23-99-902. Definitions.

Arkansas Code — all titles (historical 2020) · legal_authorities

23-99-902. Definitions.

23-99-902. Definitions. As used in this subchapter: (1) “Alternative payment system” means a payment methodology used by a healthcare payor that includes a risk-sharing or gain-sharing component for a healthcare provider that participates in a plan, program, or network offered by the healthcare payor; (2) “Gain-sharing payment” means an increase in a payment or additional payments made by a healthcare payor to a healthcare provider as a result of the achievement of identified benchmarks, including without limitation that patient care costs fall below cost thresholds of any form; (3)(A) “Healthcare payor” means an entity that reimburses a physician for the delivery of healthcare services that are covered by a plan administered, issued, or delivered by the entity. (B) “Healthcare payor” does not include a provider-based network or system that utilizes risk-sharing including an accountable care organization or a clinically integrated network; (4) “Healthcare provider” means any type of provider that renders healthcare services to patients for compensation, including: (A) A doctor of medicine, a doctor of osteopathy, or another licensed healthcare professional acting within the professional's licensed scope of practice; or (B) A healthcare facility, including a hospital, ambulatory surgery center, or other type of facility licensed in this state to provide healthcare services; and (5)(A) “Risk-sharing payment” means a reduction in a payment to or refund of a payment already made to a healthcare provider as a result of failure to achieve identified benchmarks, including without limitation that patient care costs exceed cost thresholds of any form. (B) “Risk-sharing payment” includes the alternative payment method by gift card, credit card, or other type of

Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-99-902

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.