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054.00.109-2. Purpose

AR ADC 054.00.109-2Arkansas Administrative CodeEffective: October 19, 2015

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 109. Orthotic and Prosthetic Reimbursement
Effective: October 19, 2015
Ark. Admin. Code 054.00.109-2
054.00.109-2. Purpose
The purpose of this Rule is to require health benefit plans that are subject to Ark. Code Ann. § 23-99-417 to update coverage for eligible charges for prosthetic and orthotic devices and services to no less than eighty percent (80%) of the Medicare allowable rates for such devices and services as of January 1 of each year in which the health benefit plan is issued or renewed. The current statutory requirement in Ark. Code Ann. § 23-99-417(a)(1) ties the coverage requirements for such devices and services to January 1, 2009 CMS Medicare coverage amounts under its Healthcare Common Procedure Coding System (“CPT”). The Commissioner intends in this Rule to establish the requirement that such coverage at least equal eighty-percent (80%) of CMS CPT allowable amounts as established by CMS as of January 1 of each year in which the health benefit plan is issued or renewed, rather than promulgating an amendment to this Rule each year to require the adjustment.

Credits

Adopted Oct. 19, 2015.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.109-2, AR ADC 054.00.109-2
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