Arkansas 2025 Regular Session

Arkansas House Bill HB1943 Compare Versions

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11 Stricken language would be deleted from and underlined language would be added to present law.
2-Act 962 of the Regular Session
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43 State of Arkansas 1
54 95th General Assembly A Bill 2
65 Regular Session, 2025 HOUSE BILL 1943 3
76 4
87 By: Representative L. Johnson 5
98 By: Senator B. Davis 6
109 7
1110 For An Act To Be Entitled 8
1211 AN ACT TO AMEND THE MEDICAID PROVIDER -LED ORGANIZED 9
1312 CARE ACT; TO IMPROVE THE ENROLLMENT AND SELECTION 10
1413 PROCESS IN RISK-BASED PROVIDER ORGANIZATIONS; TO 11
1514 EMPOWER MEDICAID BENEFICIARIES WITH USEFUL 12
1615 INFORMATION ABOUT RISK -BASED PROVIDER ORGANIZATIONS 13
1716 AVAILABLE TO THEM; AND FOR OTHER PURPOSES. 14
1817 15
1918 16
2019 Subtitle 17
2120 TO AMEND THE MEDICAID PROVIDER -LED 18
2221 ORGANIZED CARE ACT; TO IMPROVE THE 19
2322 ENROLLMENT AND SELECTION PROCESS IN 20
2423 RISK-BASED PROVIDER ORGANIZATIONS; AND 21
2524 TO EMPOWER BENEFICIARIES WITH 22
2625 INFORMATION. 23
2726 24
2827 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 25
2928 26
3029 SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 27, is 27
3130 amended to add additional sections to read as follows: 28
3231 20-77-2709. Quality rating system. 29
3332 (a) The risk-based provider organizations shall have a basic quality 30
3433 rating system that is accessible online that includes ratings for each risk -31
3534 based provider organization based on data that includes at a minimum the 32
3635 following measures that are currently collected by the risk -based provider 33
3736 organization: 34
3837 (1) The number of days before initial delivery of home - and 35
3938 community-based services for individuals who have received a waiver slot in 36 HB1943
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4241 the Community and Employment Support Waiver; 1
4342 (2) The care coordinator caseload ratios; 2
4443 (3) The scores of a satisfaction survey of members of the risk -3
4544 based provider organization that includes at least the following: 4
4645 (A) The satisfaction of individuals assessed with 5
4746 intellectual and developmental disabilities with their level of integration 6
4847 into the community; 7
4948 (B) The satisfaction of individuals assessed with 8
5049 intellectual and developmental disabilities who report satisfaction with 9
5150 their living arrangements; 10
5251 (C) The numbers and percentages of enrollees assessed with 11
5352 intellectual and developmental disabilities who are engaged in meaningful, 12
5453 competitive employment; 13
5554 (D) The satisfaction with care coordinators by individuals 14
5655 assessed with intellectual and developmental disabilities and by intellectual 15
5756 and developmental disabilities service providers; 16
5857 (E) The satisfaction with care coordinators by individuals 17
5958 assessed with behavioral health needs and by behavioral health providers; 18
6059 (F) The satisfaction with the website or portal of the 19
6160 risk-based provider organizations by individuals assessed with intellectual 20
6261 and developmental disabilities and by intellectual and developmental 21
6362 disabilities service providers; 22
6463 (G) The satisfaction with the website or portal of the 23
6564 risk-based provider organizations by individuals assessed with behavioral 24
6665 health needs and by behavioral health providers; 25
6766 (H) The overall satisfaction with the risk -based provider 26
6867 organization by individuals assessed with intellectual and developmental 27
6968 disabilities and by intellectual and developmental disabilities service 28
7069 providers; and 29
7170 (I) The overall satisfaction with the risk -based provider 30
7271 organization by individuals assessed with behavioral health needs and by 31
7372 behavioral health providers; 32
7473 (4) The percentage of individuals assessed with intellectual and 33
7574 developmental disabilities who receive follow -up care after an emergency 34
7675 department visit within seven (7) days; 35
7776 (5) The percentage of individuals assessed with behavioral 36 HB1943
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8079 health needs who receive follow -up care after an emergency department visit 1
8180 within seven (7) days; 2
8281 (6) The percentage of members between three (3) years age and 3
8382 twenty-one (21) years of age who had at least one (1) comprehensive well -care 4
8483 visit with a primary care provider or an obstetrician -gynecologist 5
8584 practitioner during the measurement year; 6
8685 (7) The percentage of newly enrolled members who receive an 7
8786 initial contact with a care coordinator within fourteen (14) days; 8
8887 (8) The percentage of enrolled members who receive monthly 9
8988 contact with a care coordinator; and 10
9089 (9) The incidence of enrollee complaints or grievances. 11
9190 (b) The ratings shall be prominently displayed on the website of 12
9291 Department of Human Services for risk -based provider organizations. 13
9392 14
9493 20-77-2710. Provider directories. 15
9594 (a) Each risk-based provider organization shall provide to enrollees 16
9695 real-time access to its provider network directory through a link on the 17
9796 website of Department of Human Services and on the website of the risk -based 18
9897 provider organization. 19
9998 (b) The risk-based provider organizations shall ensure that the 20
10099 provider directories are updated for the upcoming plan year so that enrollees 21
101100 can make informed decisions. 22
102101 (c) When an existing network provider’s status has or will change to 23
103102 out-of-network, the risk-based provider organization shall make that change 24
104103 in the provider directory within ten (10) business days of the change being 25
105104 communicated to or from the risk -based provider organization. 26
106105 27
107106 20-77-2711. Beneficiary support office. 28
108107 (a) The Department of Human Services shall have a dedicated 29
109108 beneficiary support system that is adequately staffed and trained to meet the 30
110109 requirements of 42 C.F.R. § 438.71, as existing on January 1, 2025. 31
111110 (b) Enrollees and other members of the public shall be able to easily 32
112111 contact the department for information about the risk -based provider 33
113112 organization, including open enrollment, choice counseling, updated 34
114113 information on provider networks, assistance in understanding how to use the 35
115114 quality rating system to select a plan, and other pertinent information. 36 HB1943
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118117 (c) The ombudsman shall also have the authority to help enrollees 1
119118 informally resolve issues between enrollees and risk -based provider 2
120119 organizations. 3
121120 4
122121 SECTION 2. DO NOT CODIFY. Rules. 5
123122 The Department of Human Services may promulgate rules to implement this 6
124123 act. 7
125124 8
126125 SECTION 3. EFFECTIVE DATE. 9
127126 This act shall be effective on January 1, 2026. 10
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130-APPROVED: 4/21/25 13
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