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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 3 - PRIMARY EYE CARE PROVIDER ACT (§§ 23-99-301 — 23-99-305) › Section 23-99-304 - Subchapter not to prevent treatment

Nothing in this subchapter shall prevent any person covered by a health benefit plan from receiving emergency eye care nor shall it prevent any person from exercising his or her right to receive treatment from his or her personal doctor and being reimbursed in accordance with the terms and fee schedule of the health benefit plan.
Acts 1995, No. 515, § 4; 1995, No. 1092, § 4.
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 3 - PRIMARY EYE CARE PROVIDER ACT (§§ 23-99-301 — 23-99-305) › Section 23-99-305 - Remedies

Any person adversely affected by a violation of this subchapter may bring action in a court of competent jurisdiction for injunctive relief against the healthcare insurer and, upon prevailing, in addition to such injunctive relief, shall recover damages not less than one thousand dollars ($1,000) plus attorney's fees and costs.
Acts 1995, No. 515, § 5; 1995, No. 1092, § 5.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-401 - Short title

This subchapter shall be known and may be cited as the "Arkansas Health Care Consumer Act".
Acts 1997, No. 1196, § 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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-402 - Legislative findings and intent

As the state's insurance sector becomes increasingly dominated by managed care features that include decisions regarding coverage and appropriateness of health care, there is a vital need to protect patients in this environment.
Acts 1997, No. 1196, § 2.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-404 - Benefits for mothers and newborns

(a)
(1)
Except as provided in subsection (b) of this section, a healthcare insurer may not restrict benefits for any hospital stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a normal vaginal delivery or to less than ninety-six (96) hours following cesarean section.
(2)
A healthcare insurer may not require that a provider obtain authorization for prescribing any length of stay required under subdivision (a)(1) of this section.
(b)
Subdivision (a)(1) of this section shall not apply if the decision to discharge the mother or her newborn child prior to the expiration of the minimum stay is made by the attending physician in consultation with the mother.
Acts 1997, No. 1196, § 4.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-405 - Mastectomies

(a)
Every health benefit plan providing mastectomy benefits and issued or renewed after July 16, 2003, shall conform with the requirements of the Women's Health and Cancer Rights Act of 1998,
42 U.S.C. §§ 300gg-6
and
300gg-52
, as it existed on January 1, 2003.
(b)
To the extent the requirements of this section do not conflict with federal law, rules, or regulations, each healthcare insurer providing mastectomy benefits in a health benefit plan shall provide, in a manner determined in consultation with the attending physician and the enrollee or insured:
(1)
For medical and surgical benefits for any hospital stay in connection with a mastectomy for not less than forty-eight (48) hours unless the decision to discharge the patient before the expiration of the minimum length of stay is made by an attending physician in consultation with the enrollee or insured;
(2)
The following medical and surgical benefits with respect to mastectomy coverage if an enrollee or insured receives benefits in connection with a mastectomy and elects breast reconstruction:
(A)
Surgery and reconstruction of the breast on which the mastectomy has been performed;
(B)
Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
(C)
Prostheses and coverage for physical complications at all stages of a mastectomy, including lymphedemas; and
(3)
Written notice of the availability of coverage under this section to the enrollee or insured upon enrollment and annually thereafter.
(c)
No healthcare insurer providing mastectomy benefits under this section shall:
(1)
Deny an enrollee or insured eligibility or continued eligibility to enroll or renew coverage under the terms of the health benefit plan solely for the purpose of avoiding the requirements of this section; or
(2)
Penalize, reduce, or limit the reimbursement of an attending provider or induce the provider to provide care in a manner inconsistent with this section.
Acts 1997, No. 1196, § 5; 2003, No. 179, § 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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-406 - Obstetrical and gynecological services

(a)
In order to ensure that healthcare benefits are safely and appropriately delivered to women, insurers which require the selection or assignment of a primary care physician shall allow each covered person who is a woman to select a participating obstetrician/gynecologist in addition to her primary care physician.
(b)
If the woman chooses to make this selection, the insurer shall allow the woman to go directly to her selected obstetrician/gynecologist, without referral from her primary care physician, for obstetrical and gynecological services.
Acts 1997, No. 1196, § 6.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-407 - "Gag clause" prohibition

