance Commissioner that contracts or offers to contract to provide health insurance coverage, including without limitation an insurance company, a health maintenance organization, a hospital medical service corporation, a self-insured governmental or church plan in this state, or the Arkansas Medicaid Program;
(4)
"Healthcare professional" means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of his or her profession; and
(5)
"Prescription eye drops" means a prescription topical eye medication that is delivered through eye drops and is used to treat a chronic condition of the eye.
Added by Act 2021, No. 357,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 22 - ARKANSAS COVERAGE FOR EARLY REFILLS OF PRESCRIPTION EYE DROPS ACT (§§ 23-79-2201 — 23-79-2203) › Section 23-79-2203 - Prescription eye drops - Early refills - Requirements

A healthcare insurer that provides coverage for prescription eye drops under a health benefit plan shall provide coverage for early refills of prescription eye drops to a covered person on and after January 1, 2022, if:
(1)
For a thirty-day supply:
(A)
The amount of time has passed after which a covered person should have used seventy percent (70%) of the dosage of the prescription eye drops according to a healthcare professional's instructions on the prescription; or
(B)
Twenty-two (22) days have passed from:
(i)
The original date the prescription eye drops were distributed to a covered person; or
(ii)
The date the most recent refill of the prescription eye drops was distributed to a covered person;
(2)
The healthcare professional indicates on the original prescription that additional quantities of the prescription eye drops are needed;
(3)
A refill request of a covered person for prescription eye drops does not exceed the number of additional quantities needed as described in subdivision (2) of this section; and
(4)
The prescription eye drops prescribed by a healthcare professional are a covered benefit under the health benefit plan of the covered person.
Added by Act 2021, No. 357,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 23 - ARKANSAS FAIRNESS IN COST SHARING ACT (§§ 23-79-2301 — 23-79-2304) › Section 23-79-2301 - Title

This subchapter shall be known and may be cited as the "Arkansas Fairness in Cost Sharing Act".
Added by Act 2021, No. 965,§ 2, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 23 - ARKANSAS FAIRNESS IN COST SHARING ACT (§§ 23-79-2301 — 23-79-2304) › Section 23-79-2302 - Definitions

As used in this subchapter:
(1)
"Cost-sharing requirement" means a copayment, coinsurance, deductible, or annual limitation on cost sharing, including without limitation a limitation subject to the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, that is required by or on behalf of an enrollee in order to receive a specific healthcare service, including a prescription drug, covered by a health benefit plan;
(2)
"Enrollee" means an individual entitled to healthcare services from a healthcare insurer;
(3)
(A)
"Health benefit plan" means any individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer in this state.
(B)
"Health benefit plan" does not include:
(i)
Accident-only plans;
(ii)
Specified disease plans;
(iii)
Disability income plans;
(iv)
Plans that provide only for indemnity for hospital confinement;
(v)
Long-term-care-only plans that do not include pharmacy benefits;
(vi)
Other limited-benefit health insurance policies or plans;
(vii)
Health benefit plans provided under 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.;
(viii)
A plan that provides only dental benefits or eye and vision care benefits; or
(ix)
A program or plan authorized and funded under
42 U.S.C. § 1396a
et seq.;
(4)
(A)
"Healthcare insurer" means an insurance company that is subject to state law regulating insurance and offers health insurance coverage under
42 U.S.C. § 300gg-91
, as it existed on January 1, 2021, a health maintenance organization, or a hospital and medical service corporation.
(B)
"Healthcare insurer" does not include an entity that provides only dental benefits or eye and vision care benefits;
(5)
"Healthcare service" means an item or service provided to an individual for the purpose of preventing, alleviating, curing, or healing illness, injury, or physical disability; and
(6)
"Person" means a natural person, corporation, mutual company, unincorporated association, partnership, joint venture, limited liability company, trust, estate, foundation, not-for-profit corporation, unincorporated organization, government, or governmental subdivision or agency.
Added by Act 2021, No. 965,§ 2, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 23 - ARKANSAS FAIRNESS IN COST SHARING ACT (§§ 23-79-2301 — 23-79-2304) › Section 23-79-2303 - Fairness in cost sharing

