(a) As used in this section:
(1) “Health carrier” means a:
(A) Health maintenance organization;
(B) Hospital medical service corporation; and
(C) Disability insurance company;
(2) “Health carrier” includes a:
(A) Self-insured governmental or church plan; and
(B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan; and
(3) “Health carrier” does not include:
(A) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or
(B) A person, company, or organization licensed or registered to issue or that issues an insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 — 23-62-107 providing medical or hospital benefits for accidental injury or disability.
(b) A health carrier that excludes or denies coverage for a specific surgical product or medical device approved for marketing by the United States Food and Drug Administration as experimental or investigational, or both, shall develop a process by which a surgeon, before utilizing the surgical product or medical device, may present medical evidence to obtain a review for the individual patient for coverage of the surgical product or medical device.
Structure Arkansas Code
Title 23 - Public Utilities and Regulated Industries
Chapter 86 - Group and Blanket Accident and Health Insurance
Subchapter 1 - General Provisions
§ 23-86-101. Blanket accident and health insurance — Definition
§ 23-86-102. Blanket accident and health insurance — Required provisions
§ 23-86-103. Blanket accident and health insurance — Application and certificates not required
§ 23-86-104. Blanket accident and health insurance — Payment of benefits
§ 23-86-106. Group accident and health insurance — Definition
§ 23-86-107. Group accident and health insurance — Authorized insurer required
§ 23-86-108. Group accident and health insurance — Required provisions
§ 23-86-109. Group accident and health insurance — Optional continuation of benefit provisions
§ 23-86-110. Group accident and health insurance — Administration of benefits
§ 23-86-112. Group accident and health insurance — Direct payment of hospital or medical services
§ 23-86-116. Continuation of benefits upon termination of policy
§ 23-86-117. Standard claim form required
§ 23-86-118. In vitro fertilization coverage required
§ 23-86-119. Disclosure to policyholders
§ 23-86-120. Hospice care coverage for terminally ill patients
§ 23-86-121. Coverage for anesthesia and hospitalization for dental procedures