reglab/statecodes huggingface dataset:
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-109 - Medicaid assistance for children - Effect on child support

(a)
By accepting Medicaid assistance for or on behalf of a child, the recipient thereof shall be deemed to have assigned to the Office of Child Support Enforcement and any appropriate division of the Department of Human Services any rights to medical support, and for collection and distribution under Title IV-D of the Social Security Act, any rights to child support from any other person as the recipient may have:
(1)
In his or her own behalf or in behalf of any other family member for whom the recipient is receiving assistance; and
(2)
Accrued at the time the assistance, or any portion thereof, is accepted.
(b)
The recipient shall have the right to revoke the assignment for the collection and distribution of child support by requesting revocation of the assignment in writing. However, a revocation shall not affect the requirements of §
20-77-307
.
(c)
Support rights assigned to the department under this section shall constitute an obligation owed to the State of Arkansas by the person responsible for providing the support, and the obligation shall be collectible under all legal processes.
(d)
The appropriate division of the department shall give notice, in writing, to each applicant for assistance. The notice shall state that acceptance of assistance would invoke the provisions of subsection (a) of this section and result in an assignment under subsection (a) of this section.
Acts 1991, No. 985, §§ 1-3; 1993, No. 1242, § 6.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-110 - Increase in reimbursement rate

Notwithstanding any other provision in federal law or departmental commitment which may exist to the contrary, the Department of Human Services shall not increase any reimbursement rate to any provider or provider groups supported in whole or in part by funds administered by the department, nor shall it adopt any other rule or amendment to the Arkansas Medicaid Program that would result in an obligation of the general revenues of the state without first seeking and receiving the approval of the Governor and the Chief Fiscal Officer of the State.
Amended by Act 2019, No. 315,§ 2263, eff. 7/24/2019.
Acts 1993, No. 1239, § 73.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-111 - Data reports

(a)
The Secretary of the Department of Human Services shall cause to be prepared a compilation of data on the Arkansas Medicaid Program.
(b)
(1)
The report shall be issued quarterly and shall include comparisons of expenditures and recipients for the quarter with those of the previous quarters and for the same period the previous year.
(2)
It shall include other comparisons in the format as may be requested by the Legislative Council, the House Committee on Public Health, Welfare, and Labor, and the Senate Committee on Public Health, Welfare, and Labor or appropriate subcommittees thereof to which the reports are to be delivered.
(c)
(1)
The report shall also identify any changes in eligibility requirements, level of benefits, methods or rates of reimbursement, and any program adjustments implemented to achieve savings in any category of the program.
(2)
The report shall also identify any increase or decrease in expenditures as a result of any of these changes in the program.
Amended by Act 2019, No. 910,§ 5221, eff. 7/1/2019.
Amended by Act 2013, No. 1132,§ 47, eff. 8/16/2013.
Acts 1993, No. 1239, § 117; 1997, No. 179, § 32; 2003, No. 1473, § 44.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-115 - Personal care reimbursement rates - Legislative findings - Definition

(a)
The General Assembly finds that:
(1)
The provision of high-quality personal care services in Arkansas is a priority concern;
(2)
Personal care service:
(A)
Is an essential service that enables residents of Arkansas to live in their own homes and avoid institutional care;
(B)
Is vital for allowing residents of Arkansas to remain in their own homes and maintain a level of personal independence and freedom; and
(C)
Saves the healthcare system money by avoiding prolonged institutionalization, high costs, and associated adverse implications; and
(3)
Providers of personal care services should be paid at a rate that is consistent with efficiency, economy, and quality of care and is sufficient to enlist enough providers so that in-home care and services are available statewide.
(b)
As used in this section, "personal care services" means assistance with activities of daily living, respite care, or attendant care provided in the home through the Arkansas Medicaid Personal Care Program.
(c)
(1)
If there is an increase in the state or federal minimum wage that is higher than the minimum wage that applies to employees in Arkansas, the Arkansas Medicaid Program shall conduct a review of the reimbursement rates for personal care services within one hundred eighty (180) days of the publishing of the rate by the Department of Labor and Licensing.
(2)
Within one hundred eighty (180) days of the completion of the review of the reimbursement rates under subdivision (c)(1) of this section, the Department of Human Services shall submit a state plan amendment, waiver, or other necessary authorization to modify the reimbursement rate of personal care services.
(3)
The reimbursement rate modifications described in subdivision (c)(2) of this section shall be retroactive to the maximum date of the increase in the state or federal minimum wage that is allowable under federal law as it relates to the federal medical assistance percentage.
(d)
A reimbursement payment made under this section may not exceed the Medicaid upper payment limit as established by the Centers for Medicare & Medicaid Services.
(e)
The Arkansas Medicaid Program shall make sufficient funds available to a beneficiary to reimburse or pay a provider of personal care services for the number of hours of personal care services that the beneficiary needs or is qualified or eligible for.
Amended by Act 2023, No. 205,§ 7, eff. 8/1/2023.
Amended by Act 2021, No. 571,§ 2, eff. 7/28/2021.
Acts 1997, No. 1360, § 125.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-116 - [Repealed]

