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Current as of March 28, 2024 | Updated by Findlaw Staff
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.
Cite this article: FindLaw.com - Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-99-1502. Definitions - last updated March 28, 2024 | https://codes.findlaw.com/ar/title-23-public-utilities-and-regulated-industries/ar-code-sect-23-99-1502/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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