(a) RBPO provider market conduct activities.

1. (1) The Insurance Commissioner is primarily authorized to regulate the financial solvency and licensing of the risk-based provider organization (RBPO) under the Medicaid Provider-Led Organized Care Act, Arkansas Code § 20-77-2701 et seq.
2. (2) The commissioner shall not administratively adjudicate, review, process complaints, enforce, or apply provisions of the Arkansas Insurance Code, rules, bulletins, or directives upon an RBPO or contracted third-party administrator, if applicable, related to claims payment disputes, claims payment delays, provider payment rate or rates, provider credentialing, provider reimbursement programs, network related procedures, or filing requirements, if such arise during the course of the Organized Care Act Program, unless the complaint or concern relates to “any willing provider” access (Arkansas Code § 23-99-201 et seq., § 23-99-801 et seq.) or significantly reflects upon the financial condition of the RBPO.
3. (3) Complaints or inquiries about claims payment delays or requirements shall be referred to the Department of Human Services.

(b) RBPO network adequacy requirements.

1. (1) The Department of Human Services shall be responsible for certifying, approving, and monitoring whether an RBPO meets the required network access or network adequacy for services under the Medicaid Provider-Led Organized Care Act.
2. (2) The commissioner, however, shall review network adequacy of the RBPO at licensure, or upon renewal of licensure, but shall accept certification from the Department of Human Services that the RBPO has sufficient network adequacy as required under the Medicaid Provider-Led Organized Care Act.