Repealed by Act 2013, No. 279,§ 1, eff. 8/16/2013.
Acts 1999, No. 1595, § 1.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-117 - [Repealed]

Repealed by Act 2013, No. 279,§ 1, eff. 8/16/2013.
Acts 1999, No. 1595, § 2.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-118 - [Repealed]

Repealed by Act 2013, No. 279,§ 1, eff. 8/16/2013.
Acts 1999, No. 1595, § 3.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-119 - Finding - Resource eligibility limit

(a)
The General Assembly finds that:
(1)
The income of many elderly Arkansans slightly exceeds the Medicaid eligibility level;
(2)
Without adequate health care, many elderly Arkansans will develop more serious health problems, causing them to become debilitated and resulting in loss of independence, higher health costs, and possibly death; and
(3)
Expanded Medicaid coverage would improve the health of elderly Arkansans, extend their lives, and reduce their health costs.
(b)
When funds become available, the Department of Human Services shall raise the resource eligibility limit for persons sixty-five (65) years of age and over to four thousand dollars ($4,000) for a single individual and six thousand dollars ($6,000) for a married couple.
Acts 2001, No. 1086, §§ 1, 2.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-120 - [Repealed]

Repealed by Act 2017, No. 591,§ 6, eff. 8/1/2017.
Amended by Act 2013, No. 1132,§ 48, eff. 8/16/2013.
Acts 2003, No. 1402, § 1.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-122 - Survey agency for psychiatric residential treatment facilities of children

(a)
To the extent required by federal law, the Division of Medical Services of the Department of Human Services shall designate a survey agency to conduct restraint and seclusion surveys in psychiatric residential treatment facilities for children as defined in §
9-28-402
.
(b)
No designation by the division shall act as a waiver of the provisions of §
9-28-407(a)(3)
or any other applicable law governing child welfare agencies.
Acts 2005, No. 2234, § 5.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-123 - Drugs for asthma and other respiratory diseases - Definitions

(a)
As used in this section:
(1)
"Drug Review Committee" means physicians and pharmacists who perform unbiased reviews of drugs to determine which drugs should be recommended for inclusion on the Preferred Drug List maintained by the Division of Medical Services of the Department of Human Services;
(2)
"Emergency override" means a process developed by the division that permits a pharmacist to obtain immediate permission to dispense an emergency supply of a drug prescribed by the treating physician to treat a medical emergency and for which Medicaid will provide reimbursement;
(3)
"Fail-first" means the requirement that a Preferred Drug List drug be utilized before the use of a non-Preferred Drug List drug;
(4)
"Override" means a process developed by the division that permits a physician to request review of and to seek permission to prescribe a non-Preferred Drug List drug for which Medicaid will provide reimbursement;
(5)
"Preferred Drug List" means a list of drugs within a class of drugs for which Medicaid will provide reimbursement without need of a prior authorization; and
(6)
"Unbiased review" means a review by physicians and pharmacists, selected, approved, or appointed by the division, of scientific evidence to determine the comparative effectiveness and safety of healthcare treatments of drugs within a class.
(b)
In the event that the division institutes a fail-first practice or policy for drugs for the treatment of asthma or other respiratory diseases, the division shall provide a process to request an override.
(c)
In cases of medical emergencies resulting from asthma or other acute respiratory diseases, the dispensing pharmacist shall seek an emergency override before dispensing the emergency supply of drug or drugs to treat the medical emergency condition.
Acts 2005, No. 2251, § 1.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-124 - Medicaid waiver for autism spectrum disorder - Definitions

