Title 23, Public Utilities and Regulated Industries

This subchapter shall be known and may be cited as the “Primary Eye Care Provider Act”.

(1) As used in this subchapter:(1) “Covered persons” means any individual or family that is enrolled in a health benefit plan or policy from a healthcare insurer and on whose behalf the healthcare insurer is obligated to pay for or provide eye and/or vision care benefits;(2) “Cov…

(1) A health benefit plan that includes, or may include, eye and/or vision care benefits shall:(1) Include all primary eye care providers who are selected by covered persons of the health benefit plan for the provision of all eye and/or vision care benefits provided by the health…

Nothing in this subchapter shall prevent any person covered by a health benefit plan from receiving emergency eye care nor shall it prevent any person from exercising his or her right to receive treatment from his or her personal doctor and being reimbursed in accordance with the…

Any person adversely affected by a violation of this subchapter may bring action in a court of competent jurisdiction for injunctive relief against the healthcare insurer and, upon prevailing, in addition to such injunctive relief, shall recover damages not less than one thousand…

This subchapter shall be known and may be cited as the “Arkansas Health Care Consumer Act”.

As the state's insurance sector becomes increasingly dominated by managed care features that include decisions regarding coverage and appropriateness of health care, there is a vital need to protect patients in this environment.

(1) As used in this subchapter:(1) “Acute condition” means a medical condition, illness, or disease having a short and relatively severe course;(2) “Commissioner” means the Insurance Commissioner;(3) “Covered person” means a person on whose behalf the healthcare insurer issuing o…

(a) (1) Except as provided in subsection (b) of this section, a healthcare insurer may not restrict benefits for any hospital stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a normal vaginal delivery or to less than…

(a) Every health benefit plan providing mastectomy benefits and issued or renewed after July 16, 2003, shall conform with the requirements of the Women's Health and Cancer Rights Act of 1998, 42 U.S.C. §§ 300gg-27 and 300gg-52, as it existed on January 1, 2025. (b) To the extent …

(a) In order to ensure that healthcare benefits are safely and appropriately delivered to women, insurers which require the selection or assignment of a primary care physician shall allow each covered person who is a woman to select a participating obstetrician/gynecologist in ad…

No participating provider may be prohibited, restricted, or penalized in any way from disclosing to any covered person any healthcare information that the participating provider deems appropriate regarding the nature of treatment, risks, or alternatives thereto, the availability …

(a) When healthcare insurers use participating providers, the healthcare insurers shall develop procedures to provide for the continuity of care of their covered persons. At a minimum, the procedures shall:(1) Ensure that when a new patient is enrolled in a health benefit plan an…

(1) When a healthcare insurer uses a formulary for prescription drugs, the insurer shall include a written procedure whereby covered persons can obtain, without penalty and in a timely fashion, specific drugs and medications not included in the formulary when:(1) The formulary's …

(a) A healthcare insurer issuing or delivering a managed care plan shall establish for those managed care plans a grievance procedure which provides covered persons with a prompt and meaningful review on the issue of denial, in whole or in part, of a healthcare treatment or servi…

(a) (1) (A) Healthcare insurers shall establish mechanisms to ensure timely processing of requests for participation or renewal by providers and in making decisions that affect participation status.(B) These mechanisms shall include, at a minimum, provisions for the provider to r…

All healthcare insurers issuing or delivering managed care plans shall be required to establish a mechanism whereby participating providers provide input into the healthcare insurer's medical policy, utilization review criteria and procedures, quality and credentialing criteria, …

(1) Upon request, healthcare insurers must provide the following information in a clear and understandable form to all prospective policyholders, policyholders, and covered persons. Insurers shall notify policyholders and covered persons of their right to request the information,…

The Insurance Commissioner may promulgate necessary rules for carrying out this subchapter.

The Insurance Commissioner shall have all the powers to enforce this subchapter as are granted to the commissioner elsewhere in the Arkansas Insurance Code.

This subchapter applies to all health benefit plans issued, renewed, extended, or modified on or after August 1, 1997. “Renewed, extended, or modified” shall include all health benefit plans in which the insurer has reserved the right to change the premium.

