1. (a)

   1. (1) Pursuant to Arkansas Code § 23-79-141(f), as amended by Acts 1995, No. 685, reimbursement levels shall be approved by the Insurance Commissioner at minimum amounts equal to current Arkansas Medicaid reimbursement levels and thereafter shall comply with each and every future alteration in Medicaid's payment mechanisms.
   2. (2) Further, these minimum reimbursement levels shall be provided for the services mandated under this section of the Arkansas Insurance Code, although payments under insurance policies and contracts exceeding these levels are permissible.
   3. (3) For any pharmaceutical products for which reimbursement levels are not established under the Medicaid program in the State of Arkansas, benefits shall be reimbursed at minimum levels equal to the average wholesale price for said pharmaceutical products, as defined in the most current edition of the Drug Topics Annual Redbook.
   4. (4) Reimbursement levels shall cover both the cost of pharmaceutical material and administration fees for providers administering vaccines and immunizations.

2. (b)

   1. (1)

      1. (A) Each disability insurance policy, contract, certificate, or plan providing benefits for children's preventive healthcare services on a periodic basis shall include at a minimum twenty (20) visits at approximately the following age intervals:

3. (i) Birth;

   1. (ii) Two (2) weeks;

      1. (iii) Two (2) months;

         1. (iv) Four (4) months;
         2. (v) Six (6) months;
         3. (vi) Nine (9) months;
         4. (vii) Twelve (12) months;
         5. (viii) Fifteen (15) months;
         6. (ix) Eighteen (18) months;
         7. (x) Two (2) years;
         8. (xi) Three (3) years;
         9. (xii) Four (4) years;
         10. (xiii) Five (5) years;
         11. (xiv) Six (6) years;
         12. (xv) Eight (8) years;
         13. (xvi) Ten (10) years;
         14. (xvii) Twelve (12) years; (xviii) Fourteen (14) years;
         15. (xix) Sixteen (16) years; and
         16. (xx) Eighteen (18) years.
      2. (B) A disability insurance policy, contract, certificate, or plan may provide that children's preventive healthcare services that are rendered during a periodic review shall only be covered to the extent that these services are provided by or under the supervision of a single physician during the course of one (1) visit.

   2. (2)

      1. (A) Benefits for recommended vaccine and immunization services shall be exempt from any copayment, coinsurance, deductible, or dollar limit provisions in the disability insurance policy.
      2. (B) Insurers, HMOs, and other licensees required to comply with this part shall explicitly state in their policy and subscriber contracts that all other children's preventive healthcare services shall be subject to copayment, coinsurance, deductible, or dollar limit provisions in the policy or contract.

      3. (C) In this regard, insurers, HMOs, and other licensees required to obtain the State Insurance Department's prior approval of forms and endorsements under Arkansas Code § 23-79-109 and other applicable laws shall make form or endorsement filings with the department to ensure current Arkansas policies and contracts are in compliance with this part by or before July 1, 1997.

         1. (c) On and after July 1, 1997, insurers, HMOs, and self-insured plans shall adhere to the provisions outlined in subsection (a) of this section.
         2. (d) Upon any subsequent increase in Medicaid's reimbursement levels for the State of Arkansas, insurers, HMOs, and self-insured plans may adjust their minimum reimbursement levels accordingly.
4. (e) Upon any adjustment of minimum reimbursement levels necessitated by subsequent changes in Arkansas’s Medicaid program, insurers and HMOs shall comply with form, rate, and/or rule filings required under the Arkansas Insurance Code to disclose such amendments.

Codification Notes: “HMO” means health maintenance organization.