(a)
As used in this section:
(1)
"Autism spectrum disorder" means a condition that is diagnosed by at least two (2) qualified professionals who both conclude that a child fully meets the diagnostic criteria under the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders;
(2)
"Evidence-based treatment" means treatment subject to research that applies rigorous, systematic, and objective procedures to obtain valid knowledge of effectiveness relative to autism spectrum disorder as published by the National Standards Report by the National Autism Center;
(3)
"Intensive early intervention treatment" means individualized treatment utilizing evidence-based treatment determined appropriate following a detailed assessment of the child that occurs:
(A)
In the home of the child or a natural community setting; and
(B)
In the presence of the parent or legal guardian of the child; and
(4)
(A)
"Qualified professional" means a professional who is educated and licensed in fields related to physical health, mental health, and child and adolescent physical and psychological development.
(B)
"Qualified professional" only includes a licensed physician, licensed psychologist, or licensed speech-language pathologist.
(b)
(1)
The Department of Human Services shall maintain a Medicaid waiver from the Centers for Medicare & Medicaid Services to provide intensive early intervention treatment to any eligible child who has a primary diagnosis of an autism spectrum disorder.
(2)
The waiver shall provide services for young children consistent with the terms specified in the waiver application approved by the Centers for Medicare & Medicaid Services.
(3)
The waiver shall seek to develop skills of children in the areas of cognition, behavior, communication, and social interaction.
(c)
To the extent funding becomes appropriated and available, the department shall apply to add additional eligibility slots to the Medicaid waiver for autism spectrum disorder.
Amended by Act 2021, No. 656,§ 1, eff. 7/28/2021.
Amended by Act 2015, No. 1008,§ 1, eff. 7/22/2015.
Acts 2007, No. 1198, § 1.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-125 - Contingency fee audits prohibited - Definitions

(a)
As used in this section:
(1)
"Healthcare provider" means a person enrolled to provide health or medical care services or goods authorized under Medicaid;
(2)
"Medicaid" means the medical assistance program provided in this state under Title XIX of the Social Security Act of 1965,
42 U.S.C. § 1396
et seq., including components of the program;
(3)
"Medicaid integrity audit contract" means a contract required under federal law between the Department of Human Services and a Medicaid integrity audit program contractor to:
(A)
Review the actions of healthcare providers furnishing services or goods for which payment may be made under the Arkansas Medicaid Program to determine whether fraud, waste, or abuse has occurred or is likely to occur, or whether fraud, waste, or abuse has the potential for resulting in an expenditure of Medicaid funds that is not intended under the Arkansas Medicaid Program;
(B)
Audit Medicaid claims to ensure proper payments were made; or
(C)
Identify overpayments made to individuals or entities receiving Medicaid funds; and
(4)
"Person" means any individual, company, firm, organization, association, corporation, or other legal entity.
(b)
The Division of Medical Services of the Department of Human Services shall not enter into a Medicaid integrity audit contract that authorizes all or part of an auditor's compensation to be based, directly or indirectly, on the amount of overpayments identified or collected by the auditor.
(c)
(1)
Within forty-five (45) days after April 11, 2013, the division shall seek a waiver from the Centers for Medicare & Medicaid Services of the requirement that recovery audit contractors, as identified in
42 U.S.C. § 1396a(a)(42)(B)
, be paid on a contingent fee basis by submitting an amendment to the Medicaid state plan to implement the requirements of this section.
(2)
(A)
Except as under subdivision (c)(2)(B) of this section, this section does not apply to:
(i)
A contract with a Medicaid integrity audit contractor entered into before the state plan amendment is approved by the Centers for Medicare & Medicaid Services; or
(ii)
An existing contingent fee contract entered into before July 1, 2013.
(B)
An existing contingent fee contract shall not be renewed from and after July 1, 2013, April 11, 2013, or the date a waiver from the Centers for Medicare & Medicaid Services becomes effective, whichever is later.
Added by Act 2013, No. 1109,§ 1, eff. 4/11/2013.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-126 - Relation to Arkansas Pharmacy Audit Bill of Rights

