Ark. Code § 23-99-1502

Current with legislation from 2024 Fiscal and Special Sessions.

Section 23-99-1502 - Definitions

As used in this subchapter:

(1) "Enrollee" means an individual who is entitled to receive healthcare services under the terms of a health benefit plan;

(2)

(A) "Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, delivered, or extended in this state by a healthcare payor in this state.

(B) "Health benefit plan" includes:

(i) Indemnity and managed care plans; and

(ii) Plans providing health benefits to state and public school employees under § 21-5-401 et seq.

(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., and 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; or

(ix) A specified disease plan;

(3)

(A) "Healthcare payor" means:

(i) A health insurance company;

(ii) A health maintenance organization;

(iii) A hospital and medical services corporation; and

(iv) An entity that provides or administers a self-funded health benefit plan, including a governmental plan.

(B) "Healthcare payor" does not include an entity that provides only dental benefits or eye and vision care benefits;

(4) "Healthcare provider" means individuals or entities licensed by the State of Arkansas to provide healthcare services, limited to the following:

(A) Advanced practice nurses;

(B) Athletic trainers;

(C) Audiologists;

(D) Certified behavioral health providers;

(E) Certified orthotists;

(F) Chiropractors;

(G) Community mental health centers or clinics;

(H) Dentists;

(I) Home health care;

(J) Hospice care;

(K) Hospital-based services;

(L) Hospitals;

(M) Licensed ambulatory surgery centers;

(N) Licensed certified social workers;

(O) Licensed dieticians;

(P) Licensed intellectual and developmental disabilities service providers;

(Q) Licensed professional counselors;

(R) Licensed psychological examiners;

(S) Long-term care facilities;

(T) Occupational therapists;

(U) Optometrists;

(V) Pharmacists;

(W) Physical therapists;

(X) Physicians and surgeons (M.D. and D.O.);

(Y) Podiatrists;

(Z) Prosthetists;

(AA) Psychologists;

(BB) Respiratory therapists;

(CC) Rural health clinics; and

(DD) Speech pathologists;

(5) "Healthcare services" means services and products, including prescription medication, provided by a healthcare provider within the scope of the healthcare provider's license; and

(6) "Prescription medication" means a drug or biologic that is prescribed by a healthcare provider to a patient for the purpose of alleviating, curing, preventing, or healing illness, injury, or physical disability.

Ark. Code § 23-99-1502

Added by Act 2021, No. 1105,§ 1, eff. 7/28/2021.