August 11, 2015
On Aug. 4, 2015, Rule 109 was issued by Arkansas Insurance Commissioner Kerr. Ark. Code Ann. § 23-99-417(a)(1) and Ark. Code Ann. § 23-99-417(e) give the Commissioner authority to promulgate a rule governing payment standards by health benefit plans for orthotic devices, orthotic services, prosthetic devices and prosthetic services.
As background, various members of the orthotic and prosthetic industry requested the Arkansas Insurance Department to update orthotic and prosthetic coverage reimbursement rates in fully insured health benefit plans to 80 percent of current CMS rates. The current law in Ark. Code Ann. § 23-99- 417(a)(1) ties the reimbursement rates to 80 percent of 2009 CMS Medicare coverage levels.
Rule 109 updates the orthotic and prosthetic coverage reimbursement rate from 80 percent of 2009 CMS rates to 80 percent of current levels. It also develops an automatic mechanism to tie yearly orthotic and prosthetic reimbursement levels to current CMS rates without amending the rule on a yearly basis.
The rule takes effect Oct. 19, 2015.
Rule 109 »