Title 20 — Public Health and Welfare
63 chapters · 2,838 sections in this title.
Ark. Code Ann. § 20-77-146 Prohibition on referrals for mental health counseling
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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.
Ark. Code Ann. § 20-77-147 Diagnostic laboratory services
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(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 covere…
Ark. Code Ann. § 20-77-148 Continuous glucose monitor — Definition
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(a) As used in this section, “continuous glucose monitor” means an instrument or device, including repair and replacement parts, that:(1) Is designed and offered for the purpose of aiding an individual with diabetes;(2) Measures glucose levels at set intervals by means of a small…
Ark. Code Ann. § 20-77-149 Coverage for screening for behavioral health conditions and for behavioral health services
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(a) The Arkansas Medicaid Program shall reimburse for screening for behavioral health conditions and behavioral health services provided in:(1) A hospital outpatient clinic; or(2) A physician clinic. (1) A hospital outpatient clinic; or (2) A physician clinic. (b) The Department …
Ark. Code Ann. § 20-77-150 Legislative findings — Supplemental reimbursement rates for preventive services for children — Definitions
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(a) The General Assembly finds that:(1) Prevention and early intervention in child health and well-being improves health outcomes and saves money in the long term;(2) A significant proportion of pediatric behavioral healthcare claims in Arkansas occur in primary care settings;(3)…
Ark. Code Ann. § 20-77-1501 Legislative findings and intent
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(a) The General Assembly finds that:(1) The State of Arkansas currently ranks forty-sixth among the fifty (50) states for having the least healthy population;(2) A major contributing factor to the state's low health ranking is its high percentage of uninsured persons;(3) There is…
Ark. Code Ann. § 20-77-1502 Definitions
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(1) As used in this subchapter:(1) “Community-based” means based in, located in, or primarily relating to the community of geographically contiguous political subdivisions, as determined by the board of a community-based health cooperative, that will be or is served by the commun…
Ark. Code Ann. § 20-77-1503 Program administration — Member agreements — Definition
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(a) A community-based health cooperative shall administer a community-based healthcare access program in a manner that:(1) Defines the population that may receive subsidized services provided through the community-based healthcare access program by limiting program eligibility to…
Ark. Code Ann. § 20-77-1504 Coordination with local health education center programs
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Whenever feasible, community-based health cooperatives shall participate actively with area health education center programs in developing and implementing recruitment, training, and retention programs directed at positively influencing the supply and distribution of healthcare p…
Ark. Code Ann. § 20-77-1505 Donations by community-based health cooperatives
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A community-based health cooperative may make donations for the public welfare or for charitable, scientific, or educational purposes, subject to such limitations, if any, as may be contained in its articles of incorporation or any amendment to the articles of incorporation.
Ark. Code Ann. § 20-77-1506 Program report
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(a) In order to demonstrate community-based healthcare access program viability and effectiveness, a community-based health cooperative shall collect data and, upon request, make available a report to the appropriate interim committees of the Senate and House of Representatives. …
Ark. Code Ann. § 20-77-1507 Community-based health cooperatives' activity deemed not to be practice of medicine
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No community-based health cooperative shall be deemed to be engaged in the corporate practice of medicine.
Ark. Code Ann. § 20-77-1508 Immunity and liability
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No liability on the part of and no cause of action of any nature shall arise against any member of the board of directors of a community-based health cooperative or against an employee or agent of a community-based health cooperative for any lawful action taken by them in the per…
Ark. Code Ann. § 20-77-1509 Community-based health cooperative deemed not to be public utility or regulated industry
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(a) (1) Community-based health cooperatives shall not be considered or regulated as any type of entity governed by Title 23 of the Arkansas Code.(2) No program offered by a community-based health cooperative shall be subject to regulation under Title 23 of the Arkansas Code. (1) …
Ark. Code Ann. § 20-77-151 [Repealed.]
