Arkansas Administrative Code › Agency 054 - Arkansas Insurance Department › Rule 054.00.91-007 - Children's Preventive Health Care Reimbursement Levels

Current through Register Vol. 49, No. 6, June, 2024
Section 1.
Purpose
The purpose of this Regulation is to implement Arkansas Code
			 Annotated §
								23-79-141.
Section 2.
Authority
This Rule is issued pursuant to the authority vested in the
			 Commissioner under Ark. Code Ann. §§
								23-61-108,
			 23-76-125,
			 25-15-203
			 and
			 23-79-141.
Section 3.
Applicability and Scope
This Rule applies to every disability insurer, hospital or
			 medical service corporation, health maintenance organization ("HMO"), fraternal
			 benefit society and self-insured plan transacting disability insurance or
			 providing disability coverage in this State which delivers, issues for
			 delivery, or renews, extends, or modifies disability policies, contracts,
			 certificates and plans providing hospital and medical coverage on an expense
			 incurred, service, or prepaid basis which contracts provide coverage for a
			 family member of the insured person. This Regulation does not apply to
			 disability income, specified disease, medicare supplement, hospital indemnity,
			 or accident only policies.
Section
		  4.
Effective Date
The effective date of this Rule is September 2, 1991.
Section 5.
Definitions
A. Anticipatory
		  Guidance
Anticipatory guidance shall include such things as visual
			 evaluation (litmus machine or other ophthalmological testing not required),
			 hearing evaluation (machine audiology test not required)
,
dental inspection for children under two years of age, and a nutritional
			 assessment.
B.
		  Developmental Assessment
A developmental assessment should be obtained by history and
			 observation of the child, or by one recognized developmental tests. This
			 portion of the screening should include assessment of eye-hand coordination,
			 gross motor function (walking, hopping, climbing), fine motor skills (use of
			 finger dexterity and hand usage), speech development, daily living personal
			 skills such as dressing, feeding and grooming oneself, behavioral development,
			 and proofs of mind with body integration.
C. Lab Test/Immunizations
Laboratory procedures and immunizations should be performed as
			 appropriate for the child's age. A hematocrit or hemoglobin test is recommended
			 for children one (1) year of age and older and a urinalysis is recommended for
			 children five (5) years of age and older. Other laboratory procedures are to be
			 performed if it is deemed appropriate by the child's age and/or health history
			 (i.e., lead toxicity, sickle cell, tuberculin, pap smear).
D. Medical History
A medical history is to be obtained from the parent, legal
			 guardian, or other responsible adult who is familiar with the child's health
			 history. The child's height and weight should also be recorded and compared
			 with the ranges considered normal for children of that age.
E. Physical Examination
A physical examination is to be performed to note obvious
			 physical defects including orthopedic, genital, skin, and other observable
			 deviations.