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Arkansas General Assembly· HB 1298Notification that HB1298 is now Act 307

An act TO MODIFY PAYMENT OF BENEFITS FOR CERTAIN 10 HEALTHCARE PROVIDERS UNDER A HEALTH BENEFIT PLAN, the official text

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Stricken language would be deleted from and underlined language would be added to present law.

1 State of Arkansas              As Engrossed: H2/11/25
2 95th General Assembly
                                       A Bill

3 Regular Session, 2025                                             HOUSE BILL 1298

4

5 By: Representative L. Johnson

6 By: Senator Irvin

7

8                                For An Act To Be Entitled

9   AN ACT TO MODIFY PAYMENT OF BENEFITS FOR CERTAIN

10  HEALTHCARE PROVIDERS UNDER A HEALTH BENEFIT PLAN; AND

11  FOR OTHER PURPOSES.

12

13

14                                   Subtitle

15                       TO MODIFY PAYMENT OF BENEFITS FOR

16                       CERTAIN HEALTHCARE PROVIDERS UNDER A

17                       HEALTH BENEFIT PLAN.

18

19 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

20

21  SECTION 1. Arkansas Code � 23-85-114 is amended to read as follows:

22  23-85-114. Payment of claims Payment-of-claims provision.

23  (a) There Except as provided under subsection (c) of this section,

24 there shall be a provision as follows:

25  "Payment of Claims: Indemnity for loss of life will be payable

26 in accordance with the beneficiary designation and the provisions respecting

27 such payment which may be prescribed herein and effective at the time of

28 payment. If no such designation or provision is then effective, such

29 indemnity shall be payable to the estate of the insured. Any other accrued

30 indemnities unpaid at the insured's death may, at the option of the insurer,

31 be paid either to such beneficiary or to such estate. All other indemnities

32 will be payable to the insured."

33  (b) The Except as provided under subsection (c) of this section,

34 either of the following provisions, or either of them, may be included with

35 the foregoing provision subsection (a) of this section at the option of the

36 healthcare insurer:

    *ANS021*                                                   02-11-2025 09:49:38 ANS021
    As Engrossed: H2/11/25                                                  HB1298

1   (1) "If any indemnity of this policy shall be payable to the

2 estate of the insured, or to an insured or beneficiary who is a minor or

3 otherwise not competent to give a valid release, the insurer may pay such

4 indemnity, up to an amount not exceeding $............. (insert an amount

5 which shall not exceed one thousand dollars ($1,000)), to any relative by

6 blood or connection by marriage of the insured or beneficiary who is deemed

7 by the insurer to be equitably entitled thereto. Any payment made by the

8 insurer in good faith pursuant to this provision shall fully discharge the

9 insurer to the extent of payment."

10  (2) "Subject to any written direction of the insured in the

11 application or otherwise, all or a portion of any indemnities provided by

12 this policy on account of hospital, nursing, medical, or surgical services

13 may be paid, at the insurer's option and unless the insured requests

14 otherwise in writing not later than the time of filing proofs of such loss,

15 directly to the hospital or person rendering such services, but it is not

16 required that the service be rendered by a particular hospital or person."

17  (c) A healthcare insurer shall pay a claim for any indemnity provided

18 by a health benefit plan on account of hospital, nursing, medical, or

19 surgical services directly to the healthcare provider that provided the

20 service for an out-of-network claim.

21  (d) As used in this section:

22  (1)(A) "Health benefit plan" means:

23                          (i) An individual, blanket, or group plan or a

24 policy or contract for healthcare services offered, issued, renewed,

25 delivered, or extended in this state by a healthcare insurer; and

26                          (ii) A health benefit program receiving state or

27 federal appropriations from the State of Arkansas, including the Arkansas

28 Medicaid Program and the Arkansas Health and Opportunity for Me Program

29 established by the Arkansas Health and Opportunity for Me Act of 2021, � 23-

30 61-1001 et seq., or any successor program.