No participating provider may be prohibited, restricted, or penalized in any way from disclosing to any covered person any healthcare information that the participating provider deems appropriate regarding the nature of treatment, risks, or alternatives thereto, the availability of alternate therapies, consultations, or tests, the decision of utilization reviewers or similar persons to authorize or deny services, the process that is used to authorize or deny healthcare services or benefits, or information on financial incentives and structures used by the insurer.
Acts 1997, No. 1196, § 7.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-408 - Continuity of care

(a)
When healthcare insurers use participating providers, the healthcare insurers shall develop procedures to provide for the continuity of care of their covered persons. At a minimum, the procedures shall:
(1)
Ensure that when a new patient is enrolled in a health benefit plan and is being treated by a nonparticipating provider for a current episode of an acute condition, the patient may continue to receive treatment as an in-network benefit from that provider until the current episode of treatment ends or until the end of ninety (90) days, whichever occurs first;
(2)
Ensure that when a provider's participation is terminated, his or her patients under the health benefit plan may continue to receive care from that provider as an in-network benefit until a current episode of treatment for an acute condition is completed or until the end of ninety (90) days, whichever occurs first; and
(3)
Explain how the covered person may request to continue services under subdivisions (a)(1) and (2) of this section.
(b)
During the period covered by subdivisions (a)(1) and (2) of this section, the provider shall be deemed to be a participating provider for purposes of reimbursement, utilization management, and quality of care.
(c)
Nothing in this section shall require a healthcare insurer to provide benefits that are not otherwise covered under the terms and provisions of the health benefit plan.
Acts 1997, No. 1196, § 8.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-409 - Prescription drug formulary

When a healthcare insurer uses a formulary for prescription drugs, the insurer shall include a written procedure whereby covered persons can obtain, without penalty and in a timely fashion, specific drugs and medications not included in the formulary when:
(1)
The formulary's equivalent has been ineffective in the treatment of the covered person's disease or condition; or
(2)
The formulary's drug causes or is reasonably expected to cause adverse or harmful reactions in the covered person.
Acts 1997, No. 1196, § 9.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-410 - Grievance procedures

(a)
A healthcare insurer issuing or delivering a managed care plan shall establish for those managed care plans a grievance procedure which provides covered persons with a prompt and meaningful review on the issue of denial, in whole or in part, of a healthcare treatment or service.
(b)
(1)
The covered person shall be provided prompt notice in writing of the outcome of the grievance procedure.
(2)
In the event the outcome is adverse to the covered person, the notice shall include specific findings related to the grievance.
Acts 1997, No. 1196, § 10.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-412 - Provider input

All healthcare insurers issuing or delivering managed care plans shall be required to establish a mechanism whereby participating providers provide input into the healthcare insurer's medical policy, utilization review criteria and procedures, quality and credentialing criteria, and medical management procedures.
Acts 1997, No. 1196, § 12.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-413 - Disclosure requirements

Upon request, healthcare insurers must provide the following information in a clear and understandable form to all prospective policyholders, policyholders, and covered persons. Insurers shall notify policyholders and covered persons of their right to request the information, which must include:
(1)
Coverage provisions, benefits, and exclusions by category of service and provider;
(2)
A description of the prior authorization, precertification, and referral requirements;
(3)
The existence of prescription drug formularies and prior approval requirements for prescription drugs;
(4)
The name, number, type, specialty, and geographic location of participating providers; and
(5)
(A)
Criteria by which providers are evaluated for network participation.
(B)
Proprietary information shall not be disclosed.
(C)
Criteria may include, but are not limited to, geographic limitations, geographic distribution of patients, specialty limitation, anticipated numbers and types of providers needed, and economic considerations. This information shall also be made available to providers upon request.
Acts 1997, No. 1196, § 13.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-414 - Rules

The Insurance Commissioner may promulgate necessary rules for carrying out this subchapter.
Amended by Act 2019, No. 315,§ 2802, eff. 7/24/2019.
Acts 1997, No. 1196, § 14.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-415 - Enforcement and penalties

The Insurance Commissioner shall have all the powers to enforce this subchapter as are granted to the commissioner elsewhere in the Arkansas Insurance Code.
Acts 1997, No. 1196, § 15.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-416 - Application of subchapter

This subchapter applies to all health benefit plans issued, renewed, extended, or modified on or after August 1, 1997. "Renewed, extended, or modified" shall include all health benefit plans in which the insurer has reserved the right to change the premium.
Acts 1997, No. 1196, § 16.
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 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-420 - [Repealed]