(a)
(1)
When calculating an enrollee's contribution to any applicable cost-sharing requirement, a healthcare insurer shall include any cost-sharing amounts paid by the enrollee or on behalf of the enrollee by another person.
(2)
The cost-sharing requirement under subdivision (a)(1) of this section does not apply for cost-sharing of a prescription drug if a name-brand prescription drug is prescribed and the prescribed drug:
(A)
Is not considered to be medically necessary by the prescriber; and
(B)
Has a medically appropriate generic prescription drug equivalent.
(b)
(1)
Except as provided in subdivision (b)(2) of this section, this section applies to a health benefit plan that is entered into, amended, extended, or renewed on or after January 1, 2022.
(2)
(A)
Benefits offered through a health benefit plan under the Evidence-Based Prescription Drug Program of the College of Pharmacy of the University of Arkansas for Medical Sciences shall satisfy the requirements of this section beginning on and after January 1, 2024, if the Insurance Commissioner reports a failure to comply with this section to the Legislative Council.
(B)
(i)
Beginning on January 1, 2022, the Director of the Evidence-Based Prescription Drug Program of the College of Pharmacy of the University of Arkansas for Medical Sciences shall report quarterly to the commissioner, Arkansas Legislative Audit, and the Legislative Council concerning details of plan savings and how the process that is used benefits an enrollee and the offered plan.
(ii)
The report described in subdivision (b)(2)(B)(i) of this section shall include the amount of enrollee savings, plan-specific data on the amount of manufacturer rebates received, and how the manufacturer rebates were applied in each plan for which the program is contracted to administer a prescription drug benefit.
(c)
The General Assembly intends for this section to regulate a healthcare insurer only to the extent permissible under applicable law.
Added by Act 2021, No. 965,§ 2, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 23 - ARKANSAS FAIRNESS IN COST SHARING ACT (§§ 23-79-2301 — 23-79-2304) › Section 23-79-2304 - Rules

(a)
The Insurance Commissioner shall promulgate rules necessary to carry out this subchapter.
(b)
The rules promulgated under this section shall require a healthcare insurer and the Director of the Evidence-Based Prescription Drug Program of the College of Pharmacy of the University of Arkansas for Medical Sciences to submit to the commissioner plan-specific information related to savings and accountability to document how enrollees are realizing a cost savings under each plan.
Added by Act 2021, No. 965,§ 2, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 24 - COVERAGE FOR BIRTH MOTHER SCREENING FOR DEPRESSION (§§ 23-79-2401 — 23-79-2402) › Section 23-79-2401 - Definitions

As used in this subchapter:
(1)
"Birth mother" means the biological mother of a child;
(2)
"Depression" means a mental illness classified as a mood disorder that causes a persistent feeling of sadness and a loss of interest;
(3)
(A)
"Health benefit plan" means:
(i)
An individual, blanket, or group plan or a policy, or contract for healthcare services issued or delivered by a healthcare insurer; and
(ii)
Any health benefit program receiving state or federal appropriations from the State of Arkansas, including the Arkansas Medicaid Program and the Arkansas Health and Opportunity for Me Program, or any successor program.
(B)
"Health benefit plan" includes:
(i)
Indemnity and managed care plans; and
(ii)
Nonfederal governmental plans as defined in
29 U.S.C. § 1002(32)
, as it existed on January 1, 2024.
(C)
"Health benefit plan" does not include:
(i)
A disability income plan;
(ii)
A credit insurance plan;
(iii)
Insurance coverage issued as a supplement to liability insurance;
(iv)
A medical payment under automobile or homeowners insurance plans;
(v)
A health benefit plan provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, §
11-9-101
et seq., or the Public Employee Workers' Compensation Act, §
21-5-601
et seq.;
(vi)
A plan that provides only indemnity for hospital confinement;
(vii)
An accident-only plan;
(viii)
A specified disease plan;
(ix)
A long-term-care-only plan;
(x)
A dental-only plan; or
(xi)
A vision-only plan;
(4)
"Healthcare insurer" means an entity subject to the insurance laws of this state or the jurisdiction of the Insurance Commissioner that contracts or offers to contract to provide health insurance coverage, including without limitation an insurance company, a health maintenance organization, a hospital medical service corporation, a self-insured governmental or church plan in this state, or the Arkansas Medicaid Program; and
(5)
"Healthcare professional" means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of his or her profession.
Added by Act 2023, No. 316,§ 2, eff. 8/1/2023.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 24 - COVERAGE FOR BIRTH MOTHER SCREENING FOR DEPRESSION (§§ 23-79-2401 — 23-79-2402) › Section 23-79-2402 - Coverage for birth mother screening for depression

