Ark. Code Ann. § 23-99-1602: Definitions

As used in this subchapter: (1) "Authorized designee" means an entity that is: (A) Designated by a healthcare payor to operate on its behalf; and (B) Authorized to access an enrollee's protected health information under the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, as it existed on January 1, 2023; (2) "Enrollee" means an individual who is entitled to receive healthcare services under the terms of a health benefit plan; (3) (A) "Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan 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; (4) (A) "Healthcare payor" means: (i) A health insurance company; (ii) A health maintenance organization; (iii) A hospital and medical service corporation; or (iv) An entity that: (a) Provides or administers a self-funded health benefit plan, including a governmental plan; or (b) Performs utilization review for a self-funded health benefit plan, including a governmental plan. (B) "Healthcare payor" includes any entity that is subject to any of the following laws: (i) The insurance laws of this state; (ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or (iii) Section 23-76-101 et seq., pertaining to health maintenance organizations. (C) "Healthcare payor" does not include an entity that provides only dental benefits or eye and vision care benefits; (5) (A) "Healthcare provider" means a person that is licensed, certified, or otherwise authorized by the laws of this state to provide healthcare services. (B) "Healthcare provider" includes only: (i) Advanced practice nurses; (ii) Athletic trainers; (iii) Audiologists; (iv) Certified behavioral health providers; (v) Certified orthotists; (vi) Chiropractors; (vii) Community mental health centers or clinics; (viii) Dentists; (ix) Home health care; (x) Hospice care; (xi) Hospital-based services; (xii) Hospitals; (xiii) Licensed ambulatory surgery centers; (xiv) Licensed certified social workers; (xv) Licensed dieticians; (xvi) Licensed intellectual and developmental disabilities service providers; (xvii) Licensed professional counselors; (xviii) Licensed psychological examiners; (xix) Long-term care facilities; (xx) Occupational therapists; (xxi) Optometrists; (xxii) Pharmacists; (xxiii) Physical therapists; (xxiv) Physicians and surgeons; (xxv) Podiatrists; (xxvi) Prosthetists; (xxvii) Psychologists; (xxviii) Respiratory therapists; (xxix) Rural health clinics; and (xxx) Speech pathologists; (6) "Healthcare services" means services and products, including prescription medication, provided by a healthcare provider within the scope of the healthcare provider's license; (7) (A) "Medical records" means the hospital or clinic records, physicians' records, or other healthcare records that a healthcare provider retains on an enrollee related to the enrollee's medical conditions

pathologists; (6) "Healthcare services" means services and products, including prescription medication, provided by a healthcare provider within the scope of the healthcare provider's license; (7) (A) "Medical records" means the hospital or clinic records, physicians' records, or other healthcare records that a healthcare provider retains on an enrollee related to the enrollee's medical conditions. (B) "Medical records" includes other reports, documents, or records that a healthcare provider has concerning: (i) The healthcare services provided to the enrollee; (ii) The enrollee's medical history; and (iii) Prescription medications written, procedures ordered, or any other information related to the patient's overall health; and (8) "Prescription medication" means a drug or biologic that is prescribed by a healthcare provider to an enrollee for the purpose of alleviating, curing, preventing, or healing illness, injury, or physical disability. Added by Act 2023, No. 502,§ 1, eff. 1/1/2024.

As used in this subchapter:

(1) "Authorized designee" means an entity that is: (A) Designated by a healthcare payor to operate on its behalf; and (B) Authorized to access an enrollee's protected health information under the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, as it existed on January 1, 2023;

(A) Designated by a healthcare payor to operate on its behalf; and

(B) Authorized to access an enrollee's protected health information under the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, as it existed on January 1, 2023;

(2) "Enrollee" means an individual who is entitled to receive healthcare services under the terms of a health benefit plan;

(3) (A) "Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan 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;

(A) "Health benefit plan" means an individual, blanket, or group plan, policy, or contract for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan 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.

for healthcare services issued, renewed, or extended in this state by a healthcare insurer, health maintenance organization, hospital medical service corporation, or self-insured governmental or church plan 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.

(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;

(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;

(4) (A) "Healthcare payor" means: (i) A health insurance company; (ii) A health maintenance organization; (iii) A hospital and medical service corporation; or (iv) An entity that: (a) Provides or administers a self-funded health benefit plan, including a governmental plan; or (b) Performs utilization review for a self-funded health benefit plan, including a governmental plan. (B) "Healthcare payor" includes any entity that is subject to any of the following laws: (i) The insurance laws of this state; (ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or (iii) Section 23-76-101 et seq., pertaining to health maintenance organizations. (C) "Healthcare payor" does not include an entity that provides only dental benefits or eye and vision care benefits;

(A) "Healthcare payor" means: (i) A health insurance company; (ii) A health maintenance organization; (iii) A hospital and medical service corporation; or (iv) An entity that: (a) Provides or administers a self-funded health benefit plan, including a governmental plan; or (b) Performs utilization review for a self-funded health benefit plan, including a governmental plan.

(i) A health insurance company;

(ii) A health maintenance organization;

(iii) A hospital and medical service corporation; or

(iv) An entity that: (a) Provides or administers a self-funded health benefit plan, including a governmental plan; or (b) Performs utilization review for a self-funded health benefit plan, including a governmental plan.

(a) Provides or administers a self-funded health benefit plan, including a governmental plan; or

(b) Performs utilization review for a self-funded health benefit plan, including a governmental plan.

(B) "Healthcare payor" includes any entity that is subject to any of the following laws: (i) The insurance laws of this state; (ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or (iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.

) Performs utilization review for a self-funded health benefit plan, including a governmental plan.