(a)
From and after the date that a state plan amendment submitted under §
20-77-125
is approved by the Centers for Medicare & Medicaid Services, §
20-77-125
shall supersede and replace §
17-92-1201(f)
with regard to Medicaid integrity audits of pharmacies and pharmacists, but all other subsections of §
17-92-1201
shall continue in full force and effect with regard to Medicaid integrity audits.
(b)
Section
17-92-1201
is not affected by §
20-77-125
with regard to audits conducted by or on behalf of a person or entity other than Medicaid integrity audits under subsection (a) of this section.
Added by Act 2013, No. 1109,§ 1, eff. 4/11/2013.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-130 - Medicaid provider tax returns - Definition

(a)
As used in this section, "affected Medicaid entity" means an individual or entity that:
(1)
Provides and is directly reimbursed by Medicaid for services in the Arkansas Medicaid Program;
(2)
Is required to submit an annual financial audit to the Department of Human Services; and
(3)
Is required to file a state income tax return, state withholding tax return, pass-through entity withholding tax return, or a composite pass-through entity tax return or pay any tax due for the previous calendar year.
(b)
(1)
On or before December 1 of each year, the Department of Human Services shall provide the Department of Finance and Administration with a list of the tax identification number of each person and entity enrolled to furnish Medicaid services as an affected Medicaid entity.
(2)
The Department of Finance and Administration shall:
(A)
Verify whether each person and entity enrolled to furnish Medicaid services identified to it under subdivision (b)(1) of this section filed and paid any state income tax liability owed for the tax year for which the return was due; and
(B)
Notify the Department of Human Services if any affected Medicaid entity failed to file any state income tax return, state withholding tax return, pass-through entity withholding tax return, or a composite pass-through entity tax return or pay any tax due for the previous calendar year.
(3)
Upon receiving notice from the Department of Finance and Administration under subdivision (b)(2) of this section, the Department of Human Services shall notify the affected Medicaid entity that the Department of Human Services will terminate the affected Medicaid entity's enrollment in the Arkansas Medicaid Program unless the affected Medicaid entity shows good cause why the affected Medicaid entity's Medicaid enrollment should continue.
(c)
The Department of Human Services and the Department of Finance and Administration may adopt rules as needed to implement this section.
Added by Act 2013, No. 1436,§ 1, eff. 8/16/2013.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-131 - Determination that a Medicaid provider is out of business - Definition

(a)
As used in this section, "entity" means:
(1)
A corporation, including without limitation a professional, medical, or dental corporation;
(2)
A limited liability company, including without limitation a professional, medical, or dental limited liability company; and
(3)
A partnership, including without limitation a limited partnership.
(b)
(1)
For the purpose of determining whether an overpayment must be refunded to the United States Government, the Director of the Division of Medical Services of the Department of Human Services is authorized to determine and certify that a Medicaid provider is out of business and that an overpayment owed by the provider cannot be collected under state law and procedures.
(2)
The director may make this determination on the basis of any facts and circumstances deemed relevant and material by the director.
(c)
For the purpose of this section, the director may conclusively presume a provider to be out of business as of:
(1)
The date of suspension, expiration, surrender, or revocation of a license or certification required for the provider to operate; or
(2)
For a provider that did business in the form of an entity, the date of the:
(A)
Dissolution of the entity;
(B)
Occurrence of an event which would trigger dissolution; or
(C)
Forfeiture or revocation of the entity's charter or authority to do business by the Secretary of State or other state authority.
(d)
A determination or certification made by the director under this section:
(1)
Does not abrogate, limit, or modify a provider's debt or obligation to repay;
(2)
Is not a defense to recoupment of Medicaid payments from a provider; and
(3)
May not serve as the basis for an adverse action against a provider.
(e)
The Department of Human Services may promulgate rules to administer this section.
Added by Act 2015, No. 1269,§ 1, eff. 7/22/2015.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-132 - Diagnosis-related group methodology for hospitals - Definition

