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 S2/15/23 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 , coinsurance, 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 S2/15/23 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; and 10
(vi) Third-party administrator; 11
(3) "Enrollee" means an i ndividual who is entitled to receive 12
healthcare services under the terms of a health benefit plan; 13
(4) "Entity of the state" means any agency, board, bureau, 14
commission, committee, council, department, division, institution of higher 15
education, office, public school, quasi -public organization, or other 16
political subdivision of the state; 17
(5)(A) "Health benefit plan" means an individual, blanket, or 18
group plan, policy, or contract for healthcare services issued, renewed, or 19
extended in this state by a healthcare insurer. 20
(B) "Health benefit plan" includes a nonfederal 21
governmental plan as defined in 29 U.S.C. § 1002(32), as it existed on 22
January 1, 2023. 23
(C) "Health benefit plan" does not include: 24
(i) A plan that provides only dental benefi ts or eye 25
and vision care benefits; 26
(ii) A disability income plan; 27
(iii) A credit insurance plan; 28
(iv) Insurance coverage issued as a supplement to 29
liability insurance; 30
(v) Medical payments under an automobile or 31
homeowners insurance pl an; 32
(vi) A health benefit plan provided under Arkansas 33
Constitution, Article 5, § 32, the Workers’ Compensation Law, § 11 -9-101 et 34
seq., or the Public Employee Workers’ Compensation Act, § 21 -5-601 et seq.; 35
(vii) A plan that provides only indemn ity for 36 As Engrossed: S1/30/23 S2/15/23 SB122
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hospital confinement; 1
(viii) An accident-only plan; 2
(ix) A specified disease plan; 3
(x) A policy, contract, certificate, or agreement 4
offered or issued by a healthcare insurer to provide, deliver, arrange for, 5
pay for, or reimburse a ny of the costs of healthcare services, including 6
pharmacy benefits, to an entity of the state; 7
(xi) A long-term care insurance plan; or 8
(xii) A healthcare provider self -insured plan; 9
(6) "Healthcare contract" means a contract entered into, 10
materially amended, or renewed between a contracting entity and a healthcare 11
provider for the delivery of healthcare services to an enrollee; 12
(7)(A) "Healthcare insurer" means an entity that is subject to 13
state insurance regulation and provides health i nsurance in this state. 14
(B) "Healthcare insurer" includes: 15
(i) An insurance company; 16
(ii) A health maintenance organization; 17
(iii) A hospital and medical service corporation; 18
(iv) A risk-based provider organization; and 19
(v) Any sponsor of a nonfederal self -funded 20
governmental plan in this state; 21
(8) "Healthcare provider" means a person or entity that is 22
licensed, certified, or otherwise authorized by the laws of this state to 23
administer healthcare services; and 24
(9) "Healthcare services" means services or goods provided for 25
preventing, diagnosing, treating, alleviating, relieving, curing, or healing 26
human illness, disease, condition, disability, or injury. 27
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23-99-1603. Collection by healthcare insurer — Authority. 29
(a) A healthcare insurer shall: 30
(1) Pay a healthcare provider the full amount due for healthcare 31
services under the terms of a health benefit plan, including any cost 32
sharing; 33
(2) Have the sole responsibility for collecting cost sharing 34
from an enrollee; and 35
(3) Upon request of the enrollee, collect cost -sharing 36 As Engrossed: S1/30/23 S2/15/23 SB122
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throughout the plan year in increments defined by the healthcare insurer. 1
(b) A healthcare insurer shall not: 2
(1) Withhold any amount for cost sharing from the payment to a 3
healthcare provider; or 4
(2) Require a healthcare provider to offer additional discounts 5
to enrollees outside the terms of the healthcare contract between the 6
healthcare insurer and the healthcare provider. 7
(c) Any value of a copay assistance coupon or similar assista nce 8
program shall be applied to an enrollee’s annual cost -sharing requirement and 9
may be paid directly to the healthcare insurer on the enrollee’s behalf. 10
(d) A healthcare insurer shall not cancel the health benefit plan of 11
an enrollee for failure to col lect cost sharing. 12
(e) Any expenses of implementing this subchapter by a healthcare 13
insurer shall not be used as justification to increase premiums or decrease 14
payments to a healthcare provider. 15
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23-99-1604. Violation of Trade Practices Act — Enforcement. 17
(a) A violation of this subchapter is a deceptive act, as defined by 18
the Trade Practices Act, § 23-66-201 et seq. 19
(b) All remedies, penalties, and authority granted to the Insurance 20
Commissioner under the Trade Practices Act, § 23-66-201 et seq., shall be 21
available to the commissioner for the enforcement of this subchapter. 22
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23-99-1605. Rules. 24
The Insurance Commissioner may promulgate rules necessary to implement 25
and administer this subchapter. 26
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/s/B. King 28
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