(a)
A healthcare insurer that offers, issues, or renews a health benefit plan in this state shall provide coverage for screening for depression of the birth mother by a healthcare professional within the first six (6) weeks of the birth mother's having given birth on or after January 1, 2024.
(b)
The coverage for screening for depression of the birth mother under this section:
(1)
Is not subject to policy deductibles or copayment requirements; and
(2)
Does not diminish or limit benefits otherwise allowable under a health benefit plan.
(c)
Coverage provided for screening under subsection (a) of this section for a government self-insured plan is subject to any health benefit plan provisions that apply to other services covered by the health benefit plan.
Added by Act 2023, No. 316,§ 2, eff. 8/1/2023.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 25 - HEALTHCARE INSURER SHARE THE SAVINGS ACT (§§ 23-79-2501 — 23-79-2503) › Section 23-79-2501 - Title

This subchapter shall be known and may be cited as the "Healthcare Insurer Share the Savings Act".
Added by Act 2023, No. 333,§ 1, eff. 8/1/2023.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 79 - INSURANCE POLICIES GENERALLY (§§ 23-79-101 — 23-79-2802) › Subchapter 25 - HEALTHCARE INSURER SHARE THE SAVINGS ACT (§§ 23-79-2501 — 23-79-2503) › Section 23-79-2502 - Definitions

As used in this subchapter:
(1)
"Defined cost sharing" means a deductible payment or coinsurance amount imposed on an enrollee for a covered prescription drug under the enrollee's health benefit plan;
(2)
"Enrollee" means an individual entitled to coverage of healthcare services from a healthcare insurer;
(3)
(A)
"Health benefit plan" means any individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer in this state.
(B)
"Health benefit plan" does not include:
(i)
Accident-only plans;
(ii)
Specified disease plans;
(iii)
Disability income plans;
(iv)
Plans that provide only for indemnity for hospital confinement;
(v)
Long-term-care-only plans that do not include pharmacy benefits;
(vi)
Other limited-benefit health insurance policies or plans;
(vii)
Health benefit plans provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, §
11-9-101
et seq., or the Public Employee Workers' Compensation Act, §
21-5-601
et seq.; or
(viii)
Any state or local governmental employee plan;
(4)
(A)
"Healthcare insurer" means a:
(i)
Health insurance issuer that:
(a)
Is subject to state law regulating insurance; and
(b)
Offers health insurance coverage under
42 U.S.C. § 300gg-91
, as it existed on January 1, 2023;
(ii)
Health maintenance organization; or
(iii)
Hospital and medical service corporation.
(B)
"Healthcare insurer" does not include an entity that provides only dental benefits or eye and vision care benefits;
(5)
"Price protection rebate" means a negotiated price concession that accrues directly or indirectly to a healthcare insurer, or other party on behalf of the healthcare insurer, if there is an increase in the wholesale acquisition cost of a prescription drug above a specified threshold; and
(6)
"Rebate" means:
(A)
A negotiated price concession, including without limitation base price concessions, whether described as a rebate or not, reasonable estimates of any price protection rebates, and performance-based price concessions that may accrue, directly or indirectly, to the healthcare insurer during the coverage year from a manufacturer or other party in connection with the dispensing or administration of a prescription drug; and
(B)
Any reasonable estimate of a negotiated price concession, fee, and other administrative cost that is passed through, or is reasonably anticipated to be passed through, to the healthcare insurer and serves to reduce the healthcare insurer's liabilities for a prescription drug.
Added by Act 2023, No. 333,§ 1, eff. 8/1/2023.