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Subchapter 2 - Patient Protection Act of 1995
§ 23-99-201. Short title - This subchapter may be cited as the “Patient Protection Act...
§ 23-99-202. Legislative findings and intent - The General Assembly finds that patients should be given the...
§ 23-99-203. Definitions - (a) (1) “Copayment” means a type of cost sharing whereby...
§ 23-99-204. Terms of health benefit plan - (a) A healthcare insurer shall not, directly or indirectly: (1)...
§ 23-99-205. Construction - (a) Nothing in this subchapter shall be construed to require...
§ 23-99-206. Violations - It is a violation of this subchapter for any healthcare...
§ 23-99-207. Civil penalties - To the extent permitted by the Employee Retirement Income Security...
§ 23-99-208. Void provisions - (a) To avoid impairment of existing contracts, this subchapter shall...
§ 23-99-209. Applicability - The provisions of this subchapter shall not apply to self-funded...
§ 23-99-210. Healthcare provider — Adverse professional review action - A healthcare insurer shall not exclude a physician as a...
Subchapter 3 - Primary Eye Care Provider Act
§ 23-99-301. Short title - This subchapter shall be known and may be cited as...
§ 23-99-302. Definitions - As used in this subchapter: (1) “Covered persons” means any...
§ 23-99-303. Requirements for health benefit plans - A health benefit plan that includes, or may include, eye...
§ 23-99-304. Subchapter not to prevent treatment - Nothing in this subchapter shall prevent any person covered by...
§ 23-99-305. Remedies - Any person adversely affected by a violation of this subchapter...
Subchapter 4 - Arkansas Health Care Consumer Act
§ 23-99-401. Short title - This subchapter shall be known and may be cited as...
§ 23-99-402. Legislative findings and intent - As the state's insurance sector becomes increasingly dominated by managed...
§ 23-99-403. Definitions - As used in this subchapter: (1) “Acute condition” means a...
§ 23-99-404. Benefits for mothers and newborns - (a) (1) Except as provided in subsection (b) of this...
§ 23-99-405. Mastectomies - (a) Every health benefit plan providing mastectomy benefits and issued...
§ 23-99-406. Obstetrical and gynecological services - (a) In order to ensure that healthcare benefits are safely...
§ 23-99-407. “Gag clause” prohibition - No participating provider may be prohibited, restricted, or penalized in...
§ 23-99-408. Continuity of care - (a) When healthcare insurers use participating providers, the healthcare insurers...
§ 23-99-409. Prescription drug formulary - When a healthcare insurer uses a formulary for prescription drugs,...
§ 23-99-410. Grievance procedures - (a) A healthcare insurer issuing or delivering a managed care...
§ 23-99-411. Processing applications of providers - (a) (1) (A) Healthcare insurers shall establish mechanisms to ensure...
§ 23-99-412. Provider input - All healthcare insurers issuing or delivering managed care plans shall...
§ 23-99-413. Disclosure requirements - Upon request, healthcare insurers must provide the following information in...
§ 23-99-414. Rules - The Insurance Commissioner may promulgate necessary rules for carrying out...
§ 23-99-415. Enforcement and penalties - The Insurance Commissioner shall have all the powers to enforce...
§ 23-99-416. Application of subchapter - This subchapter applies to all health benefit plans issued, renewed,...
§ 23-99-417. Coverage required for orthotic devices, orthotic services, prosthetic devices, and prosthetic services - (a) (1) Subject to subdivision (a)(2) of this section and...
§ 23-99-418. Coverage for autism spectrum disorders required — Definitions - (a) As used in this section: (1) “Applied behavior analysis”...
§ 23-99-419. Gastric pacemakers - (a) As used in this section: (1) “Gastric pacemaker” means...
§ 23-99-421. Pediatric dental benefits — Definitions - (a) As used in this section: (1) “Exchange” means a...
Subchapter 5 - Arkansas Mental Health Parity Act of 2009
§ 23-99-501. Short title - This subchapter shall be known and may be cited as...
§ 23-99-502. Legislative findings and intent - It is the intent of this state that if a...
