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007.05.1-XIV. ENROLLEE RIGHTS.

AR ADC 007.05.1-XIVArkansas 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-XIV
007.05.1-XIV. ENROLLEE RIGHTS.
A Health Maintenance Organization shall develop and adhere to written policies and procedures informing Enrollees of at least the following rights:
A. An Enrollee has the right to timely and effective redress of grievances through a system established by the HMO in a complaint/grievance program;
B. An Enrollee has the right to obtain current information concerning a diagnosis, treatment, and prognosis from a physician or other Provider in terms the Enrollee can be reasonably expected to understand. When it is not advisable to give such information to the Enrollee, this information shall be made available to an appropriate person on the Enrollee's behalf;
C. An Enrollee has the right to be given the name, professional title, and function of any personnel providing Health Care Services to him/her;
D. An Enrollee has the right to give his/her informed consent before the start of any surgical procedure or treatment;
E. An Enrollee has the right to refuse any medications, treatment, or other procedure offered to him/her by the HMO or its Providers to the extent provided by law and to be informed by a physician of the medical consequences of the Enrollee's refusal of any medications, treatments, or procedures;
F. An Enrollee has the right to obtain Emergency Health Care Services without unnecessary delay;
G. An Enrollee has the right to have all records pertaining to his/her medical care treated as confidential unless disclosure is otherwise permitted by law;
H. An Enrollee has the right to information in his/her medical records, consistent with state law. Nothing is these regulations shall prohibit a Provider from charging for copies of the information, also consistent with state law;
I. An Enrollee has the right to be advised if a health care facility or any of the Providers participating in his/her care propose to engage in or perform human experimentation or research affecting his/her care or treatment. An Enrollee or legally responsible party on his/her behalf may, at any time, refuse to participate or to continue in any experimentation or research program to which he/she had previously given informed consent;
J. An Enrollee has the right to be informed of these rights listed in this Section; and
K. No HMO may, in any event, cancel or refuse to renew an Enrollee solely on the basis of the health of an Enrollee.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 007.05.1-XIV, AR ADC 007.05.1-XIV
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