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