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 insurers 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 insurers or PBMs 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.
Arkansas Updates Gold Card Appeal Rules for Providers Under Act 511 of 2025
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