Arkansas 2025 Regular Session

Arkansas House Bill HB1943 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 962 of the Regular Session
3	2		JMB593 03/31/2025 4:28:55 PM JMB593
4	3		State of Arkansas 1
5	4		95th General Assembly A Bill 2
6	5		Regular Session, 2025 HOUSE BILL 1943 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 AMEND THE MEDICAID PROVIDER -LED ORGANIZED 9
13	12		CARE ACT; TO IMPROVE THE ENROLLMENT AND SELECTION 10
14	13		PROCESS IN RISK-BASED PROVIDER ORGANIZATIONS; TO 11
15	14		EMPOWER MEDICAID BENEFICIARIES WITH USEFUL 12
16	15		INFORMATION ABOUT RISK -BASED PROVIDER ORGANIZATIONS 13
17	16		AVAILABLE TO THEM; AND FOR OTHER PURPOSES. 14
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19	18		16
20	19		Subtitle 17
21	20		TO AMEND THE MEDICAID PROVIDER -LED 18
22	21		ORGANIZED CARE ACT; TO IMPROVE THE 19
23	22		ENROLLMENT AND SELECTION PROCESS IN 20
24	23		RISK-BASED PROVIDER ORGANIZATIONS; AND 21
25	24		TO EMPOWER BENEFICIARIES WITH 22
26	25		INFORMATION. 23
27	26		24
28	27		BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 25
29	28		26
30	29		SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 27, is 27
31	30		amended to add additional sections to read as follows: 28
32	31		20-77-2709. Quality rating system. 29
33	32		(a) The risk-based provider organizations shall have a basic quality 30
34	33		rating system that is accessible online that includes ratings for each risk -31
35	34		based provider organization based on data that includes at a minimum the 32
36	35		following measures that are currently collected by the risk -based provider 33
37	36		organization: 34
38	37		(1) The number of days before initial delivery of home - and 35
39	38		community-based services for individuals who have received a waiver slot in 36 HB1943
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42	41		the Community and Employment Support Waiver; 1
43	42		(2) The care coordinator caseload ratios; 2
44	43		(3) The scores of a satisfaction survey of members of the risk -3
45	44		based provider organization that includes at least the following: 4
46	45		(A) The satisfaction of individuals assessed with 5
47	46		intellectual and developmental disabilities with their level of integration 6
48	47		into the community; 7
49	48		(B) The satisfaction of individuals assessed with 8
50	49		intellectual and developmental disabilities who report satisfaction with 9
51	50		their living arrangements; 10
52	51		(C) The numbers and percentages of enrollees assessed with 11
53	52		intellectual and developmental disabilities who are engaged in meaningful, 12
54	53		competitive employment; 13
55	54		(D) The satisfaction with care coordinators by individuals 14
56	55		assessed with intellectual and developmental disabilities and by intellectual 15
57	56		and developmental disabilities service providers; 16
58	57		(E) The satisfaction with care coordinators by individuals 17
59	58		assessed with behavioral health needs and by behavioral health providers; 18
60	59		(F) The satisfaction with the website or portal of the 19
61	60		risk-based provider organizations by individuals assessed with intellectual 20
62	61		and developmental disabilities and by intellectual and developmental 21
63	62		disabilities service providers; 22
64	63		(G) The satisfaction with the website or portal of the 23
65	64		risk-based provider organizations by individuals assessed with behavioral 24
66	65		health needs and by behavioral health providers; 25
67	66		(H) The overall satisfaction with the risk -based provider 26
68	67		organization by individuals assessed with intellectual and developmental 27
69	68		disabilities and by intellectual and developmental disabilities service 28
70	69		providers; and 29
71	70		(I) The overall satisfaction with the risk -based provider 30
72	71		organization by individuals assessed with behavioral health needs and by 31
73	72		behavioral health providers; 32
74	73		(4) The percentage of individuals assessed with intellectual and 33
75	74		developmental disabilities who receive follow -up care after an emergency 34
76	75		department visit within seven (7) days; 35
77	76		(5) The percentage of individuals assessed with behavioral 36 HB1943
78	77
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80	79		health needs who receive follow -up care after an emergency department visit 1
81	80		within seven (7) days; 2
82	81		(6) The percentage of members between three (3) years age and 3
83	82		twenty-one (21) years of age who had at least one (1) comprehensive well -care 4
84	83		visit with a primary care provider or an obstetrician -gynecologist 5
85	84		practitioner during the measurement year; 6
86	85		(7) The percentage of newly enrolled members who receive an 7
87	86		initial contact with a care coordinator within fourteen (14) days; 8
88	87		(8) The percentage of enrolled members who receive monthly 9
89	88		contact with a care coordinator; and 10
90	89		(9) The incidence of enrollee complaints or grievances. 11
91	90		(b) The ratings shall be prominently displayed on the website of 12
92	91		Department of Human Services for risk -based provider organizations. 13
93	92		14
94	93		20-77-2710. Provider directories. 15
95	94		(a) Each risk-based provider organization shall provide to enrollees 16
96	95		real-time access to its provider network directory through a link on the 17
97	96		website of Department of Human Services and on the website of the risk -based 18
98	97		provider organization. 19
99	98		(b) The risk-based provider organizations shall ensure that the 20
100	99		provider directories are updated for the upcoming plan year so that enrollees 21
101	100		can make informed decisions. 22
102	101		(c) When an existing network provider’s status has or will change to 23
103	102		out-of-network, the risk-based provider organization shall make that change 24
104	103		in the provider directory within ten (10) business days of the change being 25
105	104		communicated to or from the risk -based provider organization. 26
106	105		27
107	106		20-77-2711. Beneficiary support office. 28
108	107		(a) The Department of Human Services shall have a dedicated 29
109	108		beneficiary support system that is adequately staffed and trained to meet the 30
110	109		requirements of 42 C.F.R. § 438.71, as existing on January 1, 2025. 31
111	110		(b) Enrollees and other members of the public shall be able to easily 32
112	111		contact the department for information about the risk -based provider 33
113	112		organization, including open enrollment, choice counseling, updated 34
114	113		information on provider networks, assistance in understanding how to use the 35
115	114		quality rating system to select a plan, and other pertinent information. 36 HB1943
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118	117		(c) The ombudsman shall also have the authority to help enrollees 1
119	118		informally resolve issues between enrollees and risk -based provider 2
120	119		organizations. 3
121	120		4
122	121		SECTION 2. DO NOT CODIFY. Rules. 5
123	122		The Department of Human Services may promulgate rules to implement this 6
124	123		act. 7
125	124		8
126	125		SECTION 3. EFFECTIVE DATE. 9
127	126		This act shall be effective on January 1, 2026. 10
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130		-	~~APPROVED: 4/21/25~~ 13
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