(a)
As used in this section, "diagnosis-related group methodology" means a system of classification of diagnoses and procedures based on the International Classification of Diseases, Tenth Revision, Clinical Modification, also known as ICD-10-CM, including without limitation:
(1)
The all-patient refined diagnosis-related groups system; and
(2)
The enhanced ambulatory procedure grouping system.
(b)
To the extent possible, the Department of Human Services shall convert the hospital reimbursement systems under the Arkansas Medicaid Program to a diagnosis-related group methodology to allow more accurate classification of patient populations and description of mortality risks and severity of patient illness.
(c)
(1)
The department shall promulgate rules to implement this section.
(2)
The rules adopted under subdivision (c)(1) of this section shall address:
(A)
How supplemental payments to hospitals shall be considered;
(B)
Whether funding for the transition from per diem reimbursement to diagnosis-related group methodology shall be provided to hospitals; and
(C)
Whether certain types of hospital providers shall be exempt from the diagnosis-related group methodology.
(d)
(1)
The department, in coordination with the Arkansas Hospital Association, Inc., shall develop a plan for the conversion of the hospital reimbursement systems under the Arkansas Medicaid Program as described in subsection (b) of this section.
(2)
The conversion plan shall:
(A)
Include estimates of the impact of the conversion on all state and federal funds used for hospital payment, including without limitation any impact on critical-access hospitals; and
(B)
Be submitted to the Legislative Council for review on or before January 1, 2018.
Added by Act 2017, No. 517,§ 1, eff. 8/1/2017.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-133 - Walk-in clinic and emergent care clinic - Medicaid reimbursement - Definitions

(a)
As used in this section:
(1)
"Emergent care clinic" means a walk-in clinic focused on the delivery of ambulatory care in a facility outside of traditional emergency care; and
(2)
"Walk-in clinic" means a medical clinic that accepts patients on a walk-in basis and without an appointment.
(b)
When a Medicaid beneficiary who does not have an assigned primary care provider utilizes or attempts to utilize a walk-in clinic or emergent care clinic, the walk-in clinic or emergent care clinic shall not decline to treat the patient due to his or her lack of a primary care provider.
(c)
The Arkansas Medicaid Program shall reimburse for up to four (4) healthcare visits per year at a walk-in clinic or emergent care clinic when the Medicaid beneficiary does not have a primary care provider assigned if the walk-in clinic or emergent care clinic is associated with a hospital.
Added by Act 2017, No. 546,§ 1, eff. 8/1/2017.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-134 - Direct access to chiropractic physicians

(a)
On or before January 1, 2018, the Department of Human Services shall adopt rules to allow a Medicaid recipient direct access to a chiropractic physician.
(b)
Rules adopted under this section shall:
(1)
Allow a Medicaid recipient to receive diagnosis and treatment from a chiropractic physician without a referral from a primary care physician;
(2)
Direct the Division of Medical Services of the Department of Human Services to develop a process for reporting diagnosis, treatment, costs of services, and cost-savings benefits under this section; and
(3)
Specify that a chiropractic physician who provides diagnosis or treatment, or both, under this section shall receive the same reimbursement as if the Medicaid recipient had been referred to the chiropractic physician by a primary care physician.
Added by Act 2017, No. 1092,§ 2, eff. 8/1/2017.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-135 - Peer support specialist

The Department of Human Services shall not disqualify or exclude an individual from participation in the Arkansas Medicaid Program based on a criminal background check if:
(1)
The individual is employed as a peer support specialist or other similar position;
(2)
The individual obtains certification in peer recovery from an accredited organization approved by the Arkansas Alcohol and Drug Abuse Coordinating Council;
(3)
The certification was obtained after the commission of a criminal offense;
(4)
(A)
The criminal offense does not involve violence or a sexual act.
(B)
If the offense on the person's criminal background check that would disqualify him or her from employment is an offense that involves violence, the Department of Human Services shall evaluate the offense and make a determination, on the basis of criteria and limitation adopted by the department in rule, as to whether the person may be employed as a peer support specialist; and
(5)
The certification process includes due process for appealing a decision based upon a disqualifying charge in the criminal background check.
Amended by Act 2023, No. 200,§ 2, eff. 8/1/2023.
Amended by Act 2021, No. 782,§ 1, eff. 7/28/2021.
Added by Act 2019, No. 951,§ 2, eff. 4/12/2019.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-136 - Additional albuterol inhaler