31  (B) "Health benefit plan" includes:

32                          (i) Indemnity and managed care plans; and

33                          (ii) Nonfederal governmental plans as defined in 29

34 U.S.C. � 1002(32), as it existed on January 1, 2025.

35  (C) "Health benefit plan" does not include:

36                          (i) A plan that provides only dental benefits or eye

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    As Engrossed: H2/11/25                                                  HB1298

1 and vision care benefits;

2                           (ii) A disability income plan;

3                           (iii) A credit insurance plan;

4                           (iv) Insurance coverage issued as a supplement to

5 liability insurance;

6                           (v) A medical payment under an automobile or

7 homeowners insurance plan;

8                           (vi) A health benefit plan provided under Arkansas

9 Constitution, Article 5, � 32, the Workers' Compensation Law, � 11-9-101 et

10 seq., or the Public Employee Workers' Compensation Act, � 21-5-601 et seq.;

11                          (vii) A plan that provides only indemnity for

12 hospital confinement;

13                          (viii) An accident-only plan;

14                          (ix) A specified disease plan; or

15                          (x) A long-term-care-only plan; and

16            (2)(A) "Healthcare insurer" means an entity subject to the

17 insurance laws of this state or the jurisdiction of the Insurance

18 Commissioner that contracts or offers to contract to provide health insurance

19 coverage, including without limitation an insurance company, a hospital and

20 medical service corporation, a health maintenance organization, a self-

21 insured governmental or church plan in this state, or the Arkansas Medicaid

22 Program.

23            (B) "Healthcare insurer" does not include an entity that

24 provides only dental benefits or eye and vision care benefits.

25

26

27  SECTION 2. Arkansas Code � 23-86-104 is amended to read as follows:

28  23-86-104. Blanket accident and health insurance -- Payment of

29 benefits.

30  (a)(1) All Except as provided under subsection (c) of this section,

31 all benefits under any blanket accident and health insurance policy or health

32 benefit plan shall be payable to the person insured, to the designated

33 beneficiaries, or to his or her estate.

34            (2) However, if the person insured is a minor or mental

35 incompetent, the benefits may be made payable to the parent, guardian, or

36 other person actually supporting the minor or mental incompetent. If the

                              3             02-11-2025 09:49:38 ANS021
    As Engrossed: H2/11/25                                                  HB1298

1 entire cost of the insurance has been borne by the employer, the benefits may

2 be made payable to the employer.

3   (b)(1) However, except as provided under subsection (c) of this

4 section, the policy or health benefit plan may provide that all or any

5 portion of any indemnities provided by the policy or health benefit plan on

6 account of hospital, nursing, medical, or surgical services, at the

7 healthcare insurer's option, may be paid directly to the hospital or person

8 rendering the services, but the policy or health benefit plan may not shall

9 not require that the service be rendered by a particular hospital or person.

10  (2) Payment so made shall discharge made under subdivision

11 (b)(1) of this section discharges the healthcare insurer's obligation with

12 respect to the amount of insurance paid.

13  (c) A healthcare insurer shall pay a claim for any indemnity provided

14 by a health benefit plan on account of hospital, nursing, medical, or

15 surgical services directly to the healthcare provider that provided the

16 service for an out-of-network claim.

17  (d) As used in this section:

18  (1)(A) "Health benefit plan" means:

19                          (i) An individual, blanket, or group plan or a

20 policy or contract for healthcare services offered, issued, renewed,

21 delivered, or extended in this state by a healthcare insurer; and

22                          (ii) A health benefit program receiving state or

23 federal appropriations from the State of Arkansas, including the Arkansas

24 Medicaid Program and the Arkansas Health and Opportunity for Me Program

25 established by the Arkansas Health and Opportunity for Me Act of 2021, � 23-

26 61-1001 et seq., or any successor program.

27  (B) "Health benefit plan" includes:

28                          (i) Indemnity and managed care plans; and

29                          (ii) Nonfederal governmental plans as defined in 29

30 U.S.C. � 1002(32), as it existed on January 1, 2025.

31  (C) "Health benefit plan" does not include:

32                          (i) A plan that provides only dental benefits or eye

33 and vision care benefits;

34                          (ii) A disability income plan;

35                          (iii) A credit insurance plan;

36                          (iv) Insurance coverage issued as a supplement to

                                    4          02-11-2025 09:49:38 ANS021
    As Engrossed: H2/11/25                                                  HB1298

1 liability insurance;

2                           (v) A medical payment under an automobile or

3 homeowners insurance plan;

