Arkansas Administrative Code › Agency 003 - DEPARTMENT OF COMMERCE › Division 22 - Insurance Department › Rule 003.22.21-007 - Coverage for Early Refills of Prescription Eye Drops

Current through Register Vol. 49, No. 6, June, 2024
SECTION 1.
AUTHORITY
This Rule is issued pursuant to the authority granted the
				Arkansas Insurance Commissioner ("Commissioner") by Act 357 of 2021, codified
				at Ark. Code Ann. § 23-79-2101 et seq., which provides the Commissioner
				with authority necessary to promulgate rules to implement Act 357 of 2021,
				"Arkansas Coverage for Early Refills of Prescription Eye Drops Act."
SECTION 2.
APPLICABILITY AND
			 SCOPE
This Rule shall apply to all entities defined by Ark. Code Ann.
				§ 23-79-2102 as "healthcare insurers" that provide coverage for
				prescription eye drops under a health benefit plan to a covered person on and
				after January 1, 2022.
SECTION
			 3.
DEFINITIONS
The following words and terms, when used in this Rule, shall
				have the following meanings, unless the context clearly indicates
				otherwise.
(1) "Covered person" means
			 a person who is and continues to remain eligible for coverage under a health
			 benefit plan and is covered under the health benefit plan.
(2)
(a)
			 "Health benefit plan" means:
(1) An
			 individual, blanket, or group plan, policy, or contract for healthcare services
			 issued or delivered by a healthcare insurer; and
(2) Any health benefit program receiving
			 state or federal appropriations from the State of Arkansas, including the
			 Arkansas Medicaid Program and the Arkansas Works Program, or any successor
			 program.
(b) "Health
			 benefit plan" includes:
(1) Indemnity and
			 managed care plans; and
(2)
			 Nonfederal governmental plans as defined in
			 29
			 U.S.C. §
												1002(32), as
			 it existed on January 1, 2021.
(c) "Health benefit plan" does not include:
(1) A disability income plan;
(2) A credit insurance plan;
(3) Insurance coverage issued as a supplement
			 to liability insurance;
(4) A
			 medical payment under automobile or homeowners insurance plans;
(5) A health benefit plan provided under
			 Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law,
			 §
											11-9-101 et seq.,
			 or the Public Employee Workers' Compensation Act, §
											21-5-601 et
			 seq.;
(6) A plan that provides only
			 indemnity for hospital confinement;
(7) An accident-only plan;
(8) A specified disease plan;
(9) A long-term-care-only plan;
(10) A dental-only plan; or
(11) A vision-only plan.
(3) "Healthcare insurer" means an
			 entity subject to the insurance laws of this state or the jurisdiction of the
			 Insurance Commissioner that contracts or offers to contract to provide health
			 insurance coverage, including without limitation an insurance company, a health
			 maintenance organization, a hospital medical service corporation, a self-
			 insured governmental or church plan in this state, or the Arkansas Medicaid
			 Program.
(4) "Healthcare
			 professional" means a person who is licensed, certified, or otherwise
			 authorized by the laws of this state to administer health care in the ordinary
			 course of the practice of his or her profession.
(5) "Prescription eye drops" means a
			 prescription topical eye medication that is delivered through eye drops and is
			 used to treat a chronic condition of the eye.