Prior authorization by physician - Definitions
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AR Code › Title 23 › Chapter 86 › Subchapter 1 › Section 23-86-123
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(a) As used in this section: (1) "Prior authorization" means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and (2) "Telemedicine" means the same as defined in § 23-79-1601 . (b) When conducting prior authorization, whether for healthcare services provided through telemedicine or provided in person, a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas shall make all adverse determinations for healthcare services, medications, or equipment prescribed by a physician. Amended by Act 2017, No. 203,§ 5, eff. 8/1/2017. Added by Act 2015, No. 887,§ 5, eff. 4/1/2015.
(a) As used in this section: (1) "Prior authorization" means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and (2) "Telemedicine" means the same as defined in § 23-79-1601 .
(1) "Prior authorization" means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and
(2) "Telemedicine" means the same as defined in § 23-79-1601 .
(b) When conducting prior authorization, whether for healthcare services provided through telemedicine or provided in person, a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas shall make all adverse determinations for healthcare services, medications, or equipment prescribed by a physician.
Amended by Act 2017, No. 203,§ 5, eff. 8/1/2017.
Added by Act 2015, No. 887,§ 5, eff. 4/1/2015.
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