Physician contacted by requesting healthcare provider under ARK INS 23-99-1111(c)(3)(A) shall disclose their name, license information to requesting healthcare provider.
If a healthcare provider submits an audio recording demonstrating a violation to the State Insurance Department, requested prior authorization is deemed approved.
Department shall direct utilization review entity to issue requested prior authorization.
Upon an adverse determination by utilization review entity, entity shall provide written notice to subscriber, shall include clear explanation of basis for adverse determination.
Explanation to include listing of clinical criteria, reason why provisions apply, procedure through which subscriber may request copy of report that led to adverse determination
Also information that explains to the subscriber the right to appeal the adverse determination, address and telephone number to make a complaint to State board.
Utilization review entity shall treat subscriber’s request for information as a request.
Legislative History
On Mar. 6, 2025, bill was introduced in House; on Mar. 13, 2025, bill passed House.
On Mar. 13, 2025, bill was introduced in Senate; on Apr. 8, 2025, bill passed Senate.
On Apr. 10, 2025, bill concurred in House; On Apr. 16, 2025, bill signed by governor.
Effectiveness
Act effective 91 days after legislature adjourned sine die (May 5), so Aug. 4, 2025.
