(a) The Department of Human Services may not use state policies, guidelines, manuals, or other such criteria in enforcement actions against providers unless the criteria have been promulgated.
(b) Nothing in this section requires or authorizes the department to attempt to promulgate standards of care that practitioners use in determining medical necessity or rendering medical decisions, diagnoses, or treatment.
(c) Medicaid contractors may not use a different provider manual than the Centers for Medicare & Medicaid Services Provider Reimbursement Manual promulgated for each service category.
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