Repealed by Act 2015, No. 1106,§ 1, eff. 7/22/2015.
Amended by Act 2015, No. 992,§ 2, eff. 7/22/2015.
Amended by Act 2015, No. 992,§ 1, eff. 7/22/2015.
Amended by Act 2013, No. 338,§ 1, eff. 8/16/2013.
Acts 2011, No. 1155, § 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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 4 - ARKANSAS HEALTH CARE CONSUMER ACT (§§ 23-99-401 — 23-99-422) › Section 23-99-421 - Pediatric dental benefits - Definitions

(a)
As used in this section:
(1)
"Exchange" means a health benefit exchange that offers health benefits under a health benefit plan offered by a healthcare insurer in this state through a state-based health insurance exchange or a health insurance exchange operated by the United States Government under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152;
(2)
"Qualified dental plan" means a limited scope dental plan that has a certification that the qualified dental plan meets the criteria for certification under
42 U.S.C. § 18031(d)(2)(B)(ii)
, in effect on January 1, 2015; and
(3)
"Qualified health plan" means a health benefit plan that provides healthcare coverage of essential health benefits under
42 U.S.C. § 18021(a)
, in effect on January 1, 2015.
(b)
Beginning January 1, 2016, a qualified health plan offering healthcare coverage under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, satisfies the minimum essential pediatric oral health benefits under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, for health benefit plans offered through an exchange or outside an exchange that do not include the minimum essential pediatric oral health benefits if the healthcare insurer has reasonable assurance that the minimum essential pediatric oral health benefits are otherwise provided to the purchaser of the health benefit plan.
(c)
The healthcare insurer shall be considered to have reasonable assurance that the minimum essential pediatric oral health benefits are otherwise provided to the purchaser of the health benefit plan if:
(1)
At least one (1) qualified dental plan offers the minimum essential pediatric oral health benefits that are available to the purchaser of the health benefit plan; and
(2)
A qualified health plan prominently discloses at the time of purchase on a form approved by the Insurance Commissioner that the qualified health plan does not provide the minimum essential pediatric oral health benefits.
Added by Act 2015, No. 1134,§ 1, eff. 7/22/2015.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-501 - Short title

This subchapter shall be known and may be cited as the "Arkansas Mental Health Parity Act of 2009".
Acts 1997, No. 1020, § 1; 2009, No. 1193, § 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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-502 - Legislative findings and intent

It is the intent of this state that if a health benefit plan provides insurance coverage for a mental illness or substance abuse disorder, the treatment of the mental illness or substance abuse disorder shall be as available as and at parity with that for other medical illnesses.
Acts 1997, No. 1020, § 2; 2009, No. 1193, § 2.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-503 - Definitions

As used in this subchapter:
(1)
"Carve-out arrangement" means an arrangement in which a healthcare insurer contracts with a separate person or entity to arrange for the delivery of specific types of healthcare benefits under a health benefit plan;
(2)
"Commissioner" means the Insurance Commissioner;
(3)
"Financial requirements" means copayments, deductibles, out-of-network charges, out-of-pocket contributions or fees, annual limits, lifetime aggregate limits imposed on individual patients, and other patient cost-sharing amounts;
(4)
"Health benefit plan" means any group or blanket plan, policy, or contract for healthcare services issued or delivered in this state by healthcare insurers, including indemnity and managed care plans and the plans providing health benefits to state and public school employees pursuant to §
21-5-401
et seq., but excluding plans providing health care services pursuant to 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.;
(5)
"Healthcare insurer" means any insurance company, hospital and medical service corporation, or health maintenance organization issuing or delivering health benefit plans in this state and subject to any of the following laws:
(A)
The Arkansas Insurance Code;
(B)
Section
23-75-101
et seq., pertaining to hospital and medical service corporations;
(C)
Section
23-76-101
et seq., pertaining to health maintenance organizations; and
(D)
Any successor law of the foregoing;
(6)
(A)
"Mental illnesses" and "substance use disorders" mean those illnesses and disorders that are covered by a health benefit plan listed in the International Classification of Diseases manual and the Diagnostic and Statistical Manual of Mental Disorders.
(B)
Unless specifically otherwise stated, "mental illness" includes substance use disorders;
(7)
"Person" or "entity" means and includes, individually and collectively, any individual, corporation, partnership, firm, trust, association, voluntary organization, or any other form of business enterprise or legal entity; and
(8)
"Small employer" means any person or entity actively engaged in business who, on at least fifty percent (50%) of its working days during the preceding year, employed no more than fifty (50) eligible employees.
Acts 1997, No. 1020, § 3; 2009, No. 1193, §§ 3, 4.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-504 - Exclusions