(a) (1) Subject to subdivision (a)(2) of this section and subsections (b) and (c) of this section, a health benefit plan that is issued for delivery, delivered, renewed, or otherwise contracted for in this state shall provide coverage for eligible charges within limits of coverag…

(a) As used in this section:(1) “Applied behavior analysis” means the design, implementation, and evaluation of environmental modifications by a board-certified behavior analyst using behavioral stimuli and consequences to produce socially significant improvement in human behavio…

(a) As used in this section:(1) “Gastric pacemaker” means a medical device that:(A) Uses an external programmer and implanted electrical leads to the stomach; and(B) Transmits low-frequency, high-energy electrical stimulation to the stomach to entrain and pace the gastric slow wa…

(a) As used in this section:(1) “Exchange” means a health benefit exchange that offers health benefits under a health benefit plan offered by a healthcare insurer in this state through a state-based health insurance exchange or a health insurance exchange operated by the United S…

(a) As used in this section:(1) (A) “Healthcare insurer” means an insurance company, hospital and medical service corporation, or health maintenance organization issuing or delivering health benefit plans in this state and subject to the following laws:(i) The Arkansas Insurance …

This subchapter shall be known and may be cited as the “Arkansas Mental Health Parity Act of 2009”.

It is the intent of this state that if a health benefit plan provides insurance coverage for a mental illness or substance abuse disorder, the treatment of the mental illness or substance abuse disorder shall be as available as and at parity with that for other medical illnesses.

(1) As used in this subchapter:(1) “Carve-out arrangement” means an arrangement in which a healthcare insurer contracts with a separate person or entity to arrange for the delivery of specific types of healthcare benefits under a health benefit plan;(2) “Commissioner” means the I…

(1) This subchapter does not apply to:(1) Dental insurance plans;(2) Vision insurance plans;(3) Specified-disease insurance plans;(4) Accidental injury insurance plans;(5) Long-term care plans;(6) Disability income plans;(7) Individual health benefit plans if the healthcare insur…

(a) (1) This subchapter does not apply to a health benefit plan during the health benefit plan's following health benefit plan year if the application of this subchapter to the health benefit plan in a health benefit plan year resulted in an increase in the actual costs of covera…

(a) Except as provided in § 23-99-504, a health benefit plan that provides benefits for the diagnosis and treatment of mental illnesses shall provide the benefits under the same terms and conditions as provided for covered benefits offered under the health benefit plan for the tr…

(a) The criteria for medical necessity determinations for mental illness made under a health benefit plan shall be made available by the healthcare insurer in accordance with rules established by the Insurance Commissioner to any current or potential covered individual or contrac…

(a) A healthcare insurer may at the healthcare insurer's option provide coverage for a health service, such as intensive case management, community residential treatment programs, or social rehabilitation programs, that is used in the treatment of mental illnesses but is generall…

(a) On or after October 3, 2009, this subchapter shall apply to health benefit plans on the health benefit plans' anniversaries or start dates but in no event later than one (1) year after October 3, 2009. (b) If a health benefit plan provides coverage or benefits to an Arkansas …

The Insurance Commissioner shall enforce this subchapter and shall promulgate necessary rules for carrying out this subchapter.

The Insurance Commissioner shall have all the powers to enforce this subchapter as are granted to the commissioner elsewhere in the Arkansas Insurance Code.

In the case of a health benefit plan that provides both medical benefits and mental illness benefits, if the health benefit plan provides coverage for medical benefits provided by out-of-network providers, the health benefit plan shall provide coverage for mental illness benefits…

This subchapter shall be cited as the “Dental Point of Service Act”.

The General Assembly finds that the quality of dental care is improved through patient choice among dentists and that utilization of dentists varies less than utilization of other providers. Patients should have the freedom to go to dentists outside their managed care network whe…

(1) As used in this subchapter:(1) “Commissioner” means the Insurance Commissioner;(2) “Covered person” means a person covered by a health plan including an enrollee, subscriber, policyholder, beneficiary of a group plan, or individual covered by any other health plan;(3) “Dentis…

(a) Every health plan which provides dental benefits issued, renewed, extended, or modified by a health carrier shall also include a point-of-service option which provides benefits to covered persons through dentists who are not members of the health carrier's provider network. (…

Within one hundred twenty (120) days of July 30, 1999, the Insurance Commissioner shall promulgate necessary rules for carrying out this subchapter, giving maximum possible effect to the General Assembly's intent to promote quality medical care through increased choice.

The Insurance Commissioner shall enforce this subchapter, using the powers granted to the commissioner elsewhere in the Arkansas Insurance Code.

In any legal proceeding in which the validity of this subchapter is challenged, the Attorney General shall defend the subchapter regardless of the state agency or official named as an official party.

This subchapter applies to health plans issued, renewed, extended, or modified by a health carrier on or after July 30, 1999. “Renewed, extended, or modified” shall include a change in premium or other financial term.