Title 20, Public Health and Welfare

(a) It is the specific intent of this section and § 20-77-105 to prohibit any provider of medical services who participates in the Arkansas Medicaid Program to bill or receive payment from any Medicaid-eligible person, his or her spouse, relative, guardian, or any other prospecti…

(a) Any provider of medical services which shall be determined by the administrator of the single state agency for Medicaid to purposely engage in the practice of seeking or receiving double or duplicate payments for the same services either through double billing or through any …

(a) The Arkansas Children's Hospital, as recognized by § 20-78-102, is authorized to enter into agreements with the appropriate division of the Department of Human Services to establish and maintain a medical services program for Medicaid-eligible patients of the Arkansas Childre…

(a) (1) The appropriate division of the Department of Human Services is authorized to establish and maintain an indigent medical care program.(2) However, eligibility rules for the ARKids First Program Act, § 20-77-1101 et seq., shall not include an assets or a resource test for …

(a) Every nonprofit corporation, except those licensed under § 20-9-201 et seq., which is eligible to receive payments of twenty-five thousand dollars ($25,000) or more for services supplied as a Medicaid provider shall, as a condition of enrollment, provide the Department of Hum…

(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 a…

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 …

This subchapter shall be known and may be cited as the “ARKids First Program Act”.

The purpose and intent of this subchapter is to establish a program to provide access to appropriate healthcare services for eligible children in Arkansas.

(1) For purposes of this subchapter:(1) “Family” means a family as defined in the Medical Services Policy Manual of the Division of County Operations of the Department of Human Services; and(2) “Healthcare coverage” means healthcare insurance as defined by rules promulgated by th…

(a) As used in this section:(1) (A) “Healthcare coverage” means healthcare insurance regulated by the State Insurance Department, including without limitation group and employer-sponsored health insurance plans.(B) The Department of Human Services may by rule exclude other plans …

(a) Funding for the uninsured children's program shall be derived from funds as may be provided by the General Assembly, copayments, and any federal matching funds available to the program. (b) It is further the intent of this subchapter that funds appropriated by the General Ass…

(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 pre…

(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 v…

(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 los…

This subchapter shall be known and may be cited as the “Medicaid Program for Low-Income Disabled Working Persons”.

The purpose and intent of this subchapter is to establish a new optional categorically needy Medicaid eligibility group under section 4733 of the Balanced Budget Act of 1997 to provide medical assistance to disabled working persons whose family incomes are less than two hundred f…

(1) As used in this subchapter, unless the context otherwise requires:(1) (A) “Cost sharing” means the portion of the cost of a Medicaid-covered service which must be paid at the point of service by the eligible individual.(B) Cost sharing shall be set on a sliding scale based on…

(a) The Department of Human Services is authorized to apply to the Centers for Medicare & Medicaid Services for approval to create and administer the low-income disabled working person category of Medicaid eligibility. (b) The department shall promulgate rules for and administer …

(a) Funding for the low-income disabled working person category of Medicaid eligibility shall be derived from funds as may be provided by the General Assembly, premiums, cost sharing, and any federal matching funds available to the Medicaid Program for Low-Income Disabled Working…

(a) As used in this section:(1) “Adverse action” means the denial, termination, suspension, or reduction of Medicaid eligibility or covered services; and(2) “Beneficiary” means:(A) A person who has applied for medical assistance under the Arkansas Medicaid Program; or(B) A person…

(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…

(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 …

(a) As used in this section:(1) “Autism spectrum disorder” means a condition that is diagnosed by at least two (2) qualified professionals of different types from the list in subdivision (a)(4)(B) of this section who each conclude that a child fully meets the diagnostic criteria …

(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 196…

(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…

(a) The eligibility determination regarding every applicant for long-term care nursing facility placement shall be made according to the criteria in the rules promulgated by the Department of Human Services. (b) The department shall promulgate rules to establish eligibility deter…

(a) As used in this section:(1) “Caregiver” means an individual who has responsibility for the protection, in-home care, or custody of a Medicaid enrollee as a result of assuming the responsibility by contract; and(2) “Registry records check” means the review of one (1) or more d…

(a) As used in this section:(1) “Ambulatory surgery center” means an entity certified by Medicare as an ambulatory surgical center that operates for the purpose of providing surgical services to patients and that is eligible to receive reimbursement from Medicaid for ambulatory s…

(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; an…

This subchapter may be cited as the “Medical Assistance Programs Integrity Law”.

(a) This subchapter is enacted to combat and prevent fraud and abuse committed by some healthcare providers participating in the medical assistance programs and by other persons and to negate the adverse effects those activities have on fiscal and programmatic integrity. The admi…

(1) As used in this subchapter, the following terms shall have the following meanings:(1) “Administrative adjudication” means adjudication and the adjudication process contained in the Arkansas Administrative Procedure Act, § 25-15-201 et seq.;(2) “Claim” includes any request or …

(a) (1) Pursuant to rules promulgated in accordance with the Arkansas Administrative Procedure Act, § 25-15-201 et seq., the Secretary of the Department of Human Services shall establish a process to review a claim made by a healthcare provider to determine whether the claim shou…

The Secretary of the Department of Human Services may agree to settle an administrative sanction. The terms of the settlement shall be reduced to writing and signed by the parties to the agreement. The terms of the settlement shall be a public record. The settlement shall include…

(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 partners…

(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) …

(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 app…

(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 chirop…

(1) 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 …

(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 Service…

(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 th…

(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…

(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 o…

(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 subd…

This subchapter shall be known and may be cited as the “Prescription Drug Access Improvement Act”.