1 | 1 | | Stricken language would be deleted from and underlined language would be added to present law. |
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2 | 2 | | *JMB121* 01/16/2025 1:47:10 PM JMB121 |
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3 | 3 | | State of Arkansas 1 |
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4 | 4 | | 95th General Assembly A Bill 2 |
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5 | 5 | | Regular Session, 2025 HOUSE BILL 1165 3 |
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6 | 6 | | 4 |
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7 | 7 | | By: Representative L. Johnson 5 |
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10 | 10 | | For An Act To Be Entitled 8 |
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11 | 11 | | AN ACT TO PROHIBIT DIFFERENT REIMBURSEMENT RATES FOR 9 |
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12 | 12 | | SERVICES PERFORMED BY THE SAME TYPE OF PROVIDER IN 10 |
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13 | 13 | | DIFFERENT SETTINGS WITHIN THE ARKANSAS MEDICAID 11 |
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14 | 14 | | PROGRAM; AND FOR OTHER PURPOSES. 12 |
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17 | 17 | | Subtitle 15 |
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18 | 18 | | TO PROHIBIT DIFFERENT REIMBURSEMENT 16 |
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19 | 19 | | RATES FOR SERVICES PERFORMED BY THE SAME 17 |
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20 | 20 | | TYPE OF PROVIDER IN DIFFERENT SETTINGS 18 |
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21 | 21 | | WITHIN THE ARKANSAS MEDICAID PROGRAM. 19 |
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23 | 23 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 21 |
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24 | 24 | | 22 |
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25 | 25 | | SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 1, is 23 |
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26 | 26 | | amended to add an additional section to read as follows: 24 |
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27 | 27 | | 20-77-154. Prohibition on different reimbursement rates by the same 25 |
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28 | 28 | | type of provider in different settings. 26 |
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29 | 29 | | (a) The General Assembly finds that: 27 |
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30 | 30 | | (1) There are discrepancies between the rates paid to physicians 28 |
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31 | 31 | | who see patients in an office setting when that setting is a behavioral 29 |
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32 | 32 | | health agency or a certified support services provider agency and when that 30 |
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33 | 33 | | setting is the physician’s office; 31 |
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34 | 34 | | (2) A physician is paid more for his or her services when those 32 |
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35 | 35 | | services are rendered in his or her office than when a physician provides the 33 |
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36 | 36 | | same services at a behavioral health agency or a certified support services 34 |
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37 | 37 | | provider agency; 35 |
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38 | 38 | | (3) The services in these settings employ the same billing 36 HB1165 |
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39 | 39 | | |
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40 | 40 | | 2 01/16/2025 1:47:10 PM JMB121 |
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41 | 41 | | codes; 1 |
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42 | 42 | | (4) With some billing codes, the difference in reimbursement 2 |
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43 | 43 | | rates based on the setting is quite substantial; and 3 |
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44 | 44 | | (5) Behavioral health providers and certified support services 4 |
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45 | 45 | | provider agencies are being paid at lower rates for the physician’s services 5 |
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46 | 46 | | provided in a behavioral health setting than when the physician's services 6 |
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47 | 47 | | are exactly the same as the physician would provide in his or her own office; 7 |
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48 | 48 | | and 8 |
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49 | 49 | | (6) This discrepancy places the provision of behavioral health 9 |
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50 | 50 | | services in this state at a great disadvantage. 10 |
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51 | 51 | | (b) The Arkansas Medicaid Program shall not pay different 11 |
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52 | 52 | | reimbursement rates for the same services performed by the same type of 12 |
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53 | 53 | | provider that use the same billing codes when the only difference is the 13 |
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54 | 54 | | setting in which the services are rendered. 14 |
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55 | 55 | | (c) The Department of Human Services shall apply for any federal 15 |
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56 | 56 | | waiver, Medicaid state plan amendment, or other authorization necessary to 16 |
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57 | 57 | | implement this section. 17 |
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