This subchapter does not apply to:
(1)
Dental insurance plans;
(2)
Vision insurance plans;
(3)
Specified-disease insurance plans;
(4)
Accidental injury insurance plans;
(5)
Long-term care plans;
(6)
Disability income plans;
(7)
Individual health benefit plans if the healthcare insurers offer individuals who satisfy the healthcare insurer's underwriting standards the option of purchasing a plan that, other than being optional, meets all the other requirements of this subchapter;
(8)
Health benefit plans for small employers if the healthcare insurers offer purchasers the option of purchasing a plan that, other than being optional, meets all the other requirements of this subchapter; and
(9)
Medicare supplement plans, as subject to section 1882(g)(1) of the Social Security Act.
Acts 1997, No. 1020, § 8; 2009, No. 1193, § 5.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-506 - Parity requirements

(a)
Except as provided in §
23-99-504
, a health benefit plan that provides benefits for the diagnosis and treatment of mental illnesses shall provide the benefits under the same terms and conditions as provided for covered benefits offered under the health benefit plan for the treatment of other medical illnesses and conditions, including without limitation:
(1)
The duration or frequency of coverage;
(2)
The dollar amount of coverage; or
(3)
Financial requirements.
(b)
This subchapter does not:
(1)
Require equal coverage between treatments for a mental illness with coverage for preventive care;
(2)
Prohibit a healthcare insurer from:
(A)
Negotiating separate reimbursement rates and service delivery systems, including without limitation a carve-out arrangement;
(B)
Managing the provision of mental health benefits for mental illnesses by common methods used for other medical conditions, including without limitation preadmission screening, prior authorization of services, or other mechanisms designed to limit coverage of services or mental illnesses to mental illnesses that are deemed medically necessary;
(C)
Limiting covered services to covered services authorized by the health benefit plan, if the limitations are made in accordance with this subchapter;
(D)
Using separate but equal cost-sharing features for mental illnesses; or
(E)
Using a single lifetime or annual dollar limit as applicable to other medical illness; and
(3)
Include a Medicare or Medicaid plan or contract or any privatized risk or demonstration program for Medicare or Medicaid coverage.
Acts 1997, No. 1020, § 4; 2009, No. 1193, § 7.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-507 - Medical necessity

(a)
The criteria for medical necessity determinations for mental illness made under a health benefit plan shall be made available by the healthcare insurer in accordance with rules established by the Insurance Commissioner to any current or potential covered individual or contracting provider upon request.
(b)
On request, the reason for a denial of reimbursement or payment for services to diagnose or treat mental illness under a health benefit plan shall be made available by the healthcare insurer to a covered individual in accordance with the rules of the commissioner.
Acts 1997, No. 1020, § 5; 2009, No. 1193, § 8.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-508 - Permitted provisions

(a)
A healthcare insurer may at the healthcare insurer's option provide coverage for a health service, such as intensive case management, community residential treatment programs, or social rehabilitation programs, that is used in the treatment of mental illnesses but is generally not used for other injuries, illnesses, and conditions if the other requirements of this subchapter are met.
(b)
Healthcare insurers providing educational remediation may, but are not required to, comply with the terms of this subchapter in regard to the treatment or remediation.
(c)
A healthcare insurer may provide coverage for a health service, including without limitation physical rehabilitation or durable medical equipment, which generally is not used in the diagnosis or treatment of serious mental illnesses but is used for other injuries, illnesses, and conditions if the other requirements of this subchapter are met.
(d)
A healthcare insurer may utilize common utilization management protocols, including without limitation preadmission screening, prior authorization of service, or other mechanisms designed to limit coverage of service for mental illness to individuals whose diagnosis or treatment coverage is considered medically necessary although the protocols are not used in conjunction with other medical illnesses or conditions covered by the health benefit plan.
Acts 1997, No. 1020, § 6; 2009, No. 1193, § 9.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-509 - Applicability

