§ 20-9-911. Revocation or denial of certificate
(a) The State Board of Health may revoke or deny a certificate if the holder does not comply with performance assurances under this section, violates any provision of this subchapter, or violates any rule adopted pursuant to this subchapter. (b) The board shall deny a certificate to any applicant if upon review of the application […]
§ 20-9-901. Purpose
The purpose of this subchapter is to: (1) Promote the delivery of quality health care in a cost-effective manner; (2) Foster greater coordination between payors and providers conducting utilization review activities; (3) Protect patients, business, and providers by ensuring that private review agents are qualified to perform utilization activities and to make informed decisions on […]
§ 20-9-902. Definitions
As used in this subchapter: (1) [Repealed.] (2) “Certificate” means a certificate of registration granted by the State Board of Health to a private review agent; (3) (A) “Private review agent” means a nonhospital-affiliated person or entity performing utilization review on behalf of: (i) An employer of employees in the State of Arkansas; or (ii) […]
§ 20-9-903. Certificate required
A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or medical services on a case-by-case basis may not conduct utilization review in this state unless the State Board of Health […]