(1) As used in this subchapter:(1) (A) “Clinical utility” means a test result that provides information that is used in the formulation of a treatment or monitoring strategy that informs a patient's outcome and impacts the clinical decision.(B) “Clinical utility” includes the most appropriate test that may include both information that is actionable and some information that cannot be immediately used in the formulation of a clinical decision;(2) “Evidence-based cancer imaging” means appropriate preventive screening and imaging supported by evidence;(3) “Genetic testing for an inherited gene mutation” means testing for an inherited gene mutation associated with an increased risk of cancer;(4) (A) “Health benefit plan” means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan in this state.(B) “Health benefit plan” includes:(i) Indemnity and managed care plans; and(ii) Nonfederal governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2025.(C) “Health benefit plan” does not include:(i) A plan that provides only dental benefits or eye and vision care benefits;(ii) A disability income plan;(iii) A credit insurance plan;(iv) Insurance coverage issued as a supplement to liability insurance;(v) Medical payments under an automobile or homeowners insurance plan;(vi) 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.;(vii) A plan that provides only indemnity for hospital confinement;(viii) An accident-only plan;(ix) A specified disease plan; or(x) A long-term-care-only plan;(5) (A) “Healthcare insurer” means any insurance company, hospital and medical service corporation, or health maintenance organization that issues or delivers health benefit plans in this state and is subject to any of the following laws:(i) The insurance laws of this state;(ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or(iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.(B) “Healthcare insurer” does not include an entity that provides only dental benefits or eye and vision care benefits;(6) “Healthcare provider” means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer healthcare services; and(7) “Nationally recognized clinical practice guidelines” means evidence-based clinical practice guidelines that:(A) Are developed by independent organizations or medical professional societies:(i) Using a transparent methodology and reporting structure; and(ii) With a conflict of interest policy; and(B) Establish standards of care that are informed by:(i) A systemic review of evidence; and(ii) An assessment of the benefits and costs of alternative care options that includes without limitation recommendations intended to optimize patient care.
(1) (A) “Clinical utility” means a test result that provides information that is used in the formulation of a treatment or monitoring strategy that informs a patient's outcome and impacts the clinical decision.(B) “Clinical utility” includes the most appropriate test that may include both information that is actionable and some information that cannot be immediately used in the formulation of a clinical decision;
(A) “Clinical utility” means a test result that provides information that is used in the formulation of a treatment or monitoring strategy that informs a patient's outcome and impacts the clinical decision.
(B) “Clinical utility” includes the most appropriate test that may include both information that is actionable and some information that cannot be immediately used in the formulation of a clinical decision;
(2) “Evidence-based cancer imaging” means appropriate preventive screening and imaging supported by evidence;
(3) “Genetic testing for an inherited gene mutation” means testing for an inherited gene mutation associated with an increased risk of cancer;
(4) (A) “Health benefit plan” means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan in this state.(B) “Health benefit plan” includes:(i) Indemnity and managed care plans; and(ii) Nonfederal governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2025.(C) “Health benefit plan” does not include:(i) A plan that provides only dental benefits or eye and vision care benefits;(ii) A disability income plan;(iii) A credit insurance plan;(iv) Insurance coverage issued as a supplement to liability insurance;(v) Medical payments under an automobile or homeowners insurance plan;(vi) 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.;(vii) A plan that provides only indemnity for hospital confinement;(viii) An accident-only plan;(ix) A specified disease plan; or(x) A long-term-care-only plan;
(A) “Health benefit plan” means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan in this state.
(B) “Health benefit plan” includes:(i) Indemnity and managed care plans; and(ii) Nonfederal governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2025.
(i) Indemnity and managed care plans; and
(ii) Nonfederal governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2025.
(C) “Health benefit plan” does not include:(i) A plan that provides only dental benefits or eye and vision care benefits;(ii) A disability income plan;(iii) A credit insurance plan;(iv) Insurance coverage issued as a supplement to liability insurance;(v) Medical payments under an automobile or homeowners insurance plan;(vi) 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.;(vii) A plan that provides only indemnity for hospital confinement;(viii) An accident-only plan;(ix) A specified disease plan; or(x) A long-term-care-only plan;
(i) A plan that provides only dental benefits or eye and vision care benefits;
(ii) A disability income plan;
(iii) A credit insurance plan;
(iv) Insurance coverage issued as a supplement to liability insurance;
(v) Medical payments under an automobile or homeowners insurance plan;
(vi) 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.;
(vii) A plan that provides only indemnity for hospital confinement;
(viii) An accident-only plan;
(ix) A specified disease plan; or
(x) A long-term-care-only plan;
(5) (A) “Healthcare insurer” means any insurance company, hospital and medical service corporation, or health maintenance organization that issues or delivers health benefit plans in this state and is subject to any of the following laws:(i) The insurance laws of this state;(ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or(iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.(B) “Healthcare insurer” does not include an entity that provides only dental benefits or eye and vision care benefits;
(A) “Healthcare insurer” means any insurance company, hospital and medical service corporation, or health maintenance organization that issues or delivers health benefit plans in this state and is subject to any of the following laws:(i) The insurance laws of this state;(ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or(iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.
(i) The insurance laws of this state;
(ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or
(iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.
(B) “Healthcare insurer” does not include an entity that provides only dental benefits or eye and vision care benefits;
(6) “Healthcare provider” means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer healthcare services; and
(7) “Nationally recognized clinical practice guidelines” means evidence-based clinical practice guidelines that:(A) Are developed by independent organizations or medical professional societies:(i) Using a transparent methodology and reporting structure; and(ii) With a conflict of interest policy; and(B) Establish standards of care that are informed by:(i) A systemic review of evidence; and(ii) An assessment of the benefits and costs of alternative care options that includes without limitation recommendations intended to optimize patient care.
(A) Are developed by independent organizations or medical professional societies:(i) Using a transparent methodology and reporting structure; and(ii) With a conflict of interest policy; and
(i) Using a transparent methodology and reporting structure; and
(ii) With a conflict of interest policy; and
(B) Establish standards of care that are informed by:(i) A systemic review of evidence; and(ii) An assessment of the benefits and costs of alternative care options that includes without limitation recommendations intended to optimize patient care.
(i) A systemic review of evidence; and
(ii) An assessment of the benefits and costs of alternative care options that includes without limitation recommendations intended to optimize patient care.