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 SENATE BILL 542 3
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By: Senator B. Davis 5
By: Representative L. Johnson 6
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For An Act To Be Entitled 8
AN ACT TO AMEND THE MEDICAID PROVIDER -LED ORGANIZED 9
CARE ACT; TO IMPROVE THE ENROLLMENT AND SELECTION 10
PROCESS IN RISK-BASED PROVIDER ORGANIZATIONS; TO 11
EMPOWER MEDICAID BENEFICIARIES WITH USEFUL 12
INFORMATION ABOUT RISK -BASED PROVIDER ORGANIZATIONS 13
AVAILABLE TO THEM; AND FOR OTHER PURPOSES. 14
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Subtitle 17
TO AMEND THE MEDICAID PROVIDER -LED 18
ORGANIZED CARE ACT; TO IMPROVE THE 19
ENROLLMENT AND SELECTION PROCESS IN 20
RISK-BASED PROVIDER ORGANIZATIONS; AND 21
TO EMPOWER BENEFICIARIES WITH 22
INFORMATION. 23
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 25
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SECTION 1. Arkansas Code Title 20, Chapter 77, Subchapter 27, is 27
amended to add additional sections to read as follows: 28
20-77-2709. Quality rating system. 29
(a) The risk-based provider organizations shall have a basic quality 30
rating system that is accessible online that includes ratings for each risk -31
based provider organization based on data that includes at a minimum the 32
following measures that are currently collected by the risk -based provider 33
organization: 34
(1) The number of days before initial delivery of home - and 35
community-based services for individuals who have received a waiver slot in 36 SB542
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the Community and Employment Support Waiver; 1
(2) The care coordinator caseload ratios; 2
(3) The scores of a satisfaction survey of members of the risk -3
based provider organization that includes at least the following: 4
(A) The satisfaction of individuals assessed with 5
intellectual and developmental disabilities with their level of integration 6
into the community; 7
(B) The satisfaction of individuals assessed with 8
intellectual and developmental disabilities who report satisfaction with 9
their living arrangements; 10
(C) The numbers and percentages of enrollees assessed with 11
intellectual and developmental disabilities who are engaged in meaningful, 12
competitive employment; 13
(D) The satisfaction with care coordinators by individuals 14
assessed with intellectual and developmental disabilities and by intellectual 15
and developmental disabilities service providers; 16
(E) The satisfaction with care coordinators by individuals 17
assessed with behavioral health needs and by behavioral health providers; 18
(F) The satisfaction with the website or portal of the 19
risk-based provider organizations by individuals assessed with intellectual 20
and developmental disabilities and by intellectual and developmental 21
disabilities service providers; 22
(G) The satisfaction with the website or portal of the 23
risk-based provider organizations by individuals assessed with behavioral 24
health needs and by behavioral health providers; 25
(H) The overall satisfaction with the risk -based provider 26
organization by individuals assessed with intellectual and developmental 27
disabilities and by intellectual and developmental disabilities service 28
providers; and 29
(I) The overall satisfaction with the risk -based provider 30
organization by individuals assessed with behavioral health needs and by 31
behavioral health providers; 32
(4) The percentage of individuals assessed with intellectual and 33
developmental disabilities who receive follow -up care after an emergency 34
department visit within seven (7) days; 35
(5) The percentage of individuals assessed with behavioral 36 SB542
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health needs who receive follow -up care after an emergency department visit 1
within seven (7) days; 2
(6) The percentage of members between three (3) years age and 3
twenty-one (21) years of age who had at least one (1) comprehensive well -care 4
visit with a primary care provider or an obstetrician -gynecologist 5
practitioner during the measurement year; 6
(7) The percentage of newly enrolled members who receive an 7
initial contact with a care coordinator within fourteen (14) days; 8
(8) The percentage of enrolled members who receive monthly 9
contact with a care coordinator; and 10
(9) The incidence of enrollee complaints or grievances. 11
(b) The ratings shall be prominently displayed on the website of 12
Department of Human Services for risk -based provider organizations. 13
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20-77-2710. Provider directories. 15
(a) Each risk-based provider organization shall provide to enrollees 16
real-time access to its provider network directory through a link on the 17
website of Department of Human Services and on the website of the risk -based 18
provider organization. 19
(b) The risk-based provider organizations shall ensure that the 20
provider directories are updated for the upcoming plan year so that enrollees 21
can make informed decisions. 22
(c) When an existing network provider’s status has or will change to 23
out-of-network, the risk-based provider organization shall make that change 24
in the provider directory within ten (10) business days of the change being 25
communicated to or from the risk -based provider organization. 26
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20-77-2711. Beneficiary support office. 28
(a) The Department of Human Services shall have a dedicated 29
beneficiary support system that is adequately staffed and trained to meet the 30
requirements of 42 C.F.R. § 438.71, as existing on January 1, 2025. 31
(b) Enrollees and other members of the public shall be able to easily 32
contact the department for information about the risk -based provider 33
organization, including open enrollment, choice counseling, updated 34
information on provider networks, assistance in understanding how to use the 35
quality rating system to select a plan, and other pertinent information. 36 SB542
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(c) The ombudsman shall also have the authority to help enrollees 1
informally resolve issues between enrollees and risk -based provider 2
organizations. 3
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SECTION 2. DO NOT CODIFY. Rules. 5
The Department of Human Services may promulgate rules to implement this 6
act. 7
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SECTION 3. EFFECTIVE DATE. 9
This act shall be effective on January 1, 2026. 10
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