(B) "Healthcare payor" includes any entity that is subject to any of the following laws: (i) The insurance laws of this state; (ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or (iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.

(i) The insurance laws of this state;

(ii) Section 23-75-101 et seq., pertaining to hospital and medical service corporations; or

(iii) Section 23-76-101 et seq., pertaining to health maintenance organizations.

(C) "Healthcare payor" does not include an entity that provides only dental benefits or eye and vision care benefits;

(5) (A) "Healthcare provider" means a person that is licensed, certified, or otherwise authorized by the laws of this state to provide healthcare services. (B) "Healthcare provider" includes only: (i) Advanced practice nurses; (ii) Athletic trainers; (iii) Audiologists; (iv) Certified behavioral health providers; (v) Certified orthotists; (vi) Chiropractors; (vii) Community mental health centers or clinics; (viii) Dentists; (ix) Home health care; (x) Hospice care; (xi) Hospital-based services; (xii) Hospitals; (xiii) Licensed ambulatory surgery centers; (xiv) Licensed certified social workers; (xv) Licensed dieticians; (xvi) Licensed intellectual and developmental disabilities service providers; (xvii) Licensed professional counselors; (xviii) Licensed psychological examiners; (xix) Long-term care facilities; (xx) Occupational therapists; (xxi) Optometrists; (xxii) Pharmacists; (xxiii) Physical therapists; (xxiv) Physicians and surgeons; (xxv) Podiatrists; (xxvi) Prosthetists; (xxvii) Psychologists; (xxviii) Respiratory therapists; (xxix) Rural health clinics; and (xxx) Speech pathologists;

(A) "Healthcare provider" means a person that is licensed, certified, or otherwise authorized by the laws of this state to provide healthcare services.

(B) "Healthcare provider" includes only: (i) Advanced practice nurses; (ii) Athletic trainers; (iii) Audiologists; (iv) Certified behavioral health providers; (v) Certified orthotists; (vi) Chiropractors; (vii) Community mental health centers or clinics; (viii) Dentists; (ix) Home health care; (x) Hospice care; (xi) Hospital-based services; (xii) Hospitals; (xiii) Licensed ambulatory surgery centers; (xiv) Licensed certified social workers; (xv) Licensed dieticians; (xvi) Licensed intellectual and developmental disabilities service providers; (xvii) Licensed professional counselors; (xviii) Licensed psychological examiners; (xix) Long-term care facilities; (xx) Occupational therapists; (xxi) Optometrists; (xxii) Pharmacists; (xxiii) Physical therapists; (xxiv) Physicians and surgeons; (xxv) Podiatrists; (xxvi) Prosthetists; (xxvii) Psychologists; (xxviii) Respiratory therapists; (xxix) Rural health clinics; and (xxx) Speech pathologists;

(i) Advanced practice nurses;

(ii) Athletic trainers;

(iii) Audiologists;

(iv) Certified behavioral health providers;

(v) Certified orthotists;

(vi) Chiropractors;

(vii) Community mental health centers or clinics;

(viii) Dentists;

(ix) Home health care;

(xxvi) Prosthetists; (xxvii) Psychologists; (xxviii) Respiratory therapists; (xxix) Rural health clinics; and (xxx) Speech pathologists;

(i) Advanced practice nurses;

(ii) Athletic trainers;

(iii) Audiologists;

(iv) Certified behavioral health providers;

(v) Certified orthotists;

(vi) Chiropractors;

(vii) Community mental health centers or clinics;

(viii) Dentists;

(ix) Home health care;

(x) Hospice care;

(xi) Hospital-based services;

(xii) Hospitals;

(xiii) Licensed ambulatory surgery centers;

(xiv) Licensed certified social workers;

(xv) Licensed dieticians;

(xvi) Licensed intellectual and developmental disabilities service providers;

(xvii) Licensed professional counselors;

(xviii) Licensed psychological examiners;

(xix) Long-term care facilities;

(xx) Occupational therapists;

(xxi) Optometrists;

(xxii) Pharmacists;

(xxiii) Physical therapists;

(xxiv) Physicians and surgeons;

(xxv) Podiatrists;

(xxvi) Prosthetists;

(xxvii) Psychologists;

(xxviii) Respiratory therapists;

(xxix) Rural health clinics; and

(xxx) Speech pathologists;

(6) "Healthcare services" means services and products, including prescription medication, provided by a healthcare provider within the scope of the healthcare provider's license;

(7) (A) "Medical records" means the hospital or clinic records, physicians' records, or other healthcare records that a healthcare provider retains on an enrollee related to the enrollee's medical conditions. (B) "Medical records" includes other reports, documents, or records that a healthcare provider has concerning: (i) The healthcare services provided to the enrollee; (ii) The enrollee's medical history; and (iii) Prescription medications written, procedures ordered, or any other information related to the patient's overall health; and

(A) "Medical records" means the hospital or clinic records, physicians' records, or other healthcare records that a healthcare provider retains on an enrollee related to the enrollee's medical conditions.

(B) "Medical records" includes other reports, documents, or records that a healthcare provider has concerning: (i) The healthcare services provided to the enrollee; (ii) The enrollee's medical history; and (iii) Prescription medications written, procedures ordered, or any other information related to the patient's overall health; and

(i) The healthcare services provided to the enrollee;

(ii) The enrollee's medical history; and

(iii) Prescription medications written, procedures ordered, or any other information related to the patient's overall health; and

(8) "Prescription medication" means a drug or biologic that is prescribed by a healthcare provider to an enrollee for the purpose of alleviating, curing, preventing, or healing illness, injury, or physical disability.