Stricken language would be deleted from and underlined language would be added to present law.
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State of Arkansas As Engrossed: S1/30/23 1
94th General Assembly A Bill 2
Regular Session, 2023 SENATE BILL 122 3
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By: Senator B. King 5
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For An Act To Be Entitled 7
AN ACT TO CREATE THE HEALTHCARE COST-SHARING 8
COLLECTIONS ACT; AND FOR OTHER PURPOSES. 9
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Subtitle 12
TO CREATE THE HEALTHCARE COST -SHARING 13
COLLECTIONS ACT. 14
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 17
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SECTION 1. Arkansas Code Title 23, Chapter 99, is amended to add an 19
additional subchapter to read as follows: 20
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Subchapter 16 — Healthcare Cost-Sharing Collections Act 22
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23-99-1601. Title. 24
This subchapter shall be known and may be cited as the "Healthcare 25
Cost-Sharing Collections Act". 26
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23-99-1602. Definitions. 28
As used in this subchapter: 29
(1)(A) "Cost sharing" means t he share of costs covered by a 30
health benefit plan for which an enrollee is financial responsible. 31
(B) "Cost sharing" includes deductibles, co insurance, 32
copayments, or similar charges. 33
(C) "Cost sharing" does not include premiums, balance 34
billing amounts for nonnetwork providers, or the cost of noncovered 35
healthcare services; 36 As Engrossed: S1/30/23 SB122
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(2)(A) "Contracting entity" means a healthcare insurer, 1
subcontractor, affiliate, or other entity that contracts directly or 2
indirectly with a healthcare provider for the delivery of healthcare services 3
to an enrollee. 4
(B) "Contracting entity" includes without limitation: 5
(i) An insurance company; 6
(ii) A health maintenance organization; 7
(iii) A hospital and medical service corporation; 8
(iv) A preferred provider organization; 9
(v) A risk-based provider organization; 10
(vi) Third-party administrator; and 11
(vii) A prescription ben efit management company; 12
(3) "Enrollee" means an individual who is entitled to receive 13
healthcare services under the terms of a health benefit plan; 14
(4) "Entity of the state" means any agency, board, bureau, 15
commission, committee, council, department, division, institution of higher 16
education, office, public school, quasi -public organization, or other 17
political subdivision of the state; 18
(5)(A) "Health benefit plan" means an individual, blanket, or 19
group plan, policy, or contract for healt hcare services issued, renewed, or 20
extended in this state by a healthcare insurer. 21
(B) "Health benefit plan" includes a nonfederal 22
governmental plan as defined in 29 U.S.C. § 1002(32), as it existed on 23
January 1, 2023. 24
(C) "Health benefit plan" doe s not include: 25
(i) A plan that provides only dental benefits or eye 26
and vision care benefits; 27
(ii) A disability income plan; 28
(iii) A credit insurance plan; 29
(iv) Insurance coverage issued as a supplement to 30
liability insurance; 31
(v) Medical payments under an automobile or 32
homeowners insurance plan; 33
(vi) A health benefit plan provided under Arkansas 34
Constitution, Article 5, § 32, the Workers’ Compensation Law, § 11 -9-101 et 35
seq., or the Public Employee Workers’ Compensation Act, § 21-5-601 et seq.; 36 As Engrossed: S1/30/23 SB122
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(vii) A plan that provides only indemnity for 1
hospital confinement; 2
(viii) An accident-only plan; 3
(ix) A specified disease plan; 4
(x) A policy, contract, certificate, or agreement 5
offered or issued by a healthcare in surer to provide, deliver, arrange for, 6
pay for, or reimburse any of the costs of healthcare services, including 7
pharmacy benefits, to an entity of the state; 8
(xi) A long-term care insurance plan; or 9
(xii) A healthcare provider self -insured plan; 10
(6) "Healthcare contract" means a contract entered into, 11
materially amended, or renewed between a contracting entity and a healthcare 12
provider for the delivery of healthcare services to an enrollee; 13
(7)(A) "Healthcare insurer" means an entity that i s subject to 14
state insurance regulation and provides health insurance in this state. 15
(B) "Healthcare insurer" includes: 16
(i) An insurance company; 17
(ii) A health maintenance organization; 18
(iii) A hospital and medical service corporation; 19
(iv) A risk-based provider organization; and 20
(v) Any sponsor of a nonfederal self -funded 21
governmental plan in this state; 22
(8) "Healthcare provider" means a person or entity that is 23
licensed, certified, or otherwise authorized by the laws of this state to 24
administer healthcare services; and 25
(9) "Healthcare services" means services or goods provided for 26
preventing, diagnosing, treating, alleviating, relieving, curing, or healing 27
human illness, disease, condition, disability, or injury. 28
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23-99-1603. Collection by healthcare insurer — Authority. 30
(a) A healthcare insurer shall: 31
(1) Pay a healthcare provider the full amount due for healthcare 32
services under the terms of a health benefit plan, including any cost 33
sharing; 34
(2) Have the sole responsibility for collecting cost sharing 35
from an enrollee; and 36 As Engrossed: S1/30/23 SB122
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(3) Upon request of the enrollee, collect cost -sharing 1
throughout the plan year in increments defined by the healthcare insurer. 2
(b) A healthcare insurer shall not: 3
(1) Withhold any amount for cost sharing from the payment to a 4
healthcare provider; or 5
(2) Require a healthcare provider to offer additional discounts 6
to enrollees outside the terms of the healthcare contract between the 7
healthcare insurer and the healthcare provide r. 8
(c) Any value of a copay assistance coupon or similar assistance 9
program shall be applied to an enrollee’s annual cost -sharing requirement and 10
may be paid directly to the healthcare insurer on the enrollee’s behalf. 11
(d) A healthcare insurer shall no t cancel the health benefit plan of 12
an enrollee for failure to collect cost sharing. 13
(e) Any expenses of implementing this subchapter by a healthcare 14
insurer shall not be used as justification to increase premiums or decrease 15
payments to a healthcare pro vider. 16
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23-99-1604. Violation of Trade Practices Act — Enforcement. 18
(a) A violation of this subchapter is a deceptive act, as defined by 19
the Trade Practices Act, § 23-66-201 et seq. 20
(b) All remedies, penalties, and authority granted to the Insurance 21
Commissioner under the Trade Practices Act, § 23-66-201 et seq., shall be 22
available to the commissioner for the enforcement of this subchapter. 23
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23-99-1605. Rules. 25
The Insurance Commis sioner may promulgate rules necessary to implement 26
and administer this subchapter. 27
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/s/B. King 29
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