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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 16 - ELECTRONIC ACCESS OF MEDICAL RECORDS BY HEALTHCARE PAYOR ACT (§§ 23-99-1601 — 23-99-1603) › Section 23-99-1602 - Definitions

As used in this subchapter:
(1)
"Authorized designee" means an entity that is:
(A)
Designated by a healthcare payor to operate on its behalf; and
(B)
Authorized to access an enrollee's protected health information under the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, as it existed on January 1, 2023;
(2)
"Enrollee" means an individual who is entitled to receive healthcare services under the terms of a health benefit plan;
(3)
(A)
"Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended 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 plan that provides only dental benefits or eye and vision care benefits;
(ii)
A disability income plan;
(iii)
A credit insurance plan;
(iv)
Insurance coverage issued as a supplement to liability insurance;
(v)
Medical payments under an automobile or homeowners insurance plan;
(vi)
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.;
(vii)
A plan that provides only indemnity for hospital confinement;
(viii)
An accident-only plan; or
(ix)
A specified disease plan;
(4)
(A)
"Healthcare payor" means:
(i)
A health insurance company;
(ii)
A health maintenance organization;
(iii)
A hospital and medical service corporation; or
(iv)
An entity that:
(a)
Provides or administers a self-funded health benefit plan, including a governmental plan; or
(b)
Performs utilization review for a self-funded health benefit plan, including a governmental plan.
(B)
"Healthcare payor" includes any entity that is subject to any of the following laws:
(i)
The insurance laws of this state;
(ii)
Section
23-75-101
et seq., pertaining to hospital and medical service corporations; or
(iii)
Section
23-76-101
et seq., pertaining to health maintenance organizations.
(C)
"Healthcare payor" does not include an entity that provides only dental benefits or eye and vision care benefits;
(5)
(A)
"Healthcare provider" means a person that is licensed, certified, or otherwise authorized by the laws of this state to provide healthcare services.
(B)
"Healthcare provider" includes only:
(i)
Advanced practice nurses;
(ii)
Athletic trainers;
(iii)
Audiologists;
(iv)
Certified behavioral health providers;
(v)
Certified orthotists;
(vi)
Chiropractors;
(vii)
Community mental health centers or clinics;
(viii)
Dentists;
(ix)
Home health care;
(x)
Hospice care;
(xi)
Hospital-based services;
(xii)
Hospitals;
(xiii)
Licensed ambulatory surgery centers;
(xiv)
Licensed certified social workers;
(xv)
Licensed dieticians;
(xvi)
Licensed intellectual and developmental disabilities service providers;
(xvii)
Licensed professional counselors;
(xviii)
Licensed psychological examiners;
(xix)
Long-term care facilities;
(xx)
Occupational therapists;
(xxi)
Optometrists;
(xxii)
Pharmacists;
(xxiii)
Physical therapists;
(xxiv)
Physicians and surgeons;
(xxv)
Podiatrists;
(xxvi)
Prosthetists;
(xxvii)
Psychologists;
(xxviii)
Respiratory therapists;
(xxix)
Rural health clinics; and
(xxx)
Speech pathologists;
(6)
"Healthcare services" means services and products, including prescription medication, provided by a healthcare provider within the scope of the healthcare provider's license;
(7)
(A)
"Medical records" means the hospital or clinic records, physicians' records, or other healthcare records that a healthcare provider retains on an enrollee related to the enrollee's medical conditions.
(B)
"Medical records" includes other reports, documents, or records that a healthcare provider has concerning:
(i)
The healthcare services provided to the enrollee;
(ii)
The enrollee's medical history; and
(iii)
Prescription medications written, procedures ordered, or any other information related to the patient's overall health; and
(8)
"Prescription medication" means a drug or biologic that is prescribed by a healthcare provider to an enrollee for the purpose of alleviating, curing, preventing, or healing illness, injury, or physical disability.
Added by Act 2023, No. 502,§ 1, eff. 1/1/2024.