(a)
Annually in the month of August, the Arkansas Medicaid Program shall cover the cost of one (1) additional albuterol inhaler for a Medicaid beneficiary who has been prescribed an albuterol inhaler and who is under eighteen (18) years of age.
(b)
The Department of Human Services shall apply for any federal waiver, Medicaid state plan amendments, or other authority necessary to implement this section.
(c)
This section applies to Medicaid beneficiaries in the fee-for-service Arkansas Medicaid Program and the managed care Arkansas Medicaid Program.
Added by Act 2019, No. 856,§ 1, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-137 - Ridesharing application - Medicaid reimbursement - Definition

(a)
As used in this section, "ridesharing application" means an online application that connects a passenger with a driver who is licensed under the Transportation Network Company Services Act, §
23-13-701
et seq., for a fee.
(b)
The Arkansas Medicaid Program may reimburse for the fee incurred through ridesharing applications to healthcare facilities or offices of healthcare professionals for a Medicaid beneficiary.
(c)
Reimbursement shall not be available if the Medicaid beneficiary uses the ridesharing application to travel across state lines.
Added by Act 2019, No. 952,§ 1, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-138 - Medications approved by United States Food and Drug Administration for tobacco cessation coverage

(a)
The Department of Human Services shall ensure that the Arkansas Medicaid Program covers medications approved by the United States Food and Drug Administration for tobacco cessation, including without limitation:
(1)
Nicotine replacement therapy patches;
(2)
Nicotine replacement therapy gum;
(3)
Nicotine replacement therapy lozenges;
(4)
Nicotine replacement therapy nasal spray;
(5)
Nicotine replacement therapy inhalers;
(6)
Bupropion; and
(7)
Varenicline.
(b)
Prior authorization shall not be required for coverage of medications described in subsection (a) of this section.
Added by Act 2019, No. 959,§ 2, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-139 - Elimination of waiting list

(a)
The Department of Human Services shall eliminate the waiting list as existing on March 1, 2019, for the Alternative Community Services Waiver Program, also known as the "Developmental Disabilities Waiver", or successor program.
(b)
The department shall meet the requirements of subsection (a) of this section as soon as possible but no later than three (3) years after July 24, 2019 by using available funding streams, unless the department determines that an adequate number of providers for individuals with developmental disabilities does not exist within the state.
(c)
An individual who applies for coverage or enrolls in the program after March 1, 2019, may be placed on a waiting list if the department determines that adequate funding streams or resources are not available at the time of application or enrollment.
Added by Act 2019, No. 1033,§ 1, eff. 7/24/2019.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-140 - Primary care provider for Arkansas Medicaid Program - Advanced practice registered nurse

(a)
(1)
The Arkansas Medicaid Program shall recognize an advanced practice registered nurse licensed by the Arkansas State Board of Nursing for all purposes as a primary care provider authorized to carry out the duties of a primary care case manager, except as provided under subdivision (a)(3) of this section.
(2)
Purposes under subdivision (a)(1) of this section include without limitation:
(A)
Being recognized as the initial healthcare provider in the program;
(B)
Performing initial diagnosis;
(C)
Acting as the team leader of family practice professionals and the patient-centered medical home;
(D)
Maintaining the medical records of a patient;
(E)
Ordering laboratory tests and records management as needed for patient care;
(F)
Providing preventive and periodic examinations within primary care;
(G)
Referring a patient to a physician, a specialist, or a hospital when necessary; and
(H)
Treating a patient within the scope of practice and licensure of an advanced practice registered nurse.
(3)
Purposes under subdivision (a)(1) of this section do not include owning a patient-centered medical home.
(b)
The program shall reimburse an advanced practice registered nurse:
(1)
Not less than the current reimbursement rate for services performed within the scope of practice and licensure of the advanced practice registered nurse; and
(2)
One hundred percent (100%) of the physician reimbursement rate for all out-of-pocket costs incurred by the advanced practice registered nurse such as the costs of laboratory tests, X-rays, and any additional tests ordered or conducted by the advanced practice registered nurse.
(c)
A healthcare insurance policy in which the premiums are paid directly or indirectly by the program also shall recognize and reimburse an advanced practice registered nurse under subsections (a) and (b) of this section.
(d)
This section does not increase the scope of practice or licensure of an advanced practice registered nurse.
Added by Act 2021, No. 569,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-141 - Provision of behavioral and mental health services via telemedicine - Medicaid reimbursement

