Title 23 — Public Utilities and Regulated Industries
95 chapters · 4,024 sections in this title.
Ark. Code Ann. § 23-79-2101 Legislative findings and intent
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(a) The General Assembly finds that:(1) Health benefit plans are increasingly making use of step therapy protocols under which patients are required to try one (1) or more prescription drugs before coverage is provided for a drug selected by the patient's healthcare provider;(2) …
Ark. Code Ann. § 23-79-2102 Definitions
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(1) As used in this subchapter:(1) “Clinical practice guidelines” means a systematically developed statement derived from peer-reviewed published medical literature, evidence-based research, and widely accepted medical practice to assist decision-making by healthcare providers an…
Ark. Code Ann. § 23-79-2103 Clinical review criteria
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(a) (1) Clinical review criteria used to establish a step therapy protocol shall be based on clinical practice guidelines that:(A) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review gro…
Ark. Code Ann. § 23-79-2104 Exceptions — Transparency
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(a) (1) If coverage of a prescription drug for the treatment of any medical condition is restricted for use by a healthcare insurer, health benefit plan, or utilization review organization through the use of a step therapy protocol, a patient and prescribing healthcare provider s…
Ark. Code Ann. § 23-79-2105 Applicability
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This subchapter applies to a group health benefit plan or offered in connection with a group health plan that provides coverage of a prescription drug under a policy that meets the definition of a medication step therapy protocol whether or not the policy is described as a step t…
Ark. Code Ann. § 23-79-2201 Title
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This subchapter shall be known and may be cited as the “Arkansas Coverage for Early Refills of Prescription Eye Drops Act”.
Ark. Code Ann. § 23-79-2202 Definitions
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(1) As used in this subchapter:(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:(i) An individual, blanket, or group plan, policy, …
Ark. Code Ann. § 23-79-2203 Prescription eye drops — Early refills — Requirements
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(1) A healthcare insurer that provides coverage for prescription eye drops under a health benefit plan shall provide coverage for early refills of prescription eye drops to a covered person on and after January 1, 2022, if:(1) For a thirty-day supply:(A) The amount of time has pa…
Ark. Code Ann. § 23-79-2301 Title
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This subchapter shall be known and may be cited as the “Arkansas Fairness in Cost Sharing Act”.
Ark. Code Ann. § 23-79-2302 Definitions
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(1) As used in this subchapter:(1) “Cost-sharing requirement” means a copayment, coinsurance, deductible, or annual limitation on cost sharing, including without limitation a limitation subject to the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, that is requir…
Ark. Code Ann. § 23-79-2303 Fairness in cost sharing
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(a) (1) When calculating an enrollee's contribution to any applicable cost-sharing requirement, a healthcare insurer shall include any cost-sharing amounts paid by the enrollee or on behalf of the enrollee by another person.(2) The cost-sharing requirement under subdivision (a)(1…
Ark. Code Ann. § 23-79-2304 Rules
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(a) The Insurance Commissioner shall promulgate rules necessary to carry out this subchapter. (b) The rules promulgated under this section shall require a healthcare insurer and the Director of the Evidence-Based Prescription Drug Program of the College of Pharmacy of the Univers…
Ark. Code Ann. § 23-79-2401 Definitions
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(1) As used in this subchapter:(1) “Birth mother” means the biological mother of a child;(2) “Depression” means a mental illness classified as a mood disorder that causes a persistent feeling of sadness and a loss of interest;(3) (A) “Health benefit plan” means:(i) An individual,…
Ark. Code Ann. § 23-79-2402 Coverage for birth mother screening for depression
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(a) A healthcare insurer that offers, issues, or renews a health benefit plan in this state shall provide coverage for screening for depression of the birth mother by a healthcare professional within the first six (6) weeks of the birth mother's having given birth on or after Jan…
Ark. Code Ann. § 23-79-2501 Title
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This subchapter shall be known and may be cited as the “Healthcare Insurer Share the Savings Act”.
Ark. Code Ann. § 23-79-2502 Definitions
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(1) As used in this subchapter:(1) “Defined cost sharing” means a deductible payment or coinsurance amount imposed on an enrollee for a covered prescription drug under the enrollee's health benefit plan;(2) “Enrollee” means an individual entitled to coverage of healthcare service…
Ark. Code Ann. § 23-79-2503 Implementation of subchapter — Requirements
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(a) An enrollee's defined cost sharing for a prescription drug shall be calculated at the point-of-sale based on a price that is reduced by an amount equal to at least one hundred percent (100%) of all rebates received, or to be received, in connection with the dispensing or admi…
Ark. Code Ann. § 23-79-2601 Definitions
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(1) As used in this subchapter:(1) (A) “Biomarker” means a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention, including known gene-drug …
Ark. Code Ann. § 23-79-2602 Coverage for biomarker testing for early detection and management for cancer diagnoses
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(a) A health benefit plan that is offered, issued, or renewed in this state shall provide coverage for biomarker testing. (b) The evidence of coverage document provided with a health benefit plan under this subchapter shall include biomarker testing for the purpose of diagnosis, …
Ark. Code Ann. § 23-79-2701 Title
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This subchapter shall be known and may be cited as the “Arkansas Triage, Treat, and Transport to Alternative Destination Act”.
