§ 23-99-802 - Definitions. - Arkansas Statutes

23-99-802. Definitions.

As used in this subchapter:

(1) "Any willing provider law" means a law that prohibits discrimination against a provider willing to meet the terms and conditions for participation established by a health insurer or that otherwise precludes an insurer from prohibiting or limiting participation by a provider who is willing to accept a health insurer's terms and conditions for participation in the provision of services through a health benefit plan;

(2) "ERISA" means the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1001 et seq.;

(3) "Health benefit plan" means any health insurance policy or certificate, health maintenance organization contract, hospital and medical service corporation contract or certificate, a self-insured plan or a plan provided by a multiple employer welfare arrangement, to the extent permitted by ERISA, the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1001 et seq., or any health benefit plan that affects the rights of an Arkansas insured and bears a reasonable relation to Arkansas, whether delivered or issued for delivery in Arkansas;

(4) "Health care provider" or "provider" means those individuals or entities licensed by the State of Arkansas to provide health care services, limited to the following:

(A) Advanced practice nurses;

(B) Athletic trainers;

(C) Audiologists;

(D) Certified orthotists;

(E) Chiropractors;

(F) Community mental health centers or clinics;

(G) Dentists;

(H) Home health care;

(I) Hospice care;

(J) Hospital-based services;

(K) Hospitals;

(L) Licensed ambulatory surgery centers;

(M) Licensed certified social workers;

(N) Licensed dieticians;

(O) Licensed durable medical equipment providers;

(P) Licensed professional counselors;

(Q) Licensed psychological examiners;

(R) Long-term care facilities;

(S) Occupational therapists;

(T) Optometrists;

(U) Pharmacists;

(V) Physical therapists;

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

(X) Podiatrists;

(Y) Prosthetists;

(Z) Psychologists;

(AA) Respiratory therapists;

(BB) Rural health clinics;

(CC) Speech pathologists; and

(DD) Other health care practitioners as determined by the department in regulations promulgated under the Arkansas Administrative Procedure Act, 25-15-201, et seq.;

(5) "Health insurer" or "health care insurer" means any entity that is authorized by the State of Arkansas to offer or provide health benefit plans, policies, subscriber contracts, or any other contracts of a similar nature which indemnify or compensate health care providers for the provision of health care services;

(6) "Noninsurer" means an entity that is not required to obtain authorization from the department to do business as a health insurer but that does have a provider network; and

(7) "Self-insured" includes self-funded and vice versa.