(a)
(1)
The General Assembly finds that during the public health emergency caused by coronavirus 2019 (COVID-19), the Department of Human Services issued several memorandums authorizing certain reimbursement for behavioral and mental health services provided via telemedicine for the time period of the public health emergency.
(2)
It is the intent of the General Assembly to make the authorization for certain reimbursement for behavioral and mental health services provided via telemedicine permanent.
(b)
The Arkansas Medicaid Program shall reimburse for the following behavioral and mental health services provided via telemedicine:
(1)
Counseling and psychoeducation provided by a person licensed as:
(A)
A psychologist;
(B)
A psychological examiner;
(C)
A professional counselor;
(D)
An associate counselor;
(E)
An associate marriage and family therapist;
(F)
A marriage and family therapist;
(G)
A clinical social worker; or
(H)
A master social worker;
(2)
Crisis intervention services;
(3)
Substance abuse assessments;
(4)
Mental health diagnosis assessments for an individual under twenty-one (21) years of age; and
(5)
Group therapy for individuals who are eighteen (18) years of age or older under the current service definition determined by the Arkansas Medicaid Program and when provided via audiovisual technology that is compliant with the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, and composed of beneficiaries of similar age and clinical presentation to qualified beneficiaries.
(c)
The Arkansas Medicaid Program shall reimburse for supplemental support services provided in-person or via audiovisual technology or telephone that is compliant with the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, within the managed care program in the same manner as provided by risk-based provider organizations under the Medicaid Provider-Led Organized Care Act, §
20-77-2701
et seq., through the later of:
(1)
The end of the public health emergency that began on March 11, 2020, by Executive Order 20-03; or
(2)
December 31, 2021.
(d)
The department shall apply for any federal waiver, Medicaid state plan amendment, or other authorization necessary to implement this section.
(e)
This section applies to Medicaid beneficiaries in the fee-for-service Arkansas Medicaid Program and the managed care Arkansas Medicaid Program.
Added by Act 2021, No. 624,§ 1, eff. 4/8/2021.
This section was originally enacted as §20-77-112.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-142 - Off-label use of drug treatment to treat pediatric acute-onset neuropsychiatric syndrome and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection

(a)
The General Assembly finds that:
(1)
Pediatric acute-onset neuropsychiatric syndrome, also known as "PANS", is a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms or eating restrictions, accompanied by two (2) or more symptoms of acute behavioral deterioration or motor and sensory changes, or both;
(2)
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, also known as "PANDAS", is a term used to describe a subset of symptoms affecting children and adolescents within the broader PANS classification;
(3)
Other state Medicaid programs provide coverage for off-label use of drug treatments to treat pediatric acute-onset neuropsychiatric syndrome and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections; and
(4)
However, the Arkansas Medicaid Program does not provide coverage for off-label use of drug treatments, to treat Medicaid beneficiaries who are diagnosed with pediatric acute-onset neuropsychiatric syndrome and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.
(b)
The Arkansas Medicaid Program shall provide coverage for off-label use of drug treatments, including without limitation intravenous immunoglobulin, also known as "IVIG", to treat Medicaid beneficiaries who are diagnosed with pediatric acute-onset neuropsychiatric syndrome or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or both, under a treatment plan established by the Childhood Post-infectious Autoimmune Encephalopathy Clinic in Arkansas.
(c)
The Department of Human Services shall apply for any federal waiver, state plan amendment, or other authorization necessary to implement this section.
Added by Act 2021, No. 637,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-143 - Products and label expansions approved by the United States Food and Drug Administration