4                           (vi) A health benefit plan provided under Arkansas

5 Constitution, Article 5, � 32, the Workers' Compensation Law, � 11-9-101 et

6 seq., or the Public Employee Workers' Compensation Act, � 21-5-601 et seq.;

7                           (vii) A plan that provides only indemnity for

8 hospital confinement;

9                           (viii) An accident-only plan;

10                          (ix) A specified disease plan; or

11                          (x) A long-term-care-only plan; and

12           (2)(A) "Healthcare insurer" means an entity subject to the

13 insurance laws of this state or the jurisdiction of the Insurance

14 Commissioner that contracts or offers to contract to provide health insurance

15 coverage, including without limitation an insurance company, a hospital and

16 medical service corporation, a health maintenance organization, a self-

17 insured governmental or church plan in this state, or the Arkansas Medicaid

18 Program.

19                  (B) "Healthcare insurer" does not include an entity that

20 provides only dental benefits or eye and vision care benefits.

21

22  SECTION 3. Arkansas Code � 23-86-112 is amended to read as follows:

23  23-86-112. Group accident and health insurance -- Direct payment of

24 hospital or medical services.

25  (a) On Except as provided under subsection (c) of this section, on

26 request by the group policyholder, any group accident and health insurance

27 policy or health benefit plan may provide that all or any portion of any

28 indemnities provided by any policy or health benefit plan on account of

29 hospital, nursing, medical, or surgical services may be paid, at the

30 healthcare insurer's option, directly to the hospital or person rendering

31 such services, but the policy or health benefit plan may not shall not

32 require that the service be rendered by a particular hospital or person.

33  (b) Payment so made made under subsection (a) of this section shall

34 discharge the healthcare insurer's obligation with respect to the amount of

35 insurance paid.

36  (c) A healthcare insurer shall pay a claim for any indemnity provided

                                  5  02-11-2025 09:49:38 ANS021
    As Engrossed: H2/11/25                                                  HB1298

1 by a health benefit plan on account of hospital, nursing, medical, or

2 surgical services directly to the healthcare provider that provided the

3 service for an out-of-network claim.

4   (d) As used in this section:

5   (1)(A) "Health benefit plan" means:

6                           (i) An individual, blanket, or group plan or a

7 policy or contract for healthcare services offered, issued, renewed,

8 delivered, or extended in this state by a healthcare insurer; and

9                           (ii) A health benefit program receiving state or

10 federal appropriations from the State of Arkansas, including the Arkansas

11 Medicaid Program and the Arkansas Health and Opportunity for Me Program

12 established by the Arkansas Health and Opportunity for Me Act of 2021, � 23-

13 61-1001 et seq., or any successor program.

14  (B) "Health benefit plan" includes:

15                          (i) Indemnity and managed care plans; and

16                          (ii) Nonfederal governmental plans as defined in 29

17 U.S.C. � 1002(32), as it existed on January 1, 2025.

18  (C) "Health benefit plan" does not include:

19                          (i) A plan that provides only dental benefits or eye

20 and vision care benefits;

21                          (ii) A disability income plan;

22                          (iii) A credit insurance plan;

23                          (iv) Insurance coverage issued as a supplement to

24 liability insurance;

25                          (v) A medical payment under an automobile or

26 homeowners insurance plan;

27                          (vi) A health benefit plan provided under Arkansas

28 Constitution, Article 5, � 32, the Workers' Compensation Law, � 11-9-101 et

29 seq., or the Public Employee Workers' Compensation Act, � 21-5-601 et seq.;

30                          (vii) A plan that provides only indemnity for

31 hospital confinement;

32                          (viii) An accident-only plan;

33                          (ix) A specified disease plan; or

34                          (x) A long-term-care-only plan; and

35  (2)(A) "Healthcare insurer" means an entity subject to the

36 insurance laws of this state or the jurisdiction of the Insurance

                                  6            02-11-2025 09:49:38 ANS021
    As Engrossed: H2/11/25                                                 HB1298

1 Commissioner that contracts or offers to contract to provide health insurance

2 coverage, including without limitation an insurance company, a hospital and

3 medical service corporation, a health maintenance organization, a self-

4 insured governmental or church plan in this state, or the Arkansas Medicaid

5 Program.

6 (B) "Healthcare insurer" does not include an entity that

7 provides only dental benefits or eye and vision care benefits.

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9                           /s/L. Johnson

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