Ark. Code Ann. § 23-76-116 (2026)

1. 1. Every health maintenance organization shall establish and maintain a complaint system that has been approved by the Insurance Commissioner to provide reasonable procedures for the resolution of written complaints initiated by enrollees concerning healthcare services.
   2. Each health maintenance organization shall submit to the commissioner an annual report in a form prescribed by the commissioner that shall include:
      1. A description of the procedures of the complaint system;
      2. The total number of complaints handled through the complaint system and a compilation of causes underlying the complaints filed; and
      3. The number, amount, and disposition of malpractice claims settled during the year by the health maintenance organization.
2. 1. The health maintenance organization shall maintain records of written complaints filed with it concerning issues and persons other than healthcare services and shall submit to the commissioner a summary report at such times and in such format as the commissioner may require.
   2. Complaints involving other persons shall be referred to the persons with a copy to the commissioner.
3. The commissioner may examine the complaint system, subject to the limitation concerning medical records of individuals set forth in § 23-76-122(c).

History. Acts 1975, No. 454, § 12; A.S.A. 1947, § 66-5212; Acts 2001, No. 1605, § 7; 2013, No. 1433, § 6.

Amendments. The 2013 amendment deleted “after consultation with the Director of the Department of Health” following “Insurance Commissioner” in (a)(1); in (a)(2), deleted “and the director” following “to the commissioner” and “after consultation with the director” following “by the commissioner”; redesignated former (b) as present (b)(1) and (b)(2); inserted “issues and person” in (b)(1); and deleted “or the director” following “The commissioner” in (c).