| 6 | 4 | | 95th General Assembly A Bill 2 |
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| 7 | 5 | | Regular Session, 2025 HOUSE BILL 1275 3 |
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| 8 | 6 | | 4 |
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| 9 | 7 | | By: Representative Cavenaugh 5 |
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| 10 | 8 | | By: Senator B. Johnson 6 |
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| 11 | 9 | | 7 |
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| 12 | 10 | | For An Act To Be Entitled 8 |
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| 13 | 11 | | AN ACT TO PROHIBIT PRIOR AUTHORIZATIONS FOR 9 |
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| 14 | 12 | | HEALTHCARE SERVICES PROVIDED FOR TREATMENT OF A 10 |
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| 15 | 13 | | MENTAL HEALTH CRISIS; AND FOR OTHER PURPOSES. 11 |
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| 16 | 14 | | 12 |
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| 17 | 15 | | 13 |
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| 18 | 16 | | Subtitle 14 |
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| 19 | 17 | | TO PROHIBIT PRIOR AUTHORIZATIONS FOR 15 |
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| 20 | 18 | | HEALTHCARE SERVICES PROVIDED FOR 16 |
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| 21 | 19 | | TREATMENT OF A MENTAL HEALTH CRISIS. 17 |
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| 22 | 20 | | 18 |
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| 23 | 21 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 19 |
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| 24 | 22 | | 20 |
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| 25 | 23 | | SECTION 1. Arkansas Code Title 23, Chapter 99, is amended to add an 21 |
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| 26 | 24 | | additional subchapter to read as follows: 22 |
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| 27 | 25 | | 23 |
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| 28 | 26 | | Subchapter 19 — Prohibition on Prior Authorizations for Treatment of Mental 24 |
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| 29 | 27 | | Health Crisis 25 |
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| 30 | 28 | | 26 |
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| 31 | 29 | | 23-99-1901. Definitions. 27 |
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| 32 | 30 | | As used in this subchapter: 28 |
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| 33 | 31 | | (1) "Crisis stabilization unit" means the same as defined in § 29 |
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| 34 | 32 | | 20-47-803; 30 |
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| 35 | 33 | | (2)(A) "Health benefit plan" means any individual, blanket, or 31 |
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| 36 | 34 | | group plan, policy, or contract for healthcare services issued or delivered 32 |
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| 37 | 35 | | by a healthcare insurer in this state. 33 |
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| 38 | 36 | | (B) "Health benefit plan" includes a nonfederal self -34 |
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| 39 | 37 | | funded governmental plan. 35 |
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| 45 | 41 | | includes only dental benefits or eye and vision care benefits; 1 |
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| 46 | 42 | | (3)(A) "Healthcare insurer" means an entity that: 2 |
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| 47 | 43 | | (i) Is subject to state insurance regulation, 3 |
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| 48 | 44 | | including without limitation an insurance company, a health maintenance 4 |
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| 49 | 45 | | organization, a hospital and medical service corporation, a risk -based 5 |
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| 50 | 46 | | provider organization, and a sponsor of a nonfederal self -funded governmental 6 |
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| 51 | 47 | | plan; or 7 |
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| 52 | 48 | | (ii) Has subscribers in this state. 8 |
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| 53 | 49 | | (B) “Healthcare insurer” does not include: 9 |
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| 54 | 50 | | (i) A workers' compensation plan; or 10 |
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| 55 | 51 | | (ii) An entity that provides only dental benefits or 11 |
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| 56 | 52 | | eye and vision care benefits; 12 |
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| 57 | 53 | | (4) "Healthcare provider" means: 13 |
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| 58 | 54 | | (A) A doctor of medicine, a doctor of osteopathy, or 14 |
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| 59 | 55 | | another licensed healthcare professional acting within the healthcare 15 |
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| 60 | 56 | | professional's licensed scope of practice; or 16 |
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| 61 | 57 | | (B) A healthcare facility licensed in the state where the 17 |
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| 62 | 58 | | facility is located to provide healthcare services; 18 |
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| 63 | 59 | | (5) "Healthcare service" means a healthcare procedure, 19 |
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| 64 | 60 | | treatment, or service provided: 20 |
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| 65 | | - | (A) At a crisis stabilization unit or any other program designed 21 |
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| 66 | | - | to provide immediate crisis services; or 22 |
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| 67 | | - | (B) By a healthcare provider in an emergency department; 23 |
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| 68 | | - | and 24 |
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| 69 | | - | (6) "Mental health crisis" means a situation in which an individual's 25 |
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| 70 | | - | emotional or mental state becomes so severe that it puts the individual at 26 |
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| 71 | | - | risk of harming himself, herself, or others, prevents the individual from 27 |
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| 72 | | - | properly caring for himself, herself, or significantly disrupts the 28 |
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| 73 | | - | individual's ability to function in daily life. 29 |
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| 74 | | - | 30 |
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| 75 | | - | 23-99-1902. Mental health crisis — Prior authorization or 31 |
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| 76 | | - | precertification for healthcare service prohibited. 32 |
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| 77 | | - | A health benefit plan shall not require prior authorization or 33 |
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| 78 | | - | precertification for a healthcare service provided by a healthcare provider 34 |
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| 79 | | - | to an individual who is suffering a mental health crisis. 35 |
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| 80 | | - | 36 As Engrossed: H2/26/25 HB1275 |
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| 61 | + | (A) At a crisis stabilization unit; or 21 |
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| 62 | + | (B) By a healthcare provider; and 22 |
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| 63 | + | (6) "Mental health crisis" means a situation in which an 23 |
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| 64 | + | individual's emotional or mental state becomes so severe that it puts the 24 |
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| 65 | + | individual at risk of harming himself, herself, or others, prevents the 25 |
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| 66 | + | individual from properly caring for himself, herself, or significantly 26 |
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| 67 | + | disrupts the individual's ability to function in daily life. 27 |
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| 68 | + | 28 |
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| 69 | + | 23-99-1902. Mental health crisis — Prior authorization or 29 |
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| 70 | + | precertification for healthcare service prohibited. 30 |
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| 71 | + | A health benefit plan shall not require prior authorization or 31 |
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| 72 | + | precertification for a healthcare service provided by a healthcare provider 32 |
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| 73 | + | to an individual who is suffering a mental health crisis. 33 |
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| 74 | + | 34 |
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| 75 | + | 23-99-1903. Rules. 35 |
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| 76 | + | (a) Except as provided in subsection (b) of this section, the 36 HB1275 |
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| 82 | | - | 3 02-26-2025 09:51:40 ANS155 |
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| 83 | | - | |
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| 84 | | - | |
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| 85 | | - | 23-99-1903. Rules. 1 |
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| 86 | | - | (a) Except as provided in subsection (b) of this section, the 2 |
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| 87 | | - | Insurance Commissioner may promulgate rules to implement this subchapter. 3 |
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| 88 | | - | (b) The State Board of Finance may promulgate rules to implement this 4 |
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| 89 | | - | subchapter that may apply to the State and Public School Life and Health 5 |
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| 90 | | - | Insurance Program. 6 |
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| 78 | + | 3 01/27/2025 1:41:25 PM ANS155 |
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| 79 | + | Insurance Commissioner may promulgate rules to implement this subchapter. 1 |
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| 80 | + | (b) The State Board of Finance may promulgate rules to implement this 2 |
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| 81 | + | subchapter that may apply to the State and Public School Life and Health 3 |
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| 82 | + | Insurance Program. 4 |
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| 83 | + | 5 |
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| 84 | + | 6 |
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