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 137 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 MANDATE CO VERAGE FOR NECESSARY 9
MAXILLOFACIAL SERVIC ES; AND FOR OTHER PU RPOSES. 10
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Subtitle 13
TO MANDATE COVERAGE FOR NECESSARY 14
MAXILLOFACIAL SERVICES. 15
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 18
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SECTION 1. Arkansas Code Title 23, Chapter 99, Subchapter 4, is 20
amended to add an additional section to read as follows: 21
23-99-422. Coverage for necessary maxillofacial services — 22
Definitions. 23
(a) As used in this section: 24
(1)(A) “Health benefit pla n” means an individual, blanket, or 25
group plan, policy, or contract for healthcare services offered, issued, 26
renewed, or extended in this state by a healthcare insurer, health 27
maintenance organization, hospital medical service corporation, or self -28
insured governmental or church plan in this state. 29
(B) “Health benefit plan” includes: 30
(i) Indemnity and managed care plans; and 31
(ii) Plans providing health benefits to state and 32
public school employees under § 21 -5-401 et seq. 33
(C) “Health benefit plan” does not include: 34
(i) A plan that provides only dental benefits or eye 35
and vision care benefits; 36 SB137
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(ii) A disability income plan; 1
(iii) A credit insurance plan; 2
(iv) Insurance coverage issued as a supplement to 3
liability insurance; 4
(v) Medical payments under an automobile or 5
homeowners insurance plan; 6
(vi) A health benefit plan provided under Arkansas 7
Constitution, Article 5, § 32, the Workers' Compensation Law, § 11 -9-101 et 8
seq., or the Public Employee Workers' Compensa tion Act, § 21-5-601 et seq.; 9
(vii) A plan that provides only indemnity for 10
hospital confinement; 11
(viii) An accident-only plan; 12
(ix) A specified disease plan; or 13
(x) A program established by the Arkansas Health and 14
Opportunity for Me Ac t of 2021, § 23-61-1001 et seq.; 15
(2)(A) "Healthcare insurer" means any insurance company, 16
hospital and medical service corporation, or health maintenance organization 17
that issues or delivers health benefit plans in this state and is subject to 18
any of the following laws: 19
(i) The insurance laws of this state; 20
(ii) Section 23-75-101 et seq., pertaining to 21
hospital and medical service corporations; or 22
(iii) Section 23-76-101 et seq., pertaining to 23
health maintenance organizations. 24
(B) "Healthcare insurer" does not include an entity that 25
provides only dental benefits or eye and vision care benefits; 26
(3) "Healthcare professional" means a person who is licensed, 27
certified, or otherwise authorized by the laws of this state to administer 28
health care in the ordinary course of the practice of his or her profession; 29
(4) "Healthcare services" means services and products provided 30
by a healthcare professional within the scope of the healthcare 31
professional's license; and 32
(5)(A) "Necessary maxillofacial services" means healthcare 33
services that are used to: 34
(i) Restore and manage the head and facial 35
structures of an individual that are defective because of disease, trauma, or 36 SB137
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birth or developmental deformities and cannot be replaced wit h living tissue; 1
or 2
(ii) Repair or stabilize living tissue that is 3
defective because of disease, trauma, or birth or developmental deformities. 4
(B) "Necessary maxillofacial services" includes only 5
healthcare services used for the purpose of: 6
(i) Controlling or eliminating infection; 7
(ii) Controlling or eliminating pain; or 8
(iii) Restoring facial configuration or functions 9
including without limitation speech, swallowing, or chewing. 10
(C) "Necessary maxillofacial services" does not include 11
cosmetic procedures if provided to improve on the normal range of conditions. 12
(b) A health benefit plan that is offered, issued, renewed, or 13
extended in this state shall provide coverage for necessary maxillofacial 14
services. 15
(c) An exclusion fo r coverage for dental care or orthodontic services 16
in a health benefit plan does not apply to necessary maxillofacial services. 17
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SECTION 2. DO NOT CODIFY. EFFECTIVE DATE. This act is effective on 19
and after September 1, 2023. 20
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