Stricken language would be deleted from and underlined language would be added to present law.
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State of Arkansas 1
94th General Assembly A Bill 2
Regular Session, 2023 SENATE BILL 119 3
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By: Senator Irvin 5
By: Representative L. Johnson 6
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For An Act To Be Entitled 8
AN ACT TO CLARIFY PA YMENT FOR HEALTHCARE SERVICES 9
PERFORMED BY CERTAIN OUTPATIENT SURGERY C ENTERS; AND 10
FOR OTHER PURPOSES. 11
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Subtitle 14
TO CLARIFY PAYMENT FOR HEALTHCARE 15
SERVICES PERFORMED BY CERTAIN OUTPATIENT 16
SURGERY CENTERS. 17
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 20
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SECTION 1. Arkansas Code § 23 -79-115(a), concerning the rates of 22
insurance policy reimbursement for services, is amended to read as follows: 23
(a)(1)(A) Notwithstanding any provisions of any individual or group 24
accident and health insurance policy, or any provision of a policy, contract, 25
plan, or agreement covering hospital or medical services, in In cases in 26
which the insurer, under a policy, contract, plan, or agreement, provides for 27
payment or reimbursement for any healthcare service provided by hospitals or 28
related facilities a hospital or related facility as defined in § 20-9-201 or 29
§ 20-10-213, the person entitled to payment or reimbursement for the 30
healthcare services service under the policy, contract, plan, or agreement, 31
including without limitation a healthcare provider, is entitled to payment or 32
reimbursement on an equal basis for the healthcare service when the 33
healthcare service is provided by facilities a facility licensed as an 34
outpatient surgery centers center under §§ 20-9-214 and 20-9-215. 35
(B) Subdivision (a)(1)(A) of this section applies 36 SB119
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notwithstanding any provision of: 1
(i) An individual or group accident and health 2
insurance policy; 3
(ii) A policy, contract, plan, or agreement covering 4
hospital or medical services; 5
(iii) A network participation agreement; or 6
(iv) An agreement between an insurer and a 7
healthcare provider. 8
(2) This subsection applies to an insurance policies policy and 9
hospital service corporation contracts contract that are is delivered or 10
issued for delivery in this state more than one hundred twenty (120) days 11
after July 6, 1977, and to such any other contracts, plans, or agreements 12
contract, plan, or agreement that are is entered into or effectuated in this 13
state more than one hundred twenty (120) days after July 6, 1977, including 14
without limitation a network participation agreement or an agreement between 15
an insurer and a healthcare provider. 16
(3)(A) An insurer may consider and apply the Patient Protection 17
Act of 1995, § 23-99-201 et seq., and § 23-99-801 et seq. when setting a rate 18
for payment or reimbursement for a healthcare service that is provided by an 19
outpatient surgery center licensed under §§ 20-9-214 and 20-9-215. 20
(B) An insurer shall not set a rate for payment or 21
reimbursement for a healthcare service that is less than ninety percent (90%) 22
of the average rate of payment or reimbursement for a healthcare service by 23
an insurer under the relevant Current Procedural Terminology code for a 24
procedure billed as a hospital outpatient service for a county where the 25
outpatient surgery center licensed under §§ 20-9-214 and 20-9-215 is located. 26
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