(a) As used in this section:
(1) "Prior authorization" means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and
(2) "Telemedicine" means the medium of delivering clinical healthcare services by means of real-time two-way electronic audiovisual communications, including without limitation the application of secure video conferencing, to provide or support healthcare delivery that facilitates the assessment, diagnosis, consultation, treatment, education, care management, or self-management of a patient's health care while the patient is at an originating site and the healthcare professional is at a distant site.
(b) When conducting prior authorization, whether for healthcare services provided through telemedicine or provided in person, a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas shall make all adverse determinations.
Section: Previous 23-86-110 23-86-111 23-86-112 23-86-113 23-86-114 23-86-115 23-86-116 23-86-117 23-86-118 23-86-119 23-86-120 23-86-121 23-86-122 23-86-123Last modified: November 15, 2016