# Ark. Code Ann. § 23-79-1205: Coverage by participating providers - Selection criteria and utilization protocols - Maximum benefits - Exclusions

> Arkansas · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1205

## Section

- **Citation:** Ark. Code Ann. § 23-79-1205
- **Heading:** Coverage by participating providers - Selection criteria and utilization protocols - Maximum benefits - Exclusions
- **Jurisdiction:** Arkansas
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** AR Code / Title 23 / Chapter 79 / Subchapter 12 / Section 23-79-1205

## Text

(a) (1) This subchapter does not require and shall not be construed to require the coverage of services by providers who are not designated as covered providers or that are not selected as a participating provider by a group health benefit plan or insurer having a participating network of service providers. (2) This subchapter does not expand the list or designation of participating providers as specified in any health benefit plan. (b) Insurers or other issuers of any health benefit plan covered by this subchapter may continue to establish and apply selection criteria and utilization protocols for healthcare providers including: (1) The designation of types of providers for which coverage is provided; and (2) Credentialing criteria used in the selection of providers. (c) A healthcare policy that provides coverage for the services offered under this subchapter may contain provisions for maximum benefits and coinsurance limitations, deductibles, exclusions, and utilization review protocols to the extent that the provisions are not inconsistent with the requirements of this subchapter. Acts 2005, No. 2236, § 2.

(a) (1) This subchapter does not require and shall not be construed to require the coverage of services by providers who are not designated as covered providers or that are not selected as a participating provider by a group health benefit plan or insurer having a participating network of service providers. (2) This subchapter does not expand the list or designation of participating providers as specified in any health benefit plan.

(1) This subchapter does not require and shall not be construed to require the coverage of services by providers who are not designated as covered providers or that are not selected as a participating provider by a group health benefit plan or insurer having a participating network of service providers.

(2) This subchapter does not expand the list or designation of participating providers as specified in any health benefit plan.

(b) Insurers or other issuers of any health benefit plan covered by this subchapter may continue to establish and apply selection criteria and utilization protocols for healthcare providers including: (1) The designation of types of providers for which coverage is provided; and (2) Credentialing criteria used in the selection of providers.

(1) The designation of types of providers for which coverage is provided; and

(2) Credentialing criteria used in the selection of providers.

(c) A healthcare policy that provides coverage for the services offered under this subchapter may contain provisions for maximum benefits and coinsurance limitations, deductibles, exclusions, and utilization review protocols to the extent that the provisions are not inconsistent with the requirements of this subchapter.

Acts 2005, No. 2236, § 2.

## Nearby sections

- [Ark. Code Ann. § 23-79-1201 Definitions](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1201.md)
- [Ark. Code Ann. § 23-79-1202 Coverage - Applicability](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1202.md)
- [Ark. Code Ann. § 23-79-1203 Certain activities not prohibited](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1203.md)
- [Ark. Code Ann. § 23-79-1204 Exclusions and reductions - Benefits subject to annual deductible and coinsurance](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1204.md)
- [Ark. Code Ann. § 23-79-1205 Coverage by participating providers - Selection criteria and utilization protocols - Maximum benefits - Exclusions](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1205.md)
- [Ark. Code Ann. § 23-79-1206 Additional benefit costs](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1206.md)
- [Ark. Code Ann. § 23-79-1207 Cost-sharing](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1207.md)
- [Ark. Code Ann. § 23-79-1208 Referrals to participating providers](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1208.md)
- [Ark. Code Ann. § 23-79-1209 Payment of nonparticipating providers](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1209.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C79_S12_S23-79-1205. Check the current official text before relying on it. Not legal advice.