§ 23-99-503. Definitions - As used in this subchapter: (1) “Carve-out arrangement” means an...
§ 23-99-504. Exclusions - This subchapter does not apply to: (1) Dental insurance plans;...
§ 23-99-505. Increased cost exemption - (a) (1) This subchapter does not apply to a health...
§ 23-99-506. Parity requirements - (a) Except as provided in § 23-99-504, a health benefit...
§ 23-99-507. Medical necessity - (a) The criteria for medical necessity determinations for mental illness...
§ 23-99-508. Permitted provisions - (a) A healthcare insurer may at the healthcare insurer's option...
§ 23-99-509. Applicability - (a) On or after October 3, 2009, this subchapter shall...
§ 23-99-510. Rules - The Insurance Commissioner shall enforce this subchapter and shall promulgate...
§ 23-99-511. Enforcement - The Insurance Commissioner shall have all the powers to enforce...
§ 23-99-512. Out-of-network providers - In the case of a health benefit plan that provides...
Subchapter 6 - Dental Point of Service Act
§ 23-99-601. Short title - This subchapter shall be cited as the “Dental Point of...
§ 23-99-602. Legislative findings - The General Assembly finds that the quality of dental care...
§ 23-99-603. Definitions - As used in this subchapter: (1) “Commissioner” means the Insurance...
§ 23-99-604. Coverage for out-of-network dentists - (a) Every health plan which provides dental benefits issued, renewed,...
§ 23-99-605. Rules - Within one hundred twenty (120) days of July 30, 1999,...
§ 23-99-606. Insurance Commissioner's enforcement authority - The Insurance Commissioner shall enforce this subchapter, using the powers...
§ 23-99-607. Duty of Attorney General to defend - In any legal proceeding in which the validity of this...
§ 23-99-608. Applicability of subchapter - This subchapter applies to health plans issued, renewed, extended, or...
Subchapter 7 - Grievance Systems and Quality Assessment and Improvement Systems
§ 23-99-701. Legislative findings - The General Assembly finds and declares the following: (1) The...
§ 23-99-702. Definitions - As used in this subchapter: (1) “Commissioner” means the Insurance...
§ 23-99-703. Grievance system - (a) All health carriers and networks shall make arrangements for...
§ 23-99-704. Quality assessment and improvement systems - (a) Each health carrier and network shall: (1) Make arrangements...
§ 23-99-705. Applicability and scope - (a) This subchapter shall not apply to disability income, specified...
§ 23-99-706. Enforcement and penalties - The Secretary of the Department of Health shall have the...
Subchapter 8 - Enforcement of any Willing Provider Laws
§ 23-99-801. Application and intent - (a) The state's any willing provider laws shall not be...
§ 23-99-802. Definitions - As used in this subchapter: (1) “Any willing provider law”...
§ 23-99-803. Agency enforcement - The Insurance Commissioner shall: (1) Enforce the state's any willing...
§ 23-99-804. Health insurer — Healthcare provider contracts - (a) A healthcare provider, including without limitation a physician, nurse,...
Subchapter 9 - Limitation on Financial Penalties in Alternative Payment Systems
§ 23-99-901. Legislative findings - The General Assembly finds that: (1) Under an alternative payment...
§ 23-99-902. Definitions - As used in this subchapter: (1) “Alternative payment system” means...
§ 23-99-903. Physician penalties — Limitation - (a) A healthcare payor doing business in this state, when...
§ 23-99-904. Waiver prohibited - (a) The provisions of this subchapter shall not be waived...
§ 23-99-905. Enforcement - (a) The State Insurance Department shall develop and promulgate rules...
Subchapter 10 - Vision Care Plan Act of 2015
§ 23-99-1001. Title - This subchapter shall be known and may be cited as...
§ 23-99-1002. Definitions - As used in this subchapter: (1) “Covered materials” means materials...
§ 23-99-1003. Prohibited practices — Agreements - (a) A participating provider agreement between an insurer, vision care...
§ 23-99-1004. Private civil action - (a) A vision care provider adversely affected by any violation...
