§ 23-99-201. Short title

This subchapter may be cited as the “Patient Protection Act of 1995”.

§ 23-99-202. Legislative findings and intent

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 the opportunity of providers to participate […]

§ 23-99-203. Definitions

(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 time the service is rendered. (3) The copayment may be […]

§ 23-99-204. Terms of health benefit plan

(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 offered. (B) “Monetary advantage or penalty” includes: (i) A higher copayment; (ii) […]

§ 23-99-205. Construction

(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 provide that service.

§ 23-99-206. Violations

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 violation on the basis of actions taken by the […]

§ 23-99-207. Civil penalties

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 damages. The prevailing party shall be allowed a […]

§ 23-99-208. Void provisions

(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 that is contrary to this subchapter, shall, to the extent […]

§ 23-99-209. Applicability

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.

§ 23-99-210. Healthcare provider — Adverse professional review action

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 physician peer review committee concludes that the conduct of the physician adversely […]