Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.13-016 - Arkansas Private Option (Health Care Independence Act of 2013)

Current through Register Vol. 49, No. 6, June, 2024
5.
Alternative Benefit Plan (ABP)
Effective for dates of service on or after January 1,
				2014, the Arkansas Medicaid program will cover inpatient acute hospital days in
				excess of twenty-four days (during a state fiscal year) for those beneficiaries
				covered under the Alternative Benefit Plan (APB). The per diem rate for ABP
				inpatient acute hospital days twenty-five and above will be 400 dollars per
				day. The intent of the policy change is to increase access to care in all
				hospitals in the state of Arkansas. Inpatient Acute hospital days under
				twenty-five will be reimbursed in accordance with the methodology set forth in
				Attachment 4.19A page 1. Except as otherwise noted in the Plan, this rate is
				the same for both governmental and private providers of inpatient acute
				hospital services.
Effective for dates of service on or after January 1,
				2014, the Arkansas Medicaid program will cover inpatient rehabilitation
				hospital days in excess of twenty-four days (during a state fiscal year) for
				those beneficiaries covered under the Alternative Benefit Plan (ABP). The per
				diem rate for ABP inpatient rehabilitation hospital days twenty-five and above
				will be 400 dollars per day. The intent of the policy change is to increase
				access to care in all hospitals in the state of Arkansas. Inpatient
				rehabilitation hospital days under twenty-five will be reimbursed in accordance
				with the methodology set forth in Attachment 4.19A page 9a. Except as otherwise
				noted in the State Plan, this rate is the same for both government and private
				providers of inpatient rehabilitation hospital services.
METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATES
				-INPATIENT HOSPITAL SERVICES
ATTACHMENT 4.19-A
29.
Alternative Benefit Plan
			 (ABP)
All required ABP services and immunizations not
				specifically identified in the following are covered and reimbursed in
				accordance with the methodologies described elsewhere in the State Plan. The
				state's reimbursement methodologies otherwise set forth in the State Plan meet
				the minimum ABP requirements under the Affordable Care Act (ACA). All APB and
				non-ABP are rates published on the agency's website
(www.medicaid.state.ar.us/download/provider/provdocs/manuals/)
. Fee schedules are located on the appropriate provider manual page. Except as
				otherwise noted in the Plan, the rates are the same for both governmental and
				private providers.
A.
Cochlear Implants, Auditory Brain Stem Implants and Osseointegrated
			 Hearing Aid Implants Effective for dates of service on or after January 1,
			 2014, the Arkansas Medicaid program will cover these implants for all age ABP
			 beneficiaries. Reimbursement will be the same as is currently covered for under
			 age 21 non-ABP beneficiaries.
B.
Diabetic Self-Management Training
			 Effective for dates of service on or after January 1, 2014, the Arkansas
			 Medicaid program will cover Diabetic self-management training by a qualified
			 health care professional for all age ABP beneficiaries. These services will
			 only be provided in the outpatient hospital setting. Reimbursement will be
			 based on the January 1, 2014 Medicare rates for these
			 services.
C.
Diagnosis and Treatment of Alcoholism and Drug Abuse, Including Detoxification
			 Treatment and Counseling Effective for dates of service on or after January 1,
			 2014, the Arkansas Medicaid program will cover Diagnosis and treatment of
			 alcoholism and drug abuse, including detoxification treatment and counseling
			 for all age ABP beneficiaries. Reimbursement will be the same as is currently
			 covered for under age 21 non-ABP beneficiaries
D.
Shingles Immunization Effective for
			 dates of service on or after January 1, 2014, the Arkansas Medicaid program
			 will cover shingles immunization for ABP beneficiaries. These immunizations
			 will be covered for age groups as recommended by the Centers for Disease
			 Control (CDC). Reimbursement will be based on 80% of the 2014 Arkansas Blue
			 Cross Blue Shield rate for this immunization.