(a) There is a presumption in favor of the medical judgment of the performing or prescribing physician in determining medical necessity of treatment.
(b) If an administrative law judge finds that the Department of Human Services has overcome the presumption under subsection (a) of this section, he or she shall state the manner by which the presumption was overcome.
Structure Arkansas Code
Title 20 - Public Health and Welfare
Chapter 77 - Medical Assistance
Subchapter 17 - Medicaid Fairness Act
§ 20-77-1701. Legislative findings and intent
§ 20-77-1704. Provider administrative appeals allowed
§ 20-77-1705. Explanations for adverse decisions required
§ 20-77-1706. Reimbursement at an alternate level instead of complete denial
§ 20-77-1707. Prior authorizations — Retrospective reviews
§ 20-77-1708. Medical necessity
§ 20-77-1709. Promulgation before enforcement
§ 20-77-1710. Delivery of files
§ 20-77-1711. Copies of records to be supplied to department — Exception
§ 20-77-1716. Promulgation of rules