Act 494 of 2023, “An Act To Require The Arkansas Medicaid Program And Insurance Policies To Reimburse For Behavioral Health Services Provided In Certain Settings”

Hugh McDonald SECRETARY OF COMMERCE AID * * 4 Alan McClain INSURANCE COMMISSIONER, ARKANSAS INSURANCE DEPARTMENT September 1, 2023 BULLETIN NO. 14-2023 TO: ALL HEALTH INSURERS, HEALTH MAINTENANCE ORGANIZATIONS & HOSPITAL MEDICAL SERVICES CORPORATIONS FROM: ARKANSAS INSURANCE DEPARTMENT SUBJECT: Act 494 of 2023, "An Act To Require The Arkansas Medicaid Program And Insurance Policies To Reimburse For Behavioral Health Services Provided In Certain Settings" The Arkansas Insurance Commissioner ("Commissioner") has received a significant number of inquiries related to service or coverage interpretations related to Arkansas Act 494 of 2023, "An Act To Require The Arkansas Medicaid Program And Insurance Policies To Reimburse For Behavioral Health Services Provided In Certain Settings" (hereafter, "Act 494"). For its private, commercial insurance mandate(s), Act 494 is now codified in Ark. Code Ann. §§ 23-79-2801 and 23-79-2802. Under Act 494, Ark. Code Ann. § 23-79-2802 provides: (a) A healthcare insurer that offers, issues, or renews a health benefit plan in this state shall provide coverage for screening for behavioral health conditions and coverage for behavioral health services provided in a: (1) Hospital outpatient clinic; or (2) Physician clinic. (b) The coverage for screening for behavioral health conditions or for behavioral health services as described in this section: (1) Is not subject to policy deductibles or copayment requirements; and (2) Does not diminish or limit benefits otherwise allowable under a health benefit plan. Consistent with legislative intent, the Commissioner interprets Ark. Code Ann. § 23-79-2802 to require health insurers to provide coverage for both behavioral health screenings and behavioral health services when those activities are performed at sites of service areas of hospital outpatient facilities and physician clinics in the same manner that those services or activities are covered by the policy or plan outside such facilities. Secondly, at the above described sites of service, the Commissioner interprets such provisions that behavioral health screenings are subject to no cost sharing consistent with ACA requirements. However, for behavioral health services performed at such sites, the same cost-sharing structures may be applied to those sites, consistent with the policy or contact terms as applied to covered non-sites. Arkansas Department of Commerce Arkansas Insurance Department 1 Commerce Way, Suite 102 • Little Rock, AR 72202 INSURANCE.ARKANSAS.GOV If you have any questions related to this Bulletin, please contact Booth Rand, General Counsel at AID, at 501-371-2827. ALAN McCLAIN INSURANCE COMMISSIONER STATE OF ARKANSAS DATE