Stricken language would be deleted from and underlined language would be added to present law.
Act 638 of the Regular Session
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State of Arkansas As Engrossed: S4/2/25 1
95th General Assembly A Bill 2
Regular Session, 2025 HOUSE BILL 1700 3
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By: Representative Achor 5
By: Senator J. Boyd 6
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For An Act To Be Entitled 8
AN ACT TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY 9
ACT; TO CLARIFY THE PROCESS OF AN ADVERSE 10
DETERMINATION NOTICE UNDER THE PRIOR AUTHORIZATION 11
TRANSPARENCY ACT; AND FOR OTHER PURPOSES. 12
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Subtitle 15
TO AMEND THE PRIOR AUTHORIZATION 16
TRANSPARENCY ACT; AND TO CLARIFY THE 17
PROCESS OF AN ADVERSE DETERMINATION 18
NOTICE UNDER THE PRIOR AUTHORIZATION 19
TRANSPARENCY ACT. 20
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 22
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SECTION 1. Arkansas Code § 23 -99-1111(c)(3)(A), concerning the 24
information required from a utilization review entity in an adverse 25
determination notice under the Prior Authorization Transparency Act, is 26
amended to read as follows: 27
(3)(A)(i) Subject to this subdivision (c)(3), when an adverse 28
determination is issued by a utilization review entity that questions the 29
medical necessity, the appropriateness, or the experimental or 30
investigational nature of a healthcare service, the utilization review entity 31
shall provide in the notice of adverse determination the name and telephone 32
number of a physician who possesses a current and unrestricted license in 33
this state with whom the requesting healthcare provider may have a reasonable 34
opportunity to discuss the patient's treatment plan and the clinical basis 35
for the intervention. 36 As Engrossed: S4/2/25 HB1700
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1
(ii) A physician contacted by a 2
requesting healthcare provider under subdivision (c)(3)(A)(i) of this section 3
shall disclose his or her name and license information to the requesting 4
healthcare provider. 5
(iii) If a healthcare provider submits an audio 6
recording demonstrating a violation of subdivision (c)(3)(A) of this section 7
to the State Insurance Department: 8
(a) The requested prior authorization is 9
deemed approved; and 10
(b) The department shall direct the 11
utilization review entity to immediately issue the requested prior 12
authorization to the healthcare provider. 13
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SECTION 2. Arkansas Code § 23 -99-1115(b), concerning the information 15
required in the written and verbal notice of an adverse determination under 16
the Prior Authorization Transparency Act, is amended to read as follows: 17
(b) The written or verbal notice required to a healthcare provider 18
under this section shall include: 19
(1) The following information: 20
(A) The name, title, and telephone number of the physician 21
responsible for making the adverse determination and, in the event that the 22
physician responsible for making the adverse determination is not available, 23
a telephone number where a peer -to-peer contact with another physician 24
regarding the adverse determination can be made; 25
(B) The reviewing physician's specialty or practice area, 26
including board certification status or board eligibility; and 27
(C) A list of states in which the reviewing physician is 28
licensed and the license number issued to the reviewing physician by each 29
state; 30
(D) For a verbal notice, the name and license number of 31
the reviewing physician; and 32
(E) For a written notice, a telephone number that the 33
requesting healthcare provider may call to obtain the name and license number 34
of the reviewing physician; 35
(2) The written clinical criteria, if any, and any internal 36 As Engrossed: S4/2/25 HB1700
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rule, guideline, or protocol on which the utilization review entity relied 1
when making the adverse determination and how those provisions apply to the 2
subscriber's specific medical circumstance; 3
(3) Information for the subscriber and the subscriber's 4
healthcare provider that describes the procedure through which the subscriber 5
or healthcare provider may request a copy of any report developed by 6
personnel performing the review that led to the adverse determination; and 7
(4)(A) Information that explains to the subscriber and the 8
subscriber's healthcare provider the right to appeal the adverse 9
determination. 10
(B) The information required under subdivision (b)(4)(A) 11
of this section shall include: 12
(i) Instructions concerning how to perfect an appeal 13
and how the subscriber and the subscriber's healthcare provider may ensure 14
that written materials supporting the appeal will be considered in the appeal 15
process; and 16
(ii)(a) Addresses and telephone numbers to be used 17
by healthcare providers and subscribers to make complaints to the Arkansas 18
State Medical Board, the State Board of Health, and the State Insurance 19
Department. 20
(b) Subdivision (b)(4)(B)(ii)(a) of this 21
section does not apply to self -insured plans for employees of governmental 22
entities. 23
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SECTION 3. Arkansas Code § 23 -99-1115, concerning the notice 25
requirements and process for appealing adverse determinations under the Prior 26
Authorization Transparency Act, is amended to add additional subsections to 27
read as follows: 28
(e)(1) Upon an adverse determination by a utilization review entity, 29
the utilization review entity shall provide a written notice to the 30
subscriber, which shall include without limitation: 31
(A)(i) An explanation in clear and ordinary terms of the 32
basis for the adverse determination. 33
(ii) An explanation under subdivision (e)(1)(A)(i) 34
of this section shall include without limitation: 35
(a) A listing of clinical criteria, if 36 As Engrossed: S4/2/25 HB1700
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applicable, and any internal rule, guideline, or protocol upon which a 1
utilization review entity relied when making an adverse determination; and 2
(b) The reason why the provisions listed in 3
subdivision (e)(1)(A)(ii)(a) of this section apply to the subscriber's 4
specific medical circumstance; 5
(B) A description of the procedure through which the 6
subscriber may request a copy of a report developed by personnel performing 7
the utilization review that led to the adverse determination; 8
(C) Information that explains to the subscriber the right 9
to appeal the adverse determination, including instructions concerning how to 10
perfect an appeal and how the subscriber may ensure that written materials 11
supporting the appeal will be considered in the appeals process; and 12
(D) An address and telephone number to be used by a 13
subscriber to make a complaint to the Arkansas State Medical Board, the State 14
Board of Health, and the State Insurance Department. 15
(2) A utilization review entity shall treat a subscriber’s 16
request for any information related to a prior authorization, including a 17
general inquiry, as a request under subdivision (e)(1) of this section. 18
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/s/Achor 20
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APPROVED: 4/16/25 23
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