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 1 - GENERAL PROVISIONS (§§ 23-79-101 — 23-79-168) › Section 23-79-114 - Entitlement notwithstanding policy provisions - Health services performed by professionals not licensed under Arkansas Medical Practices Act

(a)
(1)
Notwithstanding any provision of any individual or group policy of accident and health insurance or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, in cases in which the policy, contract, plan, or agreement provides for payment or reimbursement for any service provided by persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., the person entitled to benefits or person performing services under the policy, contract, plan, or agreement is entitled to payment or reimbursement on an equal basis for the service when the service is performed by any person licensed under any of the examining boards found in §
17-80-101
, as amended by §§
17-95-301
-
17-95-304
.
(2)
Nothing in this subsection shall be construed to amend, alter, or repeal any laws relating to the licensing or use of hospitals.
(3)
The provisions of this subsection shall not apply to any policy, contract, plan, or agreement in effect prior to February 3, 1971.
(b)
(1)
Notwithstanding any provision of any individual or group policy of accident and health insurance or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, whenever such a policy, contract, plan, or agreement provides for payment or reimbursement for any service in the vision or human eye field provided by persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., the person entitled to benefits or the person performing services under such a policy, contract, plan, or agreement is entitled to payment or reimbursement on an equal basis for such a service when the service is performed by any person licensed under the Arkansas Optometry Practices Act, §
17-90-101
et seq.
(2)
No person entitled to benefits under this subsection shall be denied his or her freedom of choice of any practitioner licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Arkansas Optometry Practices Act, §
17-90-101
et seq., by any insurer or agent or employee of the insurer or by any department, agency, or employee of this state.
(3)
(A)
Nothing herein shall be construed to enlarge or diminish the practice of optometry as defined by law in the Arkansas Optometry Practices Act, §
17-90-101
et seq., and, in accordance with state law, sole and complete authority regarding determination of those acts, services, procedures, and practices that constitute the practice of optometry in this state shall be vested in the State Board of Optometry.
(B)
This section shall specifically include, but not be limited to, authority of the State Board of Optometry to define the parameters of management and comanagement of persons licensed under the Arkansas Optometry Practices Act, §
17-90-101
et seq., in the treatment and management of postoperative and therapeutic care of the human eye.
(4)
The provisions of this subsection shall not apply to any policy, contract, plan, or agreement until persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., become entitled to reimbursement for services by the insurer in the vision or human eye field.
(5)
The purpose of this subsection is to ensure that persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Arkansas Optometry Practices Act, §
17-90-101
et seq., shall be entitled to payment or reimbursement on an equal basis for service in the vision or human eye field.
(c)
(1)
Notwithstanding any provision of any individual or group policy of accident and health insurance or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, in cases in which the policy, contract, plan, or agreement provides for payment or reimbursement for any services consisting of the diagnosis, medical, mechanical, or surgical treatment of ailments of the human foot provided by persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., the person entitled to benefits or person performing services under the policy, contract, plan, or agreement is entitled to payment or reimbursement on an equal basis for the service when the service is performed by any person licensed under the Arkansas Podiatry Practices Act, §
17-96-101
et seq.
(2)
No person entitled to benefits under this subsection shall be denied freedom of choice of any practitioner licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Arkansas Podiatry Practices Act, §
17-96-101
et seq., by any insurer or agency or employee of the insurer or by any department, agency, or employee of this state.
(3)
Nothing in this subsection shall be construed to enlarge or diminish the practice of podiatry as defined by law in the Arkansas Podiatry Practices Act, §
17-96-101
et seq.
(4)
The purpose of this subsection is to ensure that persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Arkansas Podiatry Practices Act, §
17-96-101
et seq., shall be entitled to payment or reimbursement on an equal basis for service consisting of the diagnosis, medical, mechanical, and/or surgical treatment of ailments of the human foot.
(d)
(1)
Notwithstanding any provision of any individual or group policy of accident and health insurance, or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, in cases in which the policy, contract, plan, or agreement provides for payment or reimbursement for any services consisting of psychological evaluation, counseling, psychotherapy, or related mental health services, provided by persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., the person entitled to benefits or persons providing services under the policy, contract, plan, or agreement are entitled to payment or reimbursement on an equal basis for the service when the service is provided by any person licensed as a psychologist under §
17-97-301
et seq. and operating within his or her area of competence.
(2)
No person entitled to benefits under this subsection shall be denied freedom of choice to select any practitioner licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or §
17-97-201
et seq. by any insurer or agency or employee of the insurer or by any department, agency, or employee of this state.
(3)
Nothing in this subsection shall be construed to enlarge or diminish the practice of psychology as defined by law in §
17-97-102
.
(4)
The purpose of this subsection is to ensure that persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or persons licensed as psychologists under §
17-97-301
et seq. shall be entitled to payment or reimbursement on an equal basis for services consisting of psychological evaluation, counseling, psychotherapy, or related mental health services.
