{"id":30313,"date":"2026-02-24T00:00:00","date_gmt":"2026-02-24T05:00:00","guid":{"rendered":"https:\/\/www.resourcepro.com\/bulletin\/arkansas-updates-gold-card-appeal-rules-for-providers-under-act-511-of-2025\/"},"modified":"2026-02-24T00:00:00","modified_gmt":"2026-02-24T05:00:00","slug":"arkansas-updates-gold-card-appeal-rules-for-providers-under-act-511-of-2025","status":"publish","type":"bulletin","link":"https:\/\/www.resourcepro.com\/bulletin\/arkansas-updates-gold-card-appeal-rules-for-providers-under-act-511-of-2025\/","title":{"rendered":"Arkansas Updates \u201cGold Card\u201d Appeal Rules for Providers Under Act 511 of 2025"},"content":{"rendered":"\n<p><strong>AR<\/strong>| <a href=\"https:\/\/portal.insurance.arkansas.gov\/LegalPubsPublic\/Documents\/Bulletins\/bulletin_4-2026.pdf\" target=\"_blank\" rel=\"noopener\">Bulletin 4-2026<\/a> from the <strong>Arkansas Insurance Department<\/strong> s<span style=\"text-decoration: underline;\">upersedes Bulletin 16-2024 and updates the appeals procedures for Arkansas \u201cgold card\u201d prior authorization exemptions to align with Act 511 of 2025, outlining two main processes:<\/span> first, how healthcare providers may appeal a healthcare insurer\u2019s rescission of a gold card for a healthcare service through an independent review organization, including a 12\u2011month appeal window, strict completeness checks and notices, timelines for insurer and commissioner actions, and the option for review of a second random sample of eligible claims; and second, how independent review is handled when the Arkansas State Medical Board or State Board of Pharmacy denies an insurer\u2019s or PBM\u2019s request to exempt a prescription drug or related service from gold card requirements, with the commissioner assigning an independent review organization and specifying documentation and timing requirements for the review.<\/p>\n\n\n\n<p><strong><em><a href=\"https:\/\/portal.insurance.arkansas.gov\/LegalPubsPublic\/Documents\/Bulletins\/bulletin_4-2026.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Click here to see AR Bulletin 4-2026<\/a><\/em><\/strong><\/p>\n\n\n\n<p><\/p>\n","protected":false},"featured_media":22239,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"department":[252],"state":[260],"class_list":["post-30313","bulletin","type-bulletin","status-publish","format-standard","has-post-thumbnail","hentry","department-department-of-insurance","state-arkansas"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/bulletin\/30313","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/bulletin"}],"about":[{"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/types\/bulletin"}],"version-history":[{"count":0,"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/bulletin\/30313\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/media\/22239"}],"wp:attachment":[{"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/media?parent=30313"}],"wp:term":[{"taxonomy":"department","embeddable":true,"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/department?post=30313"},{"taxonomy":"state","embeddable":true,"href":"https:\/\/www.resourcepro.com\/wp-json\/wp\/v2\/state?post=30313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}