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A.C.A. § 20-77-151Current through all legislation of the 2025 Regular Session.Arkansas Code of 1987 Annotated Official EditionCopyright © 2026 by the State of Arkansas All rights reserved
Ark. Code Ann. § 20-77-152 Long-acting reversible contraception coverage — Legislative findings
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(a) The General Assembly finds that:(1) The Arkansas Medicaid Program currently covers long-acting reversible contraception;(2) Due to the payment model used by the program for coverage of pregnant women, healthcare providers have found that providing long-acting reversible contr…
Ark. Code Ann. § 20-77-153 Redetermination and transition of coverage for postpartum mothers
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(a) The Arkansas Medicaid Program shall redetermine eligibility for postpartum mothers receiving coverage under a Medicaid eligibility category within eight (8) weeks of giving birth and ensure the enrollment and transition of the postpartum mother into any available Medicaid eli…
Ark. Code Ann. § 20-77-154 Physical therapy in clinic-based setting — Findings
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(a) The General Assembly finds that:(1) The Arkansas Medicaid Program covers physical therapy to help beneficiaries improve their movement and physical function, manage pain and other chronic conditions, and recover from or prevent injury and chronic disease;(2) However, the prog…
Ark. Code Ann. § 20-77-155 Primary care provider for Arkansas Medicaid Program — Physician assistant
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(a) If authorized by a physician assistant's supervising physician, the Arkansas Medicaid Program shall recognize a physician assistant licensed by the Arkansas State Medical Board as a primary care provider authorized to carry out the following duties of a primary care case mana…
Ark. Code Ann. § 20-77-156 High complexity oral health care — Reimbursement — Definitions
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(a) As used in this section:(1) “Healthcare provider” means:(A) An oral and maxillofacial surgeon;(B) A dentist;(C) A dental specialist such as an endodontist, orthodontist, periodontist, or prosthodontist;(D) An anesthesiologist or other anesthesia provider;(E) A pediatric denti…
Ark. Code Ann. § 20-77-157 Treatment of severe obesity
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(a) The Arkansas Medicaid Program shall reimburse for the treatment of diseases and conditions caused by severe obesity. (b) The coverage under subsection (a) of this section shall include coverage for:(1) Bariatric surgery, as recognized by the American Society for Metabolic and…
Ark. Code Ann. § 20-77-158 Inpatient treatment for substance use disorder — Legislative findings
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(a) The General Assembly finds that:(1) Substance use disorder is a significant public health concern in this state;(2) Inpatient treatment for substance use disorders is an essential component of comprehensive care;(3) Currently, inpatient treatment for substance use disorder is…
Ark. Code Ann. § 20-77-159 Dental services reimbursement — Adult with special needs dental services cap
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(a) (1) The Arkansas Medicaid Program shall increase reimbursement rates for:(A) Oral and maxillofacial surgeons' dental services, including anesthesia;(B) Pediatric dental services, including anesthesia; and(C) Dental services for adults with special needs.(2) Beginning on Septe…
Ark. Code Ann. § 20-77-1701 Legislative findings and intent
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(a) The General Assembly finds that:(1) Healthcare providers who serve Medicaid recipients are an indispensable and vital link in serving this state's needy citizens; and(2) The Department of Human Services already has in place various provisions to:(A) Ensure the protection and …
Ark. Code Ann. § 20-77-1702 Definitions
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(1) As used in this subchapter:(1) “Abuse” means a pattern of provider conduct that is inconsistent with sound fiscal, business, or medical practices and that results in:(A) An unnecessary cost to the Arkansas Medicaid Program; or(B) Reimbursement for services that are not medica…
Ark. Code Ann. § 20-77-1703 Recoupment
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(a) (1) The Department of Human Services shall not use a technical deficiency as grounds for recoupment unless identifying the technical deficiency as an overpayment is mandated by a specific federal statute or regulation or the state is required to repay the funds to the Centers…
Ark. Code Ann. § 20-77-1704 Provider administrative appeals allowed
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(a) The General Assembly finds it necessary to:(1) Clarify its intent that providers have the right to administrative reconsideration and fair and impartial administrative appeals; and(2) Emphasize that this right of administrative reconsideration and appeal is to be liberally co…
Ark. Code Ann. § 20-77-1705 Explanations for adverse decisions required
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(a) Each denial or other deficiency that the Department of Human Services makes against a Medicaid provider shall be prepared in writing and shall specify:(1) The nature of the adverse decision;(2) The statutory provision or specific rule alleged to have been violated; and(3) The…
Ark. Code Ann. § 20-77-1706 Reimbursement at an alternate level instead of complete denial
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(a) (1) (A) Subject to § 20-77-1707 for retrospective reviews, if the Department of Human Services has sufficient documentation to determine that some level of care other than the level that was claimed is medically necessary, then the department may recoup.(B) However, the provi…
Ark. Code Ann. § 20-77-1707 Prior authorizations — Retrospective reviews
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(1) If the Department of Human Services requires a provider to justify the medical necessity of a service through prior authorization, the department shall not later take the position that the services were not medically necessary, unless the retrospective review establishes that…
Ark. Code Ann. § 20-77-1708 Medical necessity
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(a) There is a presumption in favor of the medical judgment of the performing or prescribing physician in determining medical necessity of treatment. (b) If an administrative law judge finds that the Department of Human Services has overcome the presumption under subsection (a) o…