Ark. Code Ann. § 23-79-2702 Definitions
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(1) As used in this subchapter:(1) “911 call” means a communication made on behalf of an enrollee indicating that the enrollee may need emergency medical services;(2) (A) “Alternative destination” means a lower-acuity facility that provides medical services, including without lim…
Ark. Code Ann. § 23-79-2703 Coverage for ambulance service to triage and transport enrollee to alternative destination or treat in place
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(a) A healthcare insurer that offers, issues, or renews a health benefit plan in this state shall provide coverage for an ambulance service to:(1) Treat an enrollee in place if the ambulance service is coordinating the care of the enrollee through telemedicine with a physician fo…
Ark. Code Ann. § 23-79-2801 Definitions
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(1) As used in this subchapter:(1) (A) “Health benefit plan” means:(i) An individual, blanket, or group plan or a policy or contract for healthcare services issued or delivered by a healthcare insurer; and(ii) Any health benefit program receiving state or federal appropriations f…
Ark. Code Ann. § 23-79-2802 Coverage for screening for behavioral health conditions and coverage for behavioral health services
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(a) A healthcare insurer that offers, issues, or renews a health benefit plan in this state shall provide coverage for screening for behavioral health conditions and coverage for behavioral health services provided in a:(1) Hospital outpatient clinic; or(2) Physician clinic. (1) …
Ark. Code Ann. § 23-79-2901 Definitions
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(1) As used in this subchapter:(1) “Acquired brain injury” means an injury to the brain that occurs after birth and may be caused by:(A) An infectious disease;(B) A metabolic disorder;(C) An endocrine disorder;(D) Diminished oxygen;(E) A brain tumor;(F) A toxin;(G) A disease that…
Ark. Code Ann. § 23-79-2902 Coverage for medically necessary treatment related to acquired brain injury
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(a) (1) On and after January 1, 2026, a health benefit plan that is offered, issued, renewed, delivered, or extended in this state shall provide coverage to an enrollee for medically necessary treatment related to or as a result of an acquired brain injury.(2) As required under s…
Ark. Code Ann. § 23-79-2903 Rules— Medicaid waiver
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(a) The Insurance Commissioner may develop and promulgate rules for the implementation and administration of this subchapter. (b) The Department of Human Services shall apply for a waiver or add this population to an existing waiver program to allow a beneficiary under the Arkans…
Ark. Code Ann. § 23-79-3001 Legislative findings
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(1) The General Assembly finds that:(1) Lung cancer is the leading cause of cancer deaths in Arkansas, killing nearly two thousand (2,000) residents each year;(2) Lung cancer, which is mostly preventable, is the leading cause of cancer deaths in Arkansas;(3) In Arkansas, about on…
Ark. Code Ann. § 23-79-3002 Definitions
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(1) As used in this subchapter:(1) “Covered person” means an individual who is entitled to receive healthcare services under the terms of a health benefit plan;(2) (A) “Health benefit plan” means:(i) An individual, blanket, or group plan, or a policy or contract for healthcare se…
Ark. Code Ann. § 23-79-3003 Coverage for lung cancer screenings
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(a) On and after January 1, 2026, a health benefit plan that is offered, issued, renewed, delivered, or extended in this state shall provide coverage for lung cancer screenings and follow-up healthcare services according to American Cancer Society guidelines. (b) The coverage for…
Ark. Code Ann. § 23-79-3004 Rules
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(a) The Insurance Commissioner shall promulgate rules to implement this subchapter. (b) The Secretary of the Department of Human Services shall promulgate rules necessary to implement this subchapter that may apply to the Arkansas Medicaid Program or the Arkansas Health and Oppor…
Ark. Code Ann. § 23-79-301 Purpose
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The purpose of this subchapter is to provide minimum standards for commercial lines property and casualty insurance policies or contracts. These minimum standards are designed to minimize restrictions in coverage and to assure minimum standards for these commercial policies or co…
Ark. Code Ann. § 23-79-302 Definition
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For purposes of this subchapter, a claims-made policy as referenced in § 23-79-306 means a policy which provides coverage if a claim for damages is first made during the policy period.
