Title 20 — Public Health and Welfare
63 chapters · 2,838 sections in this title.
Ark. Code Ann. § 20-77-2607 Construction — Immunity
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(a) This subchapter shall not:(1) Confer upon the caregiver any authority to make healthcare decisions on behalf of the patient;(2) Create a private right of action against a hospital, hospital employee, or duly authorized agent of the hospital; or(3) Remove the obligation of a t…
Ark. Code Ann. § 20-77-2701 Title
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This subchapter shall be known and may be cited as the “Medicaid Provider-Led Organized Care Act”.
Ark. Code Ann. § 20-77-2702 Legislative intent and purpose
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(a) As the single state agency for administration of the medical assistance programs established under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., and Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq., the Department of Human Services is authori…
Ark. Code Ann. § 20-77-2703 Definitions
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(1) As used in this subchapter:(1) “Associated participant” means an organization or individual that is a member or contractor of a risk-based provider organization and provides necessary administrative functions, including without limitation claims processing, data collection, a…
Ark. Code Ann. § 20-77-2704 Licensure by Insurance Commissioner
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(a) The Insurance Commissioner may license for participation in the Medicaid provider-led organized care system one (1) or more risk-based provider organizations that satisfactorily meet licensure requirements and are capable of coordinating the delivery and payment of healthcare…
Ark. Code Ann. § 20-77-2705 Excluded services
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(a) Except as provided in subsection (b) of this section, all healthcare services delivered through the Medicaid provider-led organized care system shall:(1) Be available for all members of covered Medicaid beneficiary populations; and(2) Be comparable in amount, duration, or sco…
Ark. Code Ann. § 20-77-2706 Characteristics and duties of risk-based provider organization
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(a) A risk-based provider organization shall:(1) Be authorized to conduct business in the state;(2) Hold a valid certificate of authority issued by the Secretary of State;(3) Have an ownership interest of not less than fifty-one percent (51%) by participating providers; and(4) In…
Ark. Code Ann. § 20-77-2707 Reporting and performance measures
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(a) (1) On a quarterly basis, a risk-based provider organization shall submit to the Department of Human Services protected health information for each member of a covered Medicaid beneficiary population and a voluntary Medicaid beneficiary population enrolled with the risk-based…
Ark. Code Ann. § 20-77-2708 Waiver and rulemaking authority
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(1) The Department of Human Services:(1) Shall submit an application for any federal waivers, federal authority, or state plan amendments necessary to implement this subchapter; and(2) May promulgate rules as necessary to implement this subchapter. (1) Shall submit an application…
Ark. Code Ann. § 20-77-2709 Marketing — Legislative intent
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(a) It is the intent of the General Assembly to ensure that potential and actual enrollees in a risk-based provider organization have a right to know:(1) Whether a direct service provider is or will be in-network with a particular risk-based provider organization; and(2) The cons…
Ark. Code Ann. § 20-77-2710 Independent assessments for certain beneficiaries enrolled in risk-based provider organization
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(a) The Department of Human Services shall implement an abbreviated independent assessment process for beneficiaries who have been previously approved for services through an independent assessment, including without limitation a desk review, for beneficiaries who have chronic, l…
Ark. Code Ann. § 20-77-2711 Quality rating system. [Effective January 1, 2026.]
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(a) The risk-based provider organizations shall have a basic quality rating system that is accessible online that includes ratings for each risk-based provider organization based on data that includes at a minimum the following measures that are currently collected by the risk-ba…
Ark. Code Ann. § 20-77-2712 Provider directories. [Effective January 1, 2026.]
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(a) Each risk-based provider organization shall provide to enrollees real-time access to its provider network directory through a link on the website of the Department of Human Services and on the website of the risk-based provider organization. (b) The risk-based provider organi…
Ark. Code Ann. § 20-77-2713 Beneficiary support office. [Effective January 1, 2026.]