Ark. Code Ann. § 20-77-1709 Promulgation before enforcement
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(a) The Department of Human Services may not use state policies, guidelines, manuals, or other such criteria in enforcement actions against providers unless the criteria have been promulgated. (b) Nothing in this section requires or authorizes the department to attempt to promulg…
Ark. Code Ann. § 20-77-1710 Delivery of files
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(a) If the Department of Human Services makes an adverse decision in a Medicaid case and a provider then lodges an administrative appeal, the department shall deliver to the provider well in advance of the appeal its file on the matter so that the provider will have time to prepa…
Ark. Code Ann. § 20-77-1711 Copies of records to be supplied to department — Exception
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(a) Except as provided in subsection (b) of this section, providers must supply records to the Department of Human Services at their own cost. (b) If the provider has supplied records to the department and the provider identifies to whom the records were supplied, the provider is…
Ark. Code Ann. § 20-77-1712 Notices
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(a) When the Department of Human Services sends letters or other forms of notice with deadlines to providers or recipients, the deadline shall not begin to run before the next business day following the date of the postmark on the envelope, the facsimile transmission confirmation…
Ark. Code Ann. § 20-77-1713 Deadlines
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(a) The Department of Human Services may not issue a claim denial or demand for recoupment to providers for missing a deadline if the department or its contractor contributed to the delay or the delay was reasonable under the circumstances, including, but not limited to:(1) Inter…
Ark. Code Ann. § 20-77-1714 Hospital claims
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(a) When more than one (1) hospital provides services to a recipient and the amount of claims exceeds the recipient's benefit limit, then the hospitals are entitled to reimbursement based on the earliest date of service. (b) If the claims have been paid by Medicaid contrary to th…
Ark. Code Ann. § 20-77-1715 Federal law
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(a) If any provision of this subchapter is found to conflict with current federal law, including promulgated federal regulations, the federal law shall override that provision. (b) If under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., or Title XXI of the Social…
Ark. Code Ann. § 20-77-1716 Promulgation of rules
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The Department of Human Services may promulgate rules to implement this subchapter.
Ark. Code Ann. § 20-77-1717 Timelines for audits
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(a) If a Medicaid provider audit by the Medicaid Integrity Program or Audit Medicaid Integrity Contractors is conducted, the Department of Human Services or the contractor shall provide the audit report to the provider within one hundred fifty (150) days after the completion of t…
Ark. Code Ann. § 20-77-1718 Termination — Appeals
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(a) A Medicaid provider that is aggrieved by an adverse decision of the Department of Human Services with respect to termination of the provider's certification or Medicaid provider agreement or an action by the department that has the same effect as terminating the provider's ce…
Ark. Code Ann. § 20-77-1719 Publication of protocols, procedures, and requirements
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(a) The Department of Human Services shall publish and maintain all protocols, procedures, and requirements used in making adverse decisions on the website of the department. (b) The publication shall include:(1) The current version of each protocol, procedure, or requirement;(2)…
Ark. Code Ann. § 20-77-1720 Third-party entity compliance
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A third-party entity shall comply with the requirements in this subchapter, including appeal periods, notice requirements, and publication of protocols, procedures, and requirements.
Ark. Code Ann. § 20-77-1801 Findings
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The General Assembly finds that in order to alleviate the financial burden on the state's Medicaid program, the state must encourage better access to and utilization of affordable long-term care insurance that will pay for some or all of the cost of long-term care services.
Ark. Code Ann. § 20-77-1802 Definitions
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(1) As used in this subchapter:(1) “Long-term care facility” means a facility required to be licensed under § 20-10-224;(2) “Long-term care insurance” means the same as in § 23-97-304; and(3) “Long-term care services” means the following necessary services that originate in a set…
Ark. Code Ann. § 20-77-1803 Arkansas Long-Term Care Partnership Program — Created
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(a) The Arkansas Long-Term Care Partnership Program is created within the Department of Human Services. (b) The Department of Human Services in cooperation with the Insurance Commissioner shall submit applications to the United States Department of Health and Human Services neces…
Ark. Code Ann. § 20-77-1804 Applicability
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This subchapter does not supersede the obligations under the Long-Term Care Insurance Act of 2005, § 23-97-301 et seq.
Ark. Code Ann. § 20-77-1805 Continuity of asset protection
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If this subchapter is repealed, any Medicaid asset protection afforded under § 20-77-1803 shall remain effective for the life of the individual receiving long-term care services under this subchapter.
Ark. Code Ann. § 20-77-1901 Definitions
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(1) As used in this subchapter:(1) “Division” means the Division of Medical Services of the Department of Human Services;(2) “Hospital” means a health care facility licensed as a hospital by the Division of Health Facilities Services under § 20-9-213;(3) “Medicare Cost Report” me…
Ark. Code Ann. § 20-77-1902 Assessment
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(a) (1) An assessment is imposed on each hospital except those exempted under § 20-77-1905 for each state fiscal year in an amount calculated as a percentage of each hospital's net patient revenue.(2) The assessment rate shall be determined annually based upon the percentage of n…