(a)
The General Assembly finds that:
(1)
The Arkansas Medicaid Program has historically delayed or denied access to new products and label expansions approved by the United States Food and Drug Administration during the time period after the products or label expansions have been approved by the United States Food and Drug Administration but before the Arkansas Medicaid Drug Utilization Review Board has conducted a formal clinical review;
(2)
This practice:
(A)
Unnecessarily delays patient access to innovative products which can be particularly harmful for citizens of Arkansas who are living with life-shortening or life-threatening conditions; and
(B)
May result in irreversible harm to the health of citizens of Arkansas;
(3)
Other state Medicaid programs provide immediate access to new products and label expansions approved by the United States Food and Drug Administration prior to a formal clinical review; and
(4)
It is in the best interest of the citizens of this state to provide immediate access to new products and label expansions approved by the United States Food and Drug Administration prior to a formal clinical review.
(b)
Consistent with federal laws and regulations, the Arkansas Medicaid Program shall:
(1)
Provide immediate access to and reimbursement for new products and label expansions approved by the United States Food and Drug Administration, or outpatient drugs with a federal rebate agreement in place, if the product is prescribed according to approved indications or medically accepted indications; and
(2)
Not deny or delay coverage or reimbursement for new products and label expansions for an existing covered product approved by the United States Food and Drug Administration for an existing covered product, including denying or delaying access to a product solely because the Arkansas Medicaid Drug Utilization Review Board or any other advisory body has not conducted a formal clinical review of the product or label expansion.
(c)
(1)
The Department of Human Services shall appoint two (2) individuals to the Arkansas Medicaid Drug Utilization Review Board.
(2)
The individuals appointed under subdivision (c)(1) of this section shall be:
(A)
Either physicians or advanced practice registered nurses;
(B)
Licensed and practicing in this state; and
(C)
Currently treating rare diseases or conditions.
(3)
The department shall amend any rules or bylaws of the Arkansas Medicaid Drug Utilization Review Board to implement this section.
Added by Act 2021, No. 745,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-144 - Reimbursement for behavioral health services

(a)
The Arkansas Medicaid Program shall reimburse for behavioral health services that are provided in a federally qualified health center by at a minimum:
(1)
A clinical psychologist;
(2)
A licensed certified social worker;
(3)
A licensed professional counselor;
(4)
A licensed mental health counselor; or
(5)
A licensed marriage and family therapist.
(b)
The Department of Human Services shall apply for any federal waiver, Medicaid state plan amendments, or other authority necessary to implement this section.
Added by Act 2021, No. 764,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-145 - Vagus nerve stimulation therapy system device reimbursement rates

(a)
The Department of Human Services shall establish separate vagus nerve stimulation therapy system device reimbursement rates for all acute care hospitals that are Medicaid providers.
(b)
The vagus nerve stimulation therapy system device reimbursement rates for implantation of a vagus nerve stimulation therapy system device shall be:
(1)
Equal to one hundred percent (100%) of the Medicare average comprehensive payment rate for vagus nerve stimulation therapy, device, and procedure; and
(2)
In addition to the surgery fees already listed in the Arkansas Medicaid Program.
Added by Act 2021, No. 830,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-146 - Prohibition on referrals for mental health counseling

The Arkansas Medicaid Program shall not require a beneficiary to first obtain a referral from a primary care provider before receiving mental health counseling for the first ten (10) visits for mental health counseling.
Added by Act 2021, No. 886,§ 1, eff. 7/28/2021.
Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 5 - SOCIAL SERVICES (§§ 20-76-101 — 20-86-113) › Chapter 77 - MEDICAL ASSISTANCE (§§ 20-77-101 — 20-77-2811) › Subchapter 1 - GENERAL PROVISIONS (§§ 20-77-101 — 20-77-153) › Section 20-77-147 - Diagnostic laboratory services

(a)
The General Assembly finds that:
(1)
The national coronavirus 2019 (COVID-19) emergency has emphasized the critical importance of laboratory testing for diagnosing disease and promoting health;
(2)
There is a disparity in the scope of laboratory testing services that are covered by the Arkansas Medicaid Program;
(3)
Often, radiology services are grouped with diagnostic laboratory services;
(4)
Radiology services are more expensive than diagnostic laboratory services and greatly reduce the services that a beneficiary can receive;
(5)
The program only covers up to five hundred dollars ($500) for all diagnostic laboratory services, including radiology; and
(6)
This disparity in services should be reduced or eliminated.
(b)
The program shall set the annual cap for:
(1)
Diagnostic laboratory services, not including radiology services, of at least five hundred dollars ($500); and
(2)
Radiology services of at least five hundred dollars ($500).
(c)
Any laboratory or diagnostic procedure that is an essential health benefit does not count towards the caps described in subsection (b) of this section.
(d)
The Department of Human Services shall apply for any federal waiver, Medicaid state plan amendment, or other authorization necessary to implement this section.
Added by Act 2021, No. 891,§ 1, eff. 7/28/2021.