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