Title 23 — Public Utilities and Regulated Industries
95 chapters · 4,024 sections in this title.
Ark. Code Ann. § 23-99-201 Short title
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This subchapter may be cited as the “Patient Protection Act of 1995”.
Ark. Code Ann. § 23-99-202 Legislative findings and intent
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The General Assembly finds that patients should be given the opportunity to see the healthcare provider of their choice. In order to assure the citizens of the State of Arkansas the right to choose the provider of their choice, it is the intent of the General Assembly to provide …
Ark. Code Ann. § 23-99-203 Definitions
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(a) (1) “Copayment” means a type of cost sharing whereby insured or covered persons pay a specified predetermined amount per unit of service or percentage of healthcare costs with their healthcare insurer paying the remainder of the charge.(2) The copayment is incurred at the tim…
Ark. Code Ann. § 23-99-204 Terms of health benefit plan
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(a) A healthcare insurer shall not, directly or indirectly:(1) (A) Impose a monetary advantage or penalty under a health benefit plan that would affect a beneficiary's choice among those healthcare providers who participate in the health benefit plan according to the terms offere…
Ark. Code Ann. § 23-99-205 Construction
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(a) Nothing in this subchapter shall be construed to require any healthcare insurer to cover any specific healthcare service. (b) Provided, however, no condition or measure shall have the effect of excluding any type or class of provider qualified under § 23-99-204(a)(3) to provi…
Ark. Code Ann. § 23-99-206 Violations
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It is a violation of this subchapter for any healthcare insurer or other person or entity to provide any health benefit plan providing for healthcare services to residents of this state that does not conform to this subchapter, but nothing in this subchapter shall constitute a vi…
Ark. Code Ann. § 23-99-207 Civil penalties
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To the extent permitted by the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. § 1001 et seq., any provider adversely affected by a violation of this subchapter may sue in circuit court only for injunctive relief against the healthcare insurer, but not for …
Ark. Code Ann. § 23-99-208 Void provisions
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(a) To avoid impairment of existing contracts, this subchapter shall only apply to contracts issued or renewed after July 28, 1995. (b) Any provision in a health benefit plan which is executed, delivered, or renewed, or otherwise contracts for provision of services in this state …
Ark. Code Ann. § 23-99-209 Applicability
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The provisions of this subchapter shall not apply to self-funded or other health benefit plans that are exempt from state regulation by virtue of the Employee Retirement Income Security Act of 1974, as amended.
Ark. Code Ann. § 23-99-210 Healthcare provider — Adverse professional review action
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A healthcare insurer shall not exclude a physician as a participating healthcare provider in a health benefit plan based solely on an adverse professional review action, including those described in the Arkansas Peer Review Fairness Act, § 20-9-1301 et seq., unless a hospital's p…
Ark. Code Ann. § 23-99-2101 Definitions
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(a) As used in this subchapter:(1) “Contracting entity” means a healthcare insurer or a subcontractor, affiliate, or other entity that contracts directly or indirectly with a healthcare provider for the delivery of healthcare services to patients;(2) (A) “Drug” means a substance …
Ark. Code Ann. § 23-99-2102 Drug reimbursement process
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(a) (1) A contracting entity shall provide a reasonable administrative appeal procedure to allow a healthcare provider to challenge the reimbursement for a specific drug as being below the healthcare provider's drug acquisition cost.(2) The reasonable administrative appeal proced…
Ark. Code Ann. § 23-99-211 Pharmacy benefits manager network participation — Definitions
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(a) As used in this section:(1) “Pharmacist” means an individual licensed as a pharmacist by the Arkansas State Board of Pharmacy;(2) “Pharmacy” means the place licensed by the board in which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or so…
Ark. Code Ann. § 23-99-2201 Definitions
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(1) As used in this subchapter:(1) “Crisis stabilization unit” means the same as defined in § 20-47-803;(2) (A) “Health benefit plan” means any individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer in this stat…
Ark. Code Ann. § 23-99-2202 Behavioral or medical management utilization limitations, measures, or controls
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(a) Except as provided in subsection (b) of this section, a health benefit plan shall not impose or apply any behavioral or medical management utilization limitations, measures, or controls for healthcare services by a crisis stabilization unit unless the behavioral or medical ma…
Ark. Code Ann. § 23-99-2203 Prior authorization or precertification
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A health benefit plan shall not require prior authorization or precertification for a healthcare service provided by a crisis stabilization unit unless the healthcare service requires a prior authorization by rule of the Insurance Commissioner.
Ark. Code Ann. § 23-99-2204 Rules
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The Insurance Commissioner may promulgate rules to implement this subchapter.