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(a) The Department of Human Services shall have a dedicated beneficiary support system that is adequately staffed and trained to meet the requirements of 42 C.F.R. § 438.71, as existing on January 1, 2025. (b) Enrollees and other members of the public shall be able to easily cont…
Ark. Code Ann. § 20-77-2714 Home- and community-based services — Rate setting
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(a) (1) An allowance within the capitation rates for a risk-based provider organization shall not be less than the amount needed to pay providers the rates arrived at through a rate study to be completed by October 1, 2025.(2) The rates from a rate study as described in subdivisi…
Ark. Code Ann. § 20-77-2801 Legislative findings and intent
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(a) The General Assembly finds that:(1) Emergency medical services constitute an invaluable part of the healthcare delivery system of Arkansas;(2) Emergency medical services will be a key element in any healthcare reform initiative;(3) Emergency medical services are a key compone…
Ark. Code Ann. § 20-77-2802 Definitions
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(1) As used in this subchapter:(1) “Air ambulance services” means services authorized and licensed by the Department of Health to provide care and air transportation of patients;(2) “Ambulance services” means services authorized and licensed by the department to provide care and …
Ark. Code Ann. § 20-77-2803 Medical transportation provider assessment
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(a) (1) Except as provided in this subchapter, an assessment is imposed on each medical transportation provider for each state fiscal year in an amount calculated as a percentage of the net operating revenues of the medical transportation provider.(2) The assessment rate shall be…
Ark. Code Ann. § 20-77-2804 Program administration
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(a) The Director of the Division of Medical Services of the Department of Human Services shall administer the assessment program created in this subchapter. (b) (1) The Division of Medical Services of the Department of Human Services shall adopt rules to implement this subchapter…
Ark. Code Ann. § 20-77-2805 Medical Transportation Assessment Account
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(a) (1) There is created within the Arkansas Medicaid Program Trust Fund a designated account known as the “Medical Transportation Assessment Account”.(2) The medical transportation provider assessments imposed under § 20-77-2803 shall be deposited into the Medical Transportation…
Ark. Code Ann. § 20-77-2806 Exemptions
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(a) The following medical transportation providers are exempt from the assessment imposed under § 20-77-2803 unless the exemption is adjudged to be unconstitutional or otherwise determined to be invalid:(1) Volunteer ambulance services;(2) Ambulance services owned by the state, c…
Ark. Code Ann. § 20-77-2807 Quarterly notice and collection
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(a) (1) The annual medical transportation provider assessment imposed under § 20-77-2803 shall be due and payable on a quarterly basis.(2) However, an installment payment of an assessment imposed by § 20-77-2803 shall not be due and payable until:(A) The Division of Medical Servi…
Ark. Code Ann. § 20-77-2808 Notice of assessment
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(a) (1) The Division of Medical Services of the Department of Human Services shall send a notice of assessment to each medical transportation provider informing the medical transportation provider of the assessment rate, the medical transportation provider's net operating revenue…
Ark. Code Ann. § 20-77-2809 Emergency medical transportation access payments
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(a) To preserve and improve access to medical transportation services, for medical transportation services rendered on or after July 1, 2017, the Division of Medical Services of the Department of Human Services shall make emergency medical transportation access payments as set fo…
Ark. Code Ann. § 20-77-2810 Effectiveness — Cessation
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(a) The medical transportation provider assessment imposed under § 20-77-2803 shall cease to be imposed, the emergency medical transportation access payments made under § 20-77-2809 shall cease to be paid, and any moneys remaining in the Medical Transportation Assessment Account …
Ark. Code Ann. § 20-77-2811 State plan amendment
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(a) The Division of Medical Services of the Department of Human Services shall file with the Centers for Medicare & Medicaid Services a state plan amendment to implement the requirements of this subchapter, including the payment of emergency medical transportation access payments…
Ark. Code Ann. § 20-77-2901 Depression screening for pregnant women
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(a) The Arkansas Medicaid Program shall reimburse for depression screening of a pregnant woman. (b) The Department of Human Services shall apply for any federal waiver, Medicaid state plan amendments, or other authority necessary to implement this section.
Ark. Code Ann. § 20-77-2902 Coverage of prenatal, delivery, and postpartum services
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(a) The Arkansas Medicaid Program shall reimburse for prenatal, delivery, and postpartum services separately in lieu of a global payment or an all-inclusive payment methodology for maternity services. (b) Prenatal, delivery, and postpartum services include without limitation:(1) …
Ark. Code Ann. § 20-77-2903 Presumptive eligibility for pregnant women
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(a) The Arkansas Medicaid Program shall make presumptive eligibility determinations for pregnant women who are applying for the program to improve access to prenatal care and allow prenatal care to be delivered immediately while waiting for a full application to be processed. (b)…
Ark. Code Ann. § 20-77-2904 Blood pressure monitoring for pregnant and postpartum women
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(a) The Arkansas Medicaid Program shall provide coverage and reimbursement for self-measurement blood pressure monitoring services for pregnant women and postpartum women. (b) Self-measurement blood pressure monitoring services shall include:(1) Validated blood pressure monitorin…
Ark. Code Ann. § 20-77-2905 Reimbursement for remote ultrasound procedures
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(a) (1) The Arkansas Medicaid Program shall reimburse for medically necessary remote ultrasound procedures utilizing established Current Procedural Terminology codes for remote ultrasound procedures when the patient is in a residence or other off-site location from the healthcare…
Ark. Code Ann. § 20-77-2906 Coverage for certain services provided by doulas and community health workers
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The Arkansas Medicaid Program shall reimburse doulas and community health workers for home visitation related to prenatal care and postpartum care.
