- (a) The Insurance Commissioner shall develop a state audit process to ensure that a health benefit plan or health carrier calculates the qualified payment amount established under the No Surprises Act of the Consolidated Appropriations Act, 2021, Pub. L. No. 116-260.
- (b) The federal qualified health payment amount methodologies shall be included in all health policy forms for review and approval by the commissioner.
(c)
- (1) The audit process required pursuant to this part, and specifically subsection (a) of this section, shall be consistent with and included in the already required examination of insurers as contemplated by Arkansas Code § 23-61-201 et seq.
- (2) The commissioner, per his or her discretion, may conduct an examination of health carriers concerning potential violations of the administration the qualified payment amount methodology of the No Surprises Act to ensure compliance with the requirements not more often than every five (5) years on an as-needed basis if and when justified by a significant number of complaints against a particular carrier.
- (d) The resulting examination report concerning potential violations of the No Surprises Act as it relates to the qualified payment amount calculation methodology shall be shared with the United States Department of Health and Human Services in order that the commissioner and United States Department of Health and Human Services may impose appropriate sanctions and engage in proper administration to carry out all requirements of state and federal law.