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 15 - BILLING IN THE BEST INTEREST OF PATIENTS ACT (§§ 23-99-1501 — 23-99-1504) › Section 23-99-1502 - Definitions

As used in this subchapter:
(1)
"Enrollee" means an individual who is entitled to receive healthcare services under the terms of a health benefit plan;
(2)
(A)
"Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, delivered, or extended in this state by a healthcare payor 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;
(3)
(A)
"Healthcare payor" means:
(i)
A health insurance company;
(ii)
A health maintenance organization;
(iii)
A hospital and medical services corporation; and
(iv)
An entity that provides or administers a self-funded health benefit plan, including a governmental plan.
(B)
"Healthcare payor" does not include an entity that provides only dental benefits or eye and vision care benefits;
(4)
"Healthcare provider" means individuals or entities licensed by the State of Arkansas to provide healthcare services, limited to the following:
(A)
Advanced practice nurses;
(B)
Athletic trainers;
(C)
Audiologists;
(D)
Certified behavioral health providers;
(E)
Certified orthotists;
(F)
Chiropractors;
(G)
Community mental health centers or clinics;
(H)
Dentists;
(I)
Home health care;
(J)
Hospice care;
(K)
Hospital-based services;
(L)
Hospitals;
(M)
Licensed ambulatory surgery centers;
(N)
Licensed certified social workers;
(O)
Licensed dieticians;
(P)
Licensed intellectual and developmental disabilities service providers;
(Q)
Licensed professional counselors;
(R)
Licensed psychological examiners;
(S)
Long-term care facilities;
(T)
Occupational therapists;
(U)
Optometrists;
(V)
Pharmacists;
(W)
Physical therapists;
(X)
Physicians and surgeons (M.D. and D.O.);
(Y)
Podiatrists;
(Z)
Prosthetists;
(AA)
Psychologists;
(BB)
Respiratory therapists;
(CC)
Rural health clinics; and
(DD)
Speech pathologists;
(5)
"Healthcare services" means services and products, including prescription medication, provided by a healthcare provider within the scope of the healthcare provider's license; and
(6)
"Prescription medication" means a drug or biologic that is prescribed by a healthcare provider to a patient for the purpose of alleviating, curing, preventing, or healing illness, injury, or physical disability.
Added by Act 2021, No. 1105,§ 1, eff. 7/28/2021.