Ark. Code Ann. § 23-79-303 Applicability — Exceptions
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(a) This subchapter applies to property and casualty insurance on commercial risks in this state, except:(1) Reinsurance;(2) Insurance against loss of or damage to aircraft or their hulls, accessories, and equipment or against liability arising out of the ownership, maintenance, …
Ark. Code Ann. § 23-79-304 Construction
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This subchapter shall be deemed cumulative of prior laws. No prior law or part of a law shall be deemed to be in conflict with this subchapter unless failure to so determine would prevent giving effect to an explicit provision of this subchapter.
Ark. Code Ann. § 23-79-305 Violations — Order
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(a) Whenever the Insurance Commissioner shall have reason to believe that any person has violated any provision of this subchapter, the commissioner shall issue and serve upon the person a statement of the alleged violations and a notice of hearing as provided by § 23-79-309. (b)…
Ark. Code Ann. § 23-79-306 Requirements
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(1) The following requirements are applicable only as to claims-made policies as defined in § 23-79-302:(1) The policy application and the initial page of each claims-made policy must include a conspicuous notice at the top indicating that the contract is a claims-made policy;(2)…
Ark. Code Ann. § 23-79-307 Standards — Definition
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(a) In addition to other applicable provisions of the Arkansas Insurance Code, insurers and insurance policies subject to the provisions of this subchapter shall meet the following standards:(1) Notice of claim given by or on behalf of the named insured to any authorized agent of…
Ark. Code Ann. § 23-79-308 Noncomplying provisions
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Any commercial property and casualty insurance policy, contract, rider, or endorsement issued after March 13, 1987, and otherwise valid that contains any condition or provision not in compliance with the requirements of this subchapter shall be construed and applied in accordance…
Ark. Code Ann. § 23-79-309 Administrative procedures — Appeals
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(a) Administrative procedures exercised by the Insurance Commissioner under this subchapter shall be in accordance with §§ 23-61-303 — 23-61-306. (b) Appeals from orders of the commissioner made under this subchapter shall be made in accordance with § 23-61-307.
Ark. Code Ann. § 23-79-310 Rules
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The Insurance Commissioner may promulgate such reasonable rules as are necessary to carry out the provisions of this subchapter.
Ark. Code Ann. § 23-79-3101 Definitions
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(1) As used in this subchapter:(1) “Ambulatory surgery center” means an entity certified by:(A) Medicare as an ambulatory surgical center that operates for the purpose of providing surgical services to patients and that is eligible to receive reimbursement from Medicaid for ambul…
Ark. Code Ann. § 23-79-3102 Coverage for breast reconstruction surgery
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(a) On and after January 1, 2026, a health benefit plan that is offered, issued, or renewed in this state shall provide coverage for all modalities, types, and techniques of a healthcare service provided for a breast reconstruction surgery and shall cover any surgery determined a…
Ark. Code Ann. § 23-79-3103 Prior authorization required for breast reconstruction surgery — Single case agreements
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(a) A healthcare insurer shall require prior authorization for breast reconstruction surgery. (b) If a healthcare insurer does not have a participating provider who provides a breast reconstruction surgery that has been determined as the best course of treatment by a healthcare p…
Ark. Code Ann. § 23-79-3104 Reimbursement rate — Penalties for late payment or nonpayment
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(a) If a healthcare insurer does not have a participating provider who provides a breast reconstruction surgery that has been determined as the best course of treatment by a healthcare professional and is consistent with prevailing medical standards and in consultation with the p…
Ark. Code Ann. § 23-79-3105 Coverage eligibility
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A healthcare insurer providing benefits under this subchapter shall not deny an enrollee eligibility or continued eligibility to enroll or renew coverage under the terms of the health benefit plan solely for the purpose of avoiding the requirements of this subchapter.
Ark. Code Ann. § 23-79-3106 Waiver prohibited
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(a) The provisions of this subchapter shall not be waived by contract. (b) A contractual arrangement or action taken in conflict with this subchapter or that purports to waive any requirement of this subchapter is void. (c) This subchapter shall not be used by a healthcare insure…
Ark. Code Ann. § 23-79-3107 Rules
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(a) The Insurance Commissioner shall develop and promulgate rules for the implementation and administration of this subchapter. (b) The State Board of Finance shall develop and promulgate rules for the administration of this subchapter for the plans providing health benefits to s…
Ark. Code Ann. § 23-79-311 Motor vehicle liability insurance — Extraterritorial provision
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(a) (1) Motor vehicle liability insurance applies to the amounts that the owner is legally obligated to pay as damages because of accidental bodily injury and accidental property damage arising out of the ownership or operation of a motor vehicle if the accident occurs in the Uni…
Ark. Code Ann. § 23-79-312 Motor vehicle liability insurance — Prohibition regarding step-downs
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No motor vehicle liability insurance policy issued or delivered in this state shall contain a provision that converts the limits for bodily injury or property damage to lower limits in the event that the insured motor vehicle is involved in an accident while it is being driven by…