§ 23-99-1005. Rules — Enforcement — Effective date - (a) The State Insurance Department shall develop and promulgate rules...
Subchapter 11 - Prior Authorization Transparency Act
§ 23-99-1101. Title - This subchapter shall be known and may be cited as...
§ 23-99-1102. Legislative findings and intent - (a) The General Assembly finds that: (1) A physician-patient relationship...
§ 23-99-1103. Definitions - As used in this subchapter: (1) (A) “Adverse determination” means...
§ 23-99-1104. Disclosure required - (a) (1) A utilization review entity shall disclose all of...
§ 23-99-1105. Prior authorization — Nonurgent healthcare service - (a) If a utilization review entity requires prior authorization of...
§ 23-99-1106. Prior authorization — Urgent healthcare service - A utilization review entity shall render an expedited authorization or...
§ 23-99-1107. Prior authorization — Emergency healthcare service - (a) A utilization review entity shall not require prior authorization...
§ 23-99-1108. Subscribers with terminal illness — Denial of prior authorization for covered prescription pain medication prohibited - If a subscriber's covered prescription pain medication requires a prior...
§ 23-99-1109. Rescission of prior authorizations — Denial of payment for prior authorized services — Limitations - (a) A decision on a request for prior authorization by...
§ 23-99-1110. Waiver prohibited - (a) The provisions of this subchapter shall not be waived...
§ 23-99-1111. Requests for prior authorization — Qualified persons authorized to review and approve — Adverse determinations to be made only by Arkansas-licensed physicians - (a) The initial review of information submitted in support of...
§ 23-99-1112. Application of subchapter - This subchapter applies to a healthcare insurer, whether or not...
§ 23-99-1113. Benefit inquiries authorized - (a) (1) An in-network or out-of-network healthcare provider may submit...
§ 23-99-1114. Limitations on step therapy — Definition - (a) If a utilization review entity has required a healthcare...
§ 23-99-1115. Notice requirements — Process for appealing adverse determination and restriction or denial of healthcare service - (a) (1) Notice of an adverse determination shall be provided...
§ 23-99-1116. Failure to comply with subchapter — Requested healthcare services deemed approved - (a) If a healthcare insurer or utilization review entity fails...
§ 23-99-1117. Standardized form required for prescription drug benefits - (a) On and after January 1, 2017, to establish uniformity...
§ 23-99-1118. Rules - The State Insurance Department may promulgate rules for the implementation...
§ 23-99-1119. Medication-assisted treatment for opioid addiction - (a) Except in the case of injectables, a healthcare insurer,...
Subchapter 12 - Healthcare Contracting Simplification Act
§ 23-99-1201. Title - This subchapter shall be known and may be cited as...
§ 23-99-1202. Definitions - As used in this subchapter: (1) “All-products clause” means a...
§ 23-99-1203. All-products clause — Prohibition - (a) Except as provided in subsections (b) and (d) of...
§ 23-99-1204. Prohibition — Most favored nation clause - (a) A contracting entity shall not: (1) Offer to a...
§ 23-99-1205. Contracting process - (a) (1) A material amendment to a healthcare contract is...
§ 23-99-1206. Freedom of contract - (a) A contracting entity shall not, directly or indirectly, offer...
§ 23-99-1207. Enforcement - (a) A contracting entity is subject to the Trade Practices...
§ 23-99-1208. Rules - (a) The Insurance Commissioner shall promulgate rules necessary to ensure...
§ 23-99-1209. Effective date - (a) This subchapter applies to the activities of risk-based provider...
Subchapter 13 - Assignment of Benefits
§ 23-99-1301. Definitions - As used in this subchapter: (1) “Contracting entity” means a...
§ 23-99-1302. Assignment of benefits - (a) An enrollee, through an assignment of benefits, may assign...
§ 23-99-1303. Waiver prohibited - (a) This subchapter shall not be waived by contract. (b)...
§ 23-99-1304. Enforcement - (a) A contracting entity is subject to the Trade Practices...
§ 23-99-1305. Rules - (a) The Insurance Commissioner shall promulgate rules necessary to ensure...