Home Table of Contents

007.05.1-V. GENERAL REQUIREMENTS

AR ADC 007.05.1-VArkansas Administrative Code

West's Arkansas Administrative Code
Title 007. Department of Health
Division 05. Health Facility Services
Rule 1. Rules and Regulations for Health Maintenance Organizations in Arkansas
Ark. Admin. Code 007.05.1-V
007.05.1-V. GENERAL REQUIREMENTS
Currentness
A. The HMO shall provide and/or arrange for the provision of Health Care Services which assure the Enrollees adequate medical care which is available, accessible, and continuous in accordance with the Enrollee's Plan. Assurances of availability, accessibility, and continuity shall demonstrate the following:
1. Health Care Services for which Enrollees have contracted shall be provided or arranged for by the HMO;
2. Facilities and personnel, both professional and non-professional, adequate (within generally accepted norms) to make these Health Care Services available to Enrollees can and shall be secured and maintained;
3. These Health Care Services shall be provided at hours convenient to and adequate to meet the needs of Enrollees, including provision or arrangement for 24-hour emergency service. The average waiting time for appointments or to receive services shall be reasonable;
4. The location of facilities and proximity shall enhance accessibility of service to the reasonably anticipated Enrollees, including aged and persons with disabilities;
5. Owned facilities and/or leased facilities of a Staff Model HMO shall not present architectural barriers to the aged or to persons with disabilities;
6. For initial Staff Model HMO applicants, plans and resources, both current and reasonably anticipated, drawings and specifications (if applicable), and other materials shall be required, in addition to other requirements of these Rules and Regulations;
7. Continuity of service to Enrollees shall be enhanced by provision of a means for ensuring that Enrollees receive the proper level and type of care and that the provision of services is coordinated both within and outside the HMO.
B. There shall be a progressive preventive health program which shall be developed according to the prevailing health factors predominant in the Enrollee population. This program shall include, but not be limited to health evaluation, education, and immunization. The program shall be designed to prevent illness and disease and to improve the general health of the HMO Enrollees.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 007.05.1-V, AR ADC 007.05.1-V
End of Document