Section 23-86-123 - Prior authorization by physician - Definitions

(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.