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23-79-1205. Coverage by participating providers — Selection criteria and utilization protocols — Maximum benefits — Exclusions.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-79-1205. Coverage by participating providers — Selection criteria and utilization protocols — Maximum benefits — Exclusions.
(a)(1) This subchapter does not require and shall not be construed to require the coverage of services by providers who are not designated as covered providers or that are not selected as a participating provider by a group health benefit plan or insurer having a participating network of service providers.
(2) This subchapter does not expand the list or designation of participating providers as specified in any health benefit plan.
(b) Insurers or other issuers of any health benefit plan covered by this subchapter may continue to establish and apply selection criteria and utilization protocols for healthcare providers including:
(1) The designation of types of providers for which coverage is provided; and
(2) Credentialing criteria used in the selection of providers.
(c) A healthcare policy that provides coverage for the services offered under this subchapter may contain provisions for maximum benefits and coinsurance limitations, deductibles, exclusions, and utilization review protocols to the extent that the provisions are not inconsistent with the requirements of this subchapter.
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-79-1205
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. A text match is a research starting point; applicability is not established.
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Record provenance
Stable record: arkansas_code:legal_authorities:23-79-1205
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: 20269b18e91372352a194827275e9288d76f117e675055bbf0e5b9d4a03a8379
Source location: content.xml paragraph 47800
Stored source content
23-79-1205. Coverage by participating providers — Selection criteria and utilization protocols — Maximum benefits — Exclusions.
(a)(1) This subchapter does not require and shall not be construed to require the coverage of services by providers who are not designated as covered providers or that are not selected as a participating provider by a group health benefit plan or insurer having a participating network of service providers.
(2) This subchapter does not expand the list or designation of participating providers as specified in any health benefit plan.
(b) Insurers or other issuers of any health benefit plan covered by this subchapter may continue to establish and apply selection criteria and utilization protocols for healthcare providers including:
(1) The designation of types of providers for which coverage is provided; and
(2) Credentialing criteria used in the selection of providers.
(c) A healthcare policy that provides coverage for the services offered under this subchapter may contain provisions for maximum benefits and coinsurance limitations, deductibles, exclusions, and utilization review protocols to the extent that the provisions are not inconsistent with the requirements of this subchapter.
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