(e)
(1)
Notwithstanding any provision of any accident and health insurance contract or any group accident and health insurance contract or blanket accident and health insurance contract as provided for in this section and §§
23-79-101
-
23-79-107
,
23-79-109
-
23-79-113
,
23-79-115
-
23-79-128
,
23-79-131
-
23-79-134
, and
23-79-202
-
23-79-210
, benefits shall not be denied thereunder for any health service performed by any person licensed pursuant to the provisions of the Arkansas Dental Practice Act, §
17-82-101
et seq., if the service performed was within the lawful scope of the person's license and the contract would have provided benefits if the service had been performed by a holder of a license issued pursuant to the provisions of the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq.
(2)
No person entitled to benefits under this subsection shall be denied freedom of choice to select any practitioner licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Arkansas Dental Practice Act, §
17-82-101
et seq., by any insurer or agency or employee of the insurer or by any department, agency, or employee of this state.
(3)
Nothing in this subsection shall be construed to enlarge or diminish the practice of dentistry as defined by the Arkansas Dental Practice Act, §
17-82-101
et seq.
(f)
(1)
Notwithstanding any provision of any individual or group policy of accident and health insurance, or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, in cases in which the policy, contract, plan, or agreement provides for payment or reimbursement for any anesthesia services provided by persons licensed under the Arkansas Medical Practices Act, § 17-95- 201 et seq., §
17-95-301
et seq., and §
17-95-401
et seq., the person entitled to benefits or the persons providing services under the policy, contract, plan, or agreement are entitled to the same method of payment for the service when the service is provided by any person licensed as a certified registered nurse anesthetist and operating within his or her area of competence.
(2)
No person entitled to benefits under this subsection shall be denied freedom of choice to select any practitioner licensed under §
17-87-302
by any insurer or agency or employee of the insurer or by any department, agency, or employee of this state.
(3)
Nothing in this subsection shall be construed to enlarge or diminish the practice of certified registered nurse anesthetists under §
17-87-302
.
(4)
The purpose of this subsection is to ensure that persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or persons licensed as certified registered nurse anesthetists under §
17-87-302
shall be entitled to the same method of payment for anesthesia services.
(g)
(1)
Notwithstanding any provision of any individual or group policy of accident and health insurance or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, whenever the policy, contract, plan, or agreement provides for payment or reimbursement for any service in the audiology field provided by persons licensed as audiologists under the Licensure Act of Speech-Language Pathologists and Audiologists, §
17-100-101
et seq., the person entitled to benefits or the person performing services under the policy, contract, plan, or agreement is entitled to payment or reimbursement on an equal basis for the service when the service is performed by any person licensed as an audiologist under the Licensure Act of Speech-Language Pathologists and Audiologists, §
17-100-101
et seq.
(2)
No person entitled to benefits under this subsection shall be denied his or her freedom of choice of any practitioner licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Licensure Act of Speech-Language Pathologists and Audiologists, §
17-100-101
et seq., by any insurer or agent or employee of the insurer or by any department, agency, or employee of this state.
(3)
(A)
Nothing in this subsection shall be construed to enlarge or diminish the practice of audiology as defined under §
17-100-103
.
(B)
Under state law, sole and complete authority regarding determination of those acts, services, procedures, and practices that may be reimbursed on an equal basis shall be vested in the Board of Examiners in Speech-Language Pathology and Audiology.
(C)
This section shall specifically include, but not be limited to, the authority of the board to define the parameters of management and comanagement of persons licensed under the Licensure Act of Speech-Language Pathologists and Audiologists, §
17-100-101
et seq., in the treatment and management of hearing and disorders of hearing.
(4)
The purpose of this subsection is to ensure that persons licensed under the Arkansas Medical Practices Act, §
17-95-201
et seq., §
17-95-301
et seq., and §
17-95-401
et seq., or the Licensure Act of Speech-Language Pathologists and Audiologists, §
17-100-101
et seq., shall be entitled to payment or reimbursement on an equal basis for service in the audiology field.
(5)
The failure to comply with any provision in this subsection shall be deemed an unfair trade practice under the Trade Practices Act, §
23-66-201
et seq., and may be punished by fines and penalties established under §§
23-60-108
,
23-66-210
, and
23-66-215
.
Acts 1959, No. 148, § 279; 1971, No. 34, §§ 1-3; 1971, No. 531, §§ 1-5; 1975, No. 303, §§ 1-4; 1975, No. 741, §§ 1-4; 1981, No. 196, §§ 1-3; A.S.A. 1947, §§ 66-3212, 66-3212n, 66-3212.2 -- 66-3212.9, 66-3212.2n, 66-3212.3n, 66-3212.5n, 66-3212.7n; Acts 1993, No. 577, § 1; 1993, No. 1271, § 1; 2001, No. 1604, § 92; 2003, No. 1455, § 2; 2005, No. 1995, § 1.