Arkansas 2025 Regular Session

Arkansas House Bill HB1942 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		Stricken language would be deleted from and underlined language would be added to present law.
2		-	Act 1023 of the Regular Session
3	2		JMB592 03/31/2025 4:28:40 PM JMB592
4	3		State of Arkansas 1
5	4		95th General Assembly A Bill 2
6	5		Regular Session, 2025 HOUSE BILL 1942 3
7	6		4
8	7		By: Representative L. Johnson 5
9	8		By: Senator B. Davis 6
10	9		7
11	10		For An Act To Be Entitled 8
12	11		AN ACT TO REQUIRE CERTAIN REIMBURSEMENT RATES FOR 9
13	12		HOME- AND COMMUNITY-BASED SERVICES WITHIN RISK -BASED 10
14	13		PROVIDER ORGANIZATIONS; AND FOR OTHER PURPOSES. 11
15	14		12
16	15		13
17	16		Subtitle 14
18	17		TO REQUIRE CERTAIN REIMBURSEMENT RATES 15
19	18		FOR HOME- AND COMMUNITY-BASED SERVICES 16
20	19		WITHIN RISK-BASED PROVIDER 17
21	20		ORGANIZATIONS. 18
22	21		19
23	22		BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 20
24	23		21
25	24		SECTION 1. Arkansas Code § 20 -77-2706(d)(1), concerning the 22
26	25		characteristics and duties of a risk -based provider organization under the 23
27	26		Medicaid Provider-Led Organized Care Act, is amended to read as follows: 24
28	27		(d)(1) Except as provided in subdivision (d)(2) of this section, 25
29	28		reimbursement rates paid by a risk -based provider organization to direct 26
30	29		service providers shall: 27
31	30		(A) Be determined by mutual agreement of the risk -based 28
32	31		provider organization and direct service provider without regard to Medicaid 29
33	32		provider rates established by the Department of Human Services if the 30
34	33		reimbursement rates are not less than the minimum rates established under § 31
35	34		20-77-2709; and 32
36	35		(B) Assure efficiency, economy, quality, and equal access 33
37	36		to enrollable Medicaid beneficiary populations in the same manner as to 34
38	37		individuals who are not covered by the Arkansas Medicaid Program. 35
39	38		36 HB1942
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42	41		SECTION 2. Arkansas Code § 20 -77-2706(e)(1), concerning the 1
43	42		characteristics and duties of a risk -based provider organization under the 2
44	43		Medicaid Provider-Led Organized Care Act, is amended to read as follows: 3
45	44		(e)(1) Except as provided in subdivision (e)(2) of this section, all 4
46	45		policies and procedures regarding the provision of healthcare services by a 5
47	46		direct service provider shall: 6
48	47		(A) Be determined by mutual agreement of the risk -based 7
49	48		provider organization and the direct service provider without regard to 8
50	49		Medicaid provider rates established by the Department of Human Services if 9
51	50		the reimbursement rates are not less than the minimum rates established under 10
52	51		§ 20-77-2709; and 11
53	52		(B) Assure efficiency, economy, quality, and equal access 12
54	53		to the enrollable Medicaid beneficiary population in the same manner as 13
55	54		individuals who are not covered by the Arkansas Medicaid Program. 14
56	55		15
57	56		SECTION 3. Arkansas Code Title 20, Chapter 77, Subchapter 27, is 16
58	57		amended to add an additional section to read as follows: 17
59	58		20-77-2709. Home- and community-based services — Rate setting. 18
60	59		(a)(1) An allowance within the capitation rates for a risk -based 19
61	60		provider organization shall not be less than the amount needed to pay 20
62	61		providers the rates arrived at through a rate study to be completed by 21
63	62		October 1, 2025. 22
64	63		(2) The rates from a rate study as described in subdivision 23
65	64		(a)(1) of this section serve as the minimums that risk -based provider 24
66	65		organizations may pay for home - and community-based services, as authorized 25
67	66		in 42 C.F.R. § 438.6, as existing on January 1, 2025. 26
68	67		(b) The rate study under subdivision (a)(1) of this section shall: 27
69	68		(1) Cover services in the Community and Employment Support 28
70	69		1915(c) waiver and the Section 1915(i) of the state plan amendment for the 29
71	70		coverage under this subchapter; and 30
72	71		(2) Accurately capture provider costs and other relevant 31
73	72		considerations that promote economy, efficiency, quality of care, and equal 32
74	73		access as required by the Centers for Medicare & Medicaid Services under 42 33
75	74		U.S.C. § 1396a, as existing on January 1, 2025, and in federal regulations 34
76	75		under 42 C.F.R. Part 447, as existing on January 1, 2025. 35
77	76		(c)(1) The Department of Human Services shall develop the cost factors 36 HB1942
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80	79		and other criteria for the rate study with input from home - and community-1
81	80		based service providers. 2
82	81		(2) As no rate study for home - and community-based service 3
83	82		providers has been conducted since the risk -based provider organizations 4
84	83		began serving the state, if the outcome of the rate study under subdivision 5
85	84		(a)(1) of this section produces an increase greater than ten percent (10%), 6
86	85		the department may be phase in a rate increase across two (2) years as 7
87	86		authorized by state appropriations and budgets. 8
88	87		(3) The department shall conduct a full provider rate review in 9
89	88		accordance with the published rate review schedule to ensure that rates 10
90	89		remain adequate and aligned with actual costs. 11
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