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What It Means for You

In March 2017 the Arkansas State Legislature passed Senate Bill 665 and it became Act 815 of 2017. Known as the Prior Authorization Transparency Act, it requires health insurers to implement certain changes that may impact your clients and their insured employees. The Act became effective August 1, 2017 and requires the following:
  • Disclosure of clinical criteria used in making medical coverage decisions for services that are subject to a prior authorization process;
  • Disclosure of statistics on approvals and denials of prior authorization requests, by physician specialty and medical service category;
  • Disclosure of eligibility status of an individual for whom a prior authorization is being requested, both at the time of the request and at the time of service, including the individual's premium payment status; and
  • Limitations on the part of the health insurer to recover payments for services when a member is retroactively terminated and the above disclosures have not been made available to the service provider.
The new Act has required QualChoice to make changes in our procedures that may impact employers and their insured employees. The disclosure of clinical criteria and disclosure of statistics are now available on our website. The disclosure of premium payment status to determine if the member is in their grace period is now available to providers only through the My Account portal at QualChoice.com

To retain health insurance coverage for the current month, a member's premium must be received and processed by the end of the State-mandated 30-day grace period.

Effective October 1, 2017 QualChoice will process requests for termination of coverage only as of the end of the month in which the notification is received.

Understanding the new required disclosures, the new administration procedures and how to use this information, will be a learning process for providers, employers and individual members. QualChoice is committed to assisting all parties in understanding and utilizing this information. See Paid Premiums and Eligibility Status.

For questions, please contact Customer Service through our QuicQuestions messaging service at QualChoice.com or by calling 501.228.7111. We appreciate your business!