§ 23-99-801 — Application and intent

Arkansas § 23-99-801

• Jurisdiction: Arkansas
• Title: 23

Text

(a) The state's any willing provider laws shall not be construed: (1) To require all physicians or a percentage of physicians in the state or a locale to participate in the provision of services for a health maintenance organization; or (2) To take away the authority of health maintenance organizations that provide coverage of physician services to set the terms and conditions for participation by physicians, though health maintenance organizations shall apply the terms and conditions in a nondiscriminatory manner. (b) (1) The state's any willing provider laws shall apply to: (A) All health insurers, regardless of whether they are providing insurance, including prepaid coverage, or administering or contracting to provide provider networks; and (B) All multiple-employer welfare arrangements and multiple-employer trusts. (2) This subsection shall apply only to the extent permitted by the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. § 1001 et seq. (c) (1) The state's any willing provider laws shall be construed to include within their provider definitions all those providers of the same class or classes who are: (A) Practicing or operating within a border city in an adjoining state; and (B) Licensed or authorized to practice or operate by the adjoining state, regardless of whether the provider is licensed or otherwise authorized to operate in Arkansas. (2) As used in this section, "border city" means a city in a state adjoining Arkansas which adjoins the Arkansas state line and is not separated from an Arkansas city only by a navigable river. (d) (1) As clarification, nothing in the state's any willing provider laws shall be construed to cover or regulate healthcare provider networks offered by noninsurers. (2) If an employer sponsoring a self-insured health benefit plan contracts directly with providers or contracts for a healthcare provider network through a noninsurer, then the any willing provider law does not apply. (3) If a health insurer subcontracts with a noninsurer whose healthcare network does not meet the requirements of the any willing provider law, then the noninsurer may create a separate healthcare provider network that meets the requirements of the any willing provider law. (4) If the noninsurer chooses not to create the separate healthcare provider network, then the responsibility for compliance with the any willing provider law is the obligation of the health insurer to the extent permitted by the federal Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. § 1001 et seq. (e) Notwithstanding the provisions of subsection (d) of this section, the Patient Protection Act of 1995, § 23-99-201 et seq., and this subchapter apply to a health benefit plan provided by the State of Arkansas to state employees and public school personnel under § 21-5-401 et seq., whether self-funded or insured.

Legislative History

Acts 2005, No. 491, § 4; 2009, No. 702, § 1.