Ark. Code Ann. § 23-99-2301 Title
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This subchapter shall be known and may be cited as the “Pharmacy Services Administrative Organization Act”.
Ark. Code Ann. § 23-99-2302 Definitions
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(1) As used in this subchapter:(1) (A) “Administrative services” means a service provided by a pharmacy services administrative organization.(B) “Administrative services” includes without limitation:(i) Assistance with a claim;(ii) Assistance with an audit;(iii) Assistance with a…
Ark. Code Ann. § 23-99-2303 Registration required
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(a) (1) A person or organization shall not establish or operate as a pharmacy services administrative organization in Arkansas for health benefit plans without obtaining a license from the Insurance Commissioner under this subchapter.(2) The commissioner shall prescribe the appli…
Ark. Code Ann. § 23-99-2304 Notice and disclosure requirements
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(a) A pharmacy services administrative organization-pharmacy contract shall include a provision that requires a pharmacy services administrative organization to provide to a pharmacy a copy of the pharmacy services administrative organization-pharmacy contract, amendment, payment…
Ark. Code Ann. § 23-99-2305 Wholesale and pharmacy services administrative organization services — Single pharmacy services administrative organization-pharmacy contract
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(a) A pharmacy services administrative organization that owns or is owned by, in whole or in part, an entity that manufactures, sells, or distributes prescription drugs, biologicals, or medical devices, as a condition of entering into a pharmacy services administrative organizati…
Ark. Code Ann. § 23-99-2306 Notice of appeals
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(a) A pharmacy services administrative organization-pharmacy contract shall provide that if there is a dispute between a pharmacy and a pharmacy benefits manager or a third-party payer, the pharmacy services administrative organization shall ensure and facilitate timely communica…
Ark. Code Ann. § 23-99-2307 Enforcement
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(a) The Insurance Commissioner shall enforce this subchapter. (b) (1) The commissioner may examine or audit the books and records of a pharmacy services administrative organization providing claims administrative services for a pharmacy to determine if the pharmacy services admin…
Ark. Code Ann. § 23-99-301 Short title
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This subchapter shall be known and may be cited as the “Primary Eye Care Provider Act”.
Ark. Code Ann. § 23-99-302 Definitions
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(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…
Ark. Code Ann. § 23-99-303 Requirements for health benefit plans
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(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…
Ark. Code Ann. § 23-99-304 Subchapter not to prevent treatment
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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…
Ark. Code Ann. § 23-99-305 Remedies
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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…
Ark. Code Ann. § 23-99-401 Short title
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This subchapter shall be known and may be cited as the “Arkansas Health Care Consumer Act”.
Ark. Code Ann. § 23-99-402 Legislative findings and intent
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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.
Ark. Code Ann. § 23-99-403 Definitions
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(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…
Ark. Code Ann. § 23-99-404 Benefits for mothers and newborns
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(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…
Ark. Code Ann. § 23-99-405 Mastectomies. [Effective until June 30, 2031.]
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(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 …
Ark. Code Ann. § 23-99-406 Obstetrical and gynecological services
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(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…
Ark. Code Ann. § 23-99-407 “Gag clause” prohibition
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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 …
Ark. Code Ann. § 23-99-408 Continuity of care
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(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…
Ark. Code Ann. § 23-99-409 Prescription drug formulary
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(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 …
Ark. Code Ann. § 23-99-410 Grievance procedures
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(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…
Ark. Code Ann. § 23-99-411 Processing applications of providers
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(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…
Ark. Code Ann. § 23-99-412 Provider input
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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, …
Ark. Code Ann. § 23-99-413 Disclosure requirements
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(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,…
Ark. Code Ann. § 23-99-414 Rules
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The Insurance Commissioner may promulgate necessary rules for carrying out this subchapter.
Ark. Code Ann. § 23-99-415 Enforcement and penalties
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The Insurance Commissioner shall have all the powers to enforce this subchapter as are granted to the commissioner elsewhere in the Arkansas Insurance Code.
Ark. Code Ann. § 23-99-416 Application of subchapter
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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.
Ark. Code Ann. § 23-99-417 Coverage required for orthotic devices, orthotic services, prosthetic devices, and prosthetic services — Definitions
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(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…
Ark. Code Ann. § 23-99-418 Coverage for autism spectrum disorders required — Definitions
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(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…
Ark. Code Ann. § 23-99-419 Gastric pacemakers
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(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…
Ark. Code Ann. § 23-99-420 [Repealed.]
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A.C.A. § 23-99-420Current through all legislation of the 2025 Regular Session.Arkansas Code of 1987 Annotated Official EditionCopyright © 2026 by the State of Arkansas All rights reserved
Ark. Code Ann. § 23-99-421 Pediatric dental benefits — Definitions
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(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…