# Ark. Code Ann. § 23-99-1105: Prior authorization - Nonurgent healthcare service > Arkansas · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1105 ## Section - **Citation:** Ark. Code Ann. § 23-99-1105 - **Heading:** Prior authorization - Nonurgent healthcare service - **Jurisdiction:** Arkansas - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** AR Code / Title 23 / Chapter 99 / Subchapter 11 / Section 23-99-1105 ## Text (a) If a utilization review entity requires prior authorization of a nonurgent healthcare service, the utilization review entity shall make an authorization or adverse determination and notify the subscriber and the subscriber's nonurgent healthcare provider of the decision within two (2) business days of obtaining all necessary information to make the authorization or adverse determination. (b) For purposes of this section, "necessary information" includes the results of any face-to-face clinical evaluation or second opinion that may be required. (c) (1) If a utilization review entity denies a prior authorization of a nonurgent healthcare service, then the subscriber or the healthcare provider may elect to appeal the denial of the prior authorization of the nonurgent healthcare service. (2) If a denial of a prior authorization of a nonurgent healthcare service is appealed to the utilization review entity, then within four (4) business days of receiving all necessary information required, the utilization review entity shall: (A) Make an authorization or adverse determination; and (B) Notify the subscriber and the healthcare provider that appealed the denial of the prior authorization of the nonurgent healthcare service of the decision. (3) This subsection applies to an enrollee who is being evaluated or treated for: (A) A hematology diagnosis; (B) An oncology diagnosis; or (C) An additional disease state or other diagnoses that the Insurance Commissioner may include by rule. Amended by Act 2023, No. 501,§ 2, eff. 8/1/2023. Added by Act 2015, No. 1106,§ 2, eff. 7/22/2015. (a) If a utilization review entity requires prior authorization of a nonurgent healthcare service, the utilization review entity shall make an authorization or adverse determination and notify the subscriber and the subscriber's nonurgent healthcare provider of the decision within two (2) business days of obtaining all necessary information to make the authorization or adverse determination. (b) For purposes of this section, "necessary information" includes the results of any face-to-face clinical evaluation or second opinion that may be required. (c) (1) If a utilization review entity denies a prior authorization of a nonurgent healthcare service, then the subscriber or the healthcare provider may elect to appeal the denial of the prior authorization of the nonurgent healthcare service. (2) If a denial of a prior authorization of a nonurgent healthcare service is appealed to the utilization review entity, then within four (4) business days of receiving all necessary information required, the utilization review entity shall: (A) Make an authorization or adverse determination; and (B) Notify the subscriber and the healthcare provider that appealed the denial of the prior authorization of the nonurgent healthcare service of the decision. (3) This subsection applies to an enrollee who is being evaluated or treated for: (A) A hematology diagnosis; (B) An oncology diagnosis; or (C) An additional disease state or other diagnoses that the Insurance Commissioner may include by rule. (1) If a utilization review entity denies a prior authorization of a nonurgent healthcare service, then the subscriber or the healthcare provider may elect to appeal the denial of the prior authorization of the nonurgent healthcare service. A hematology diagnosis; (B) An oncology diagnosis; or (C) An additional disease state or other diagnoses that the Insurance Commissioner may include by rule. (1) If a utilization review entity denies a prior authorization of a nonurgent healthcare service, then the subscriber or the healthcare provider may elect to appeal the denial of the prior authorization of the nonurgent healthcare service. (2) If a denial of a prior authorization of a nonurgent healthcare service is appealed to the utilization review entity, then within four (4) business days of receiving all necessary information required, the utilization review entity shall: (A) Make an authorization or adverse determination; and (B) Notify the subscriber and the healthcare provider that appealed the denial of the prior authorization of the nonurgent healthcare service of the decision. (A) Make an authorization or adverse determination; and (B) Notify the subscriber and the healthcare provider that appealed the denial of the prior authorization of the nonurgent healthcare service of the decision. (3) This subsection applies to an enrollee who is being evaluated or treated for: (A) A hematology diagnosis; (B) An oncology diagnosis; or (C) An additional disease state or other diagnoses that the Insurance Commissioner may include by rule. (A) A hematology diagnosis; (B) An oncology diagnosis; or (C) An additional disease state or other diagnoses that the Insurance Commissioner may include by rule. Amended by Act 2023, No. 501,§ 2, eff. 8/1/2023. Added by Act 2015, No. 1106,§ 2, eff. 7/22/2015. ## Nearby sections - [Ark. Code Ann. § 23-99-1101 Title](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1101.md) - [Ark. Code Ann. § 23-99-1102 Legislative findings and intent](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1102.md) - [Ark. Code Ann. § 23-99-1103 Definitions](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1103.md) - [Ark. Code Ann. § 23-99-1104 Disclosure required](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1104.md) - [Ark. Code Ann. § 23-99-1105 Prior authorization - Nonurgent healthcare service](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1105.md) - [Ark. Code Ann. § 23-99-1106 Prior authorization - Urgent healthcare service](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1106.md) - [Ark. Code Ann. § 23-99-1107 Prior authorization - Emergency healthcare service](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1107.md) - [Ark. Code Ann. § 23-99-1108 Subscribers with terminal illness - Denial of prior authorization for covered prescription pain medication prohibited](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1108.md) - [Ark. Code Ann. § 23-99-1109 Rescission of prior authorizations - Denial of payment for prior authorized services - Limitations](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1109.md) - [Ark. Code Ann. § 23-99-1110 Waiver prohibited](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1110.md) - [Ark. Code Ann. § 23-99-1111 Requests for prior authorization - Qualified persons authorized to review and approve - Adverse determinations to be made only by Arkansas-licensed physicians - Opportunity to discuss treatment before adverse determination](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1111.md) - [Ark. Code Ann. § 23-99-1112 Application of subchapter](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1112.md) - [Ark. Code Ann. § 23-99-1113 Benefit inquiries authorized](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1113.md) - [Ark. Code Ann. § 23-99-1114 Limitation on step therapy - Definitions](https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1114.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_AR_T23_C99_S11_S23-99-1105. Check the current official text before relying on it. Not legal advice.