AR| Bulletin 4-2026 from the Arkansas Insurance Department supersedes Bulletin 16-2024 and updates the appeals procedures for Arkansas “gold card” prior authorization exemptions to align with Act 511 of 2025, outlining two main processes: first, how healthcare providers may appeal a healthcare insurer’s rescission of a gold card for a healthcare service through an independent review organization, including a 12‑month appeal window, strict completeness checks and notices, timelines for insurer and commissioner actions, and the option for review of a second random sample of eligible claims; and second, how independent review is handled when the Arkansas State Medical Board or State Board of Pharmacy denies an insurer’s or PBM’s request to exempt a prescription drug or related service from gold card requirements, with the commissioner assigning an independent review organization and specifying documentation and timing requirements for the review.