Ark. Code Ann. § 20-77-2907 Implementation and rules
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(1) The Department of Human Services shall:(1) Apply for any federal waiver, Medicaid state plan amendments, or other authority necessary to implement this subchapter; and(2) Adopt rules to implement this subchapter. (1) Apply for any federal waiver, Medicaid state plan amendment…
Ark. Code Ann. § 20-77-301 Action by Department of Human Services
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(a) (1) When medical assistance benefits are provided or will be provided to a medical assistance recipient because of injury, disease, disability, or death for which a third party is or may be liable, the appropriate division of the Department of Human Services may recover from …
Ark. Code Ann. § 20-77-302 Action by recipient alone — Reimbursement of division
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(a) When an action or claim is brought by a medical assistance recipient or his or her legal representative against a third party who may be liable for injury, disease, disability, or death of a medical assistance recipient, any settlement, judgment, or award obtained is subject …
Ark. Code Ann. § 20-77-303 Action by division and recipient
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(a) If an action is prosecuted both by the medical assistance recipient and the division against a third party who is or may be liable for injury, disease, disability, or death of the medical assistance recipient, then in the event of judgment or award in a suit or claim against …
Ark. Code Ann. § 20-77-304 Notice of action or claim — Intervention or consolidation
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(a) (1) If either the medical assistance recipient or the appropriate division brings an action or claim against a third party, the recipient or Department of Human Services shall give to the other party written notice of the action or claim by personal service or registered mail…
Ark. Code Ann. § 20-77-305 Notice to Department of Human Services of award or settlement by recipient required
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(a) A judgment, an award, or a settlement in any action or claim by a medical assistance recipient to recover damages for injuries, disease, disability, or death in which the Department of Human Services has an interest, shall not be satisfied without first giving the department …
Ark. Code Ann. § 20-77-306 Liability of third parties to Department of Human Services — Definitions
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(a) As used in this section:(1) “Health insurer” means a commercial insurance company offering health or casualty insurance to individuals or groups including without limitation experience-rated insurance contracts and indemnity contracts that offer the following:(A) Automobile i…
Ark. Code Ann. § 20-77-307 Assignment to Department of Human Services of rights of recovery
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(a) As a condition of eligibility, every Medicaid applicant shall automatically assign his or her right to any settlement, judgment, or award which may be obtained against any third party to the Department of Human Services to the full extent of any amount which may be paid by Me…
Ark. Code Ann. § 20-77-308 Release of information to Department of Human Services
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All recipients of medical assistance under the Arkansas Medicaid Program shall be deemed to have authorized all third parties including, but not limited to, insurance companies and providers of medical care to release to the Department of Human Services information needed by the …
Ark. Code Ann. § 20-77-309 Denial or reduction of benefits — Insurance policies
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No policy of accident or illness insurance issued or renewed after July 1, 1981, shall contain any provision denying or reducing benefits because services are rendered to an insured or dependent who is eligible for medical assistance under the Arkansas Medicaid Program.
Ark. Code Ann. § 20-77-310 Denial or reduction of benefits — Service plan corporation contracts
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After July 1, 1981, no service plan corporation shall deliver, issue for delivery, or renew any subscriber's contract which contains any provision denying or reducing benefits because services are rendered to a subscriber or dependent who is eligible for medical assistance under …
Ark. Code Ann. § 20-77-311 Denial or reduction of benefits — Healthcare providers
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After July 1, 1981, no association authorized to do business in this state which provides or pays for any healthcare benefits shall issue any certificate which contains any provision denying or reducing benefits because services are rendered to a certificate holder or beneficiary…
Ark. Code Ann. § 20-77-312 Denial or reduction of benefits — Provisions not applicable to Arkansas Medicaid Program
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General exclusion or reduction provisions relating to benefits paid by or eligibility under governmental programs, whether state or federal, shall not be construed to apply to the Arkansas Medicaid Program.
Ark. Code Ann. § 20-77-313 Billing statements
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Billing statements forwarded to recipients of medical assistance by vendors of medical care shall clearly state that reimbursement from the Arkansas Medicaid Program is contemplated.
Ark. Code Ann. § 20-77-314 Definitions
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(1) As used in this subchapter:(1) “Action” or “claim” means a complaint, demand letter, or any other notification given to a third party by the Department of Human Services, the medical assistance recipient, the recipient's attorney, or any person acting on behalf of the recipie…
Ark. Code Ann. § 20-77-315 Distribution of proceeds from third-party settlement, judgment, or award or from other third-party payment
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(a) The Department of Human Services is entitled to reimbursement for past medical assistance payments from that portion of a third-party settlement, judgment, or award or from any other third-party payment that compensates for the medical expenses. (b) The department is entitled…
Ark. Code Ann. § 20-77-401 Purpose
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The purpose of this subchapter is to allow for the continued operation of a prescription drug program as a portion of the Title XIX Medicaid Program for the State of Arkansas.
Ark. Code Ann. § 20-77-402 Continuation of program
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(a) The Secretary of the Department of Human Services and the deputy director of the appropriate division of the Department of Human Services are authorized to provide for continued coverage of prescription drugs under the Title XIX Medicaid Program for the State of Arkansas. (b)…