(a)
On or after October 3, 2009, this subchapter shall apply to health benefit plans on the health benefit plans' anniversaries or start dates but in no event later than one (1) year after October 3, 2009.
(b)
If a health benefit plan provides coverage or benefits to an Arkansas resident, the health benefit plan shall be deemed to be delivered in this state within the meaning of this subchapter, regardless of whether the healthcare insurer or other entity that provides the coverage is located within or outside Arkansas.
Acts 1997, No. 1020, § 7; 2009, No. 1193, § 10.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 23-99-510 - Rules

The Insurance Commissioner shall enforce this subchapter and shall promulgate necessary rules for carrying out this subchapter.
Amended by Act 2019, No. 315,§ 2803, eff. 7/24/2019.
Acts 1997, No. 1020, § 10.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 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.
Acts 1997, No. 1020, § 11.
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 5 - ARKANSAS MENTAL HEALTH PARITY ACT OF 2009 (§§ 23-99-501 — 23-99-512) › Section 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.
Acts 2009, No. 1193, § 11.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 23-99-601 - Short title

This subchapter shall be cited as the "Dental Point of Service Act".
Acts 1999, No. 1232, § 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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Acts 1999, No. 1232, § 2.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Acts 1999, No. 1232, § 3.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Acts 1999, No. 1232, § 4.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Amended by Act 2019, No. 315,§ 2804, eff. 7/24/2019.
Acts 1999, No. 1232, § 5.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Acts 1999, No. 1232, § 6.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Acts 1999, No. 1232, § 7.
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 6 - DENTAL POINT OF SERVICE ACT (§§ 23-99-601 — 23-99-608) › Section 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.
Acts 1999, No. 1232, § 8.
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 7 - GRIEVANCE SYSTEMS AND QUALITY ASSESSMENT AND IMPROVEMENT SYSTEMS (§§ 23-99-701 — 23-99-706) › Section 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.
Acts 1999, No. 1200, § 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 99 - HEALTH CARE PROVIDERS (§§ 23-99-201 — 23-99-1802) › Subchapter 7 - GRIEVANCE SYSTEMS AND QUALITY ASSESSMENT AND IMPROVEMENT SYSTEMS (§§ 23-99-701 — 23-99-706) › Section 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.
Amended by Act 2019, No. 910,§ 5109, eff. 7/1/2019.
Acts 1999, No. 1200, § 2.
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 7 - GRIEVANCE SYSTEMS AND QUALITY ASSESSMENT AND IMPROVEMENT SYSTEMS (§§ 23-99-701 — 23-99-706) › Section 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.
Amended by Act 2019, No. 315,§ 2805, eff. 7/24/2019.
Amended by Act 2019, No. 910,§ 5111, eff. 7/1/2019.
Amended by Act 2019, No. 910,§ 5110, eff. 7/1/2019.
Acts 1999, No. 1200, § 3.
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 7 - GRIEVANCE SYSTEMS AND QUALITY ASSESSMENT AND IMPROVEMENT SYSTEMS (§§ 23-99-701 — 23-99-706) › Section 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.
Amended by Act 2019, No. 315,§ 2806, eff. 7/24/2019.
Amended by Act 2019, No. 910,§ 5113, eff. 7/1/2019.
Amended by Act 2019, No. 910,§ 5112, eff. 7/1/2019.
Acts 1999, No. 1200, § 4.
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 7 - GRIEVANCE SYSTEMS AND QUALITY ASSESSMENT AND IMPROVEMENT SYSTEMS (§§ 23-99-701 — 23-99-706) › Section 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.
Amended by Act 2019, No. 910,§ 5114, eff. 7/1/2019.
Acts 1999, No. 1200, § 5.
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 7 - GRIEVANCE SYSTEMS AND QUALITY ASSESSMENT AND IMPROVEMENT SYSTEMS (§§ 23-99-701 — 23-99-706) › Section 23-99-706 - Enforcement and penalties

The Secretary of the Department of Health shall have the power to implement and enforce this subchapter.
Amended by Act 2019, No. 910,§ 5115, eff. 7/1/2019.
Acts 1999, No. 1200, § 6.
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 8 - ENFORCEMENT OF ANY WILLING PROVIDER LAWS (§§ 23-99-801 — 23-99-804) › Section 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.
Acts 2005, No. 491, § 3.
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 8 - ENFORCEMENT OF ANY WILLING PROVIDER LAWS (§§ 23-99-801 — 23-99-804) › Section 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.
Added by Act 2019, No. 589,§ 1, eff. 3/29/2019.