Arkansas Code Title 23, Subtitle 3, Chapter 76 - Health Maintenance Organizations
- § 23-76-101 - Purpose.
(a) The General Assembly determines that health maintenance organizations, when properly regulated, encourage methods of treatment and controls over the quality of care which...
- § 23-76-102 - Definitions.
As used in this chapter: (1) "Commissioner" means the Insurance Commissioner; (2) "Domestic corporation" means any corporation organized pursuant to the Arkansas Business Corporation...
- § 23-76-103 - Applicability of Arkansas Insurance Code and Laws Concerning Hospital and Medical Service Corporations.
(a) (1) Except as otherwise provided in this chapter, provisions of the insurance law and provisions of hospital and medical service corporation laws shall...
- § 23-76-104 - Arkansas Insurance Code Sections Applicable to Health Maintenance Organizations.
(a) Except to the extent that the Insurance Commissioner determines that the nature of health maintenance organizations, healthcare plans, and evidences of coverage render...
- § 23-76-105 - Penalties -- Enforcement.
(a) In lieu of suspension or revocation of a certificate of authority under § 23-76-123, the Insurance Commissioner may levy an administration penalty in...
- § 23-76-106 - License to Practice, Sell, or Dispense Required.
No person shall perform any of the services or procedures or sell or dispense any goods or devices in the field of the healing...
- § 23-76-107 - Establishment.
(a) (1) Any person that meets the requirements of § 23-76-102(9) may apply to the Insurance Commissioner for and obtain a certificate of authority...
- § 23-76-108 - Issuance of Certificate of Authority.
(a) Upon receipt of an application for issuance of a certificate of authority, the Insurance Commissioner shall determine whether the applicant furnishes or proposes...
- § 23-76-109 - Powers.
(a) The powers of a health maintenance organization include, but are not limited to, the following: (1) The purchase, lease, construction, renovation, operation, or...
- § 23-76-110 - Advisory Board.
(a) The advisory board of any health maintenance organization shall include at least one (1) physician, one (1) dentist, one (1) pharmacist, one (1)...
- § 23-76-111 - Fiduciary Responsibilities of Director, Officer, or Partner.
(a) Any director, officer, or partner of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of...
- § 23-76-112 - Evidence of Coverage and Charges for Healthcare Services.
(a) (1) (A) Every enrollee residing in this state is entitled to evidence of coverage under a healthcare plan. (B) If the enrollee obtains...
- § 23-76-113 - Annual Report and Quarterly Report.
(a) A health maintenance organization shall annually on or before March 1 file a report verified by at least two (2) principal officers with...
- § 23-76-114 - Information to Enrollees.
(a) A health maintenance organization shall make available to its subscribers a list of providers upon enrollment and re-enrollment.(b) Every health maintenance organization shall...
- § 23-76-115 - Open Enrollment.
(a) (1) After a health maintenance organization has been in operation twenty-four (24) months, it shall have an annual open enrollment period of at...
- § 23-76-116 - Complaint System.
(a) (1) Every health maintenance organization shall establish and maintain a complaint system that has been approved by the Insurance Commissioner to provide reasonable...
- § 23-76-117 - Investments.
With the exception of investments made in accordance with § 23-76-109(a)(1) and (2) and § 23-76-109(b), the investable funds of a health maintenance organization...
- § 23-76-118 - Protection Against Insolvency.
(a) Deposit Requirements. (1) (A) All health maintenance organizations authorized to transact business in this state shall deposit through the Insurance Commissioner securities eligible...
- § 23-76-119 - Prohibited Practices.
(a) No health maintenance organization, or representative thereof, may knowingly cause or knowingly permit the use of advertising that is untrue or misleading, solicitation...
- § 23-76-120 - Regulation of Agents.
(a) After notice and hearing, the Insurance Commissioner may promulgate such reasonable rules and regulations as are necessary to provide for the licensing of...
- § 23-76-121 - Powers of Insurers and Hospital and Medical Service Corporations.
(a) An insurance company licensed in this state, or a hospital or medical service corporation authorized to do business in this state, may either...
- § 23-76-122 - Examinations.
(a) The Insurance Commissioner may make an examination of the affairs of any health maintenance organization as often as he or she deems it...
- § 23-76-123 - Suspension or Revocation of Certificate of Authority.
(a) The Insurance Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if the commissioner...
- § 23-76-124 - Rehabilitation, Liquidation, or Conservation of Health Maintenance Organization.
(a) Any rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance...
- § 23-76-125 - Regulations.
(a) After notice and hearing, the Insurance Commissioner may promulgate reasonable rules and regulations, not inconsistent with existing statutes of this state, as are...
- § 23-76-126 - Administrative Proceedings.
(a) (1) If the Insurance Commissioner has cause to believe that grounds for the suspension or revocation of a certificate of authority exist, the...
- § 23-76-127 - Fees.
A health maintenance organization subject to this chapter shall pay to the State Insurance Department Trust Fund as special revenues the following fees: (1)...
- § 23-76-128 - Applications, Filings, and Reports Public.
All applications, filings, and reports required under this chapter shall be treated as public documents.
- § 23-76-129 - Medical Information Confidential -- Exceptions.
(a) Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from the person or from any...
- § 23-76-130 - Insurance Commissioner's Authority to Contract.
(a) The Insurance Commissioner may contract with qualified persons to make recommendations concerning the adequacy, network adequacy, or accessibility of healthcare services under a...
- § 23-76-131 - Tax on Premiums and Copayments.
(a) (1) (A) (i) Each health maintenance organization shall pay a tax on the premiums for coverages provided during the calendar year. (ii) The...
- § 23-76-132 - College Students.
If a health maintenance organization requires the selection or assignment of a primary care physician, the health maintenance organization shall provide an enrollee who...
Last modified: November 15, 2016