Arkansas Code
Subtitle 5 - Social Services
Chapter 77 - Medical Assistance

§ 20-77-105. Double billing — Suspension of medical services provider from Arkansas Medicaid Program - (a) Any provider of medical services which shall be determined...

§ 20-77-106. Medical services program for Medicaid-eligible patients of Arkansas Children's Hospital - (a) The Arkansas Children's Hospital, as recognized by § 20-78-102,...

§ 20-77-107. Program for indigent medical care — Rules - (a) (1) The appropriate division of the Department of Human...

§ 20-77-108. Furnishing of annual audit by nonprofit Medicaid providers - (a) Every nonprofit corporation, except those licensed under § 20-9-201...

§ 20-77-109. Medicaid assistance for children — Effect on child support - (a) By accepting Medicaid assistance for or on behalf of...

§ 20-77-110. Increase in reimbursement rate - Notwithstanding any other provision in federal law or departmental commitment...

§ 20-77-111. Data reports - (a) The Secretary of the Department of Human Services shall...

§ 20-77-115. Personal care reimbursement rates - Personal care reimbursement rates shall be established at twelve dollars...

§ 20-77-119. Finding — Resource eligibility limit - (a) The General Assembly finds that: (1) The income of...

§ 20-77-121. Adverse decisions — Notice — Rights — Definitions - (a) As used in this section: (1) “Adverse action” means...

§ 20-77-122. Survey agency for psychiatric residential treatment facilities of children - (a) To the extent required by federal law, the Division...

§ 20-77-123. Drugs for asthma and other respiratory diseases — Definitions - (a) As used in this section: (1) “Drug Review Committee”...

§ 20-77-124. Medicaid waiver for autism — Definitions - (a) As used in this section: (1) “Autism spectrum disorder”...

§ 20-77-125. Contingency fee audits prohibited — Definitions - (a) As used in this section: (1) “Healthcare provider” means...

§ 20-77-126. Relation to Arkansas Pharmacy Audit Bill of Rights - (a) From and after the date that a state plan...

§ 20-77-127. Eligibility for long-term care - (a) The eligibility determination regarding every applicant for long-term care...

§ 20-77-128. In-home caregiver drug tests and criminal background checks — Definition - (a) As used in this section, “caregiver” means an individual...

§ 20-77-129. Ambulatory surgery centers — Medicaid reimbursement — Definitions - (a) As used in this section: (1) “Ambulatory surgery center”...

§ 20-77-130. Medicaid provider tax returns — Definition - (a) As used in this section, “affected Medicaid entity” means...

§ 20-77-131. Determination that a Medicaid provider is out of business — Definition - (a) As used in this section, “entity” means: (1) A...

§ 20-77-132. Diagnosis-related group methodology for hospitals — Definition - (a) As used in this section, “diagnosis-related group methodology” means...

§ 20-77-133. Walk-in clinic and emergent care clinic — Medicaid reimbursement — Definitions - (a) As used in this section: (1) “Emergent care clinic”...

§ 20-77-134. Direct access to chiropractic physicians - (a) On or before January 1, 2018, the Department of...

§ 20-77-135. Peer support specialist - The Department of Human Services shall not disqualify or exclude...

§ 20-77-136. Additional albuterol inhaler - (a) Annually in the month of August, the Arkansas Medicaid...

§ 20-77-137. Ridesharing application — Medicaid reimbursement — Definition - (a) As used in this section, “ridesharing application” means an...

§ 20-77-138. Medications approved by United States Food and Drug Administration for tobacco cessation coverage - (a) The Department of Human Services shall ensure that the...

§ 20-77-139. Elimination of waiting list - (a) The Department of Human Services shall eliminate the waiting...

Subchapter 3 - Third-Party Liability

§ 20-77-301. Action by Department of Human Services - (a) (1) When medical assistance benefits are provided or will...

§ 20-77-302. Action by recipient alone — Reimbursement of division - (a) When an action or claim is brought by a...

§ 20-77-303. Action by division and recipient - (a) If an action is prosecuted both by the medical...

§ 20-77-304. Notice of action or claim — Intervention or consolidation - (a) (1) If either the medical assistance recipient or the...

§ 20-77-305. Notice to Department of Human Services of award or settlement by recipient required - (a) A judgment, an award, or a settlement in any...

§ 20-77-306. Liability of third parties to Department of Human Services — Definitions - (a) As used in this section: (1) “Health insurer” means...

§ 20-77-307. Assignment to Department of Human Services of rights of recovery - (a) As a condition of eligibility, every Medicaid applicant shall...

§ 20-77-308. Release of information to Department of Human Services - All recipients of medical assistance under the Arkansas Medicaid Program...

§ 20-77-309. Denial or reduction of benefits — Insurance policies - No policy of accident or illness insurance issued or renewed...

§ 20-77-310. Denial or reduction of benefits — Service plan corporation contracts - After July 1, 1981, no service plan corporation shall deliver,...

§ 20-77-311. Denial or reduction of benefits — Healthcare providers - After July 1, 1981, no association authorized to do business...

§ 20-77-312. Denial or reduction of benefits — Provisions not applicable to Arkansas Medicaid Program - General exclusion or reduction provisions relating to benefits paid by...

§ 20-77-313. Billing statements - Billing statements forwarded to recipients of medical assistance by vendors...

§ 20-77-314. Definitions - As used in this subchapter: (1) “Action” or “claim” means...

§ 20-77-315. Distribution of proceeds from third-party settlement, judgment, or award or from other third-party payment - (a) The Department of Human Services is entitled to reimbursement...

Subchapter 4 - Prescription Drugs

§ 20-77-401. Purpose - The purpose of this subchapter is to allow for the...

§ 20-77-402. Continuation of program - (a) The Secretary of the Department of Human Services and...

§ 20-77-403. Fees paid to participating pharmacists - (a) The Secretary of the Department of Human Services and...

§ 20-77-404. Approval from United States Department of Health and Human Services - (a) The Secretary of the Department of Human Services and...

§ 20-77-405. Preference for generic drugs - Drugs dispensed under the Arkansas Medicaid Program provided for in...

Subchapter 5 - Eye Care

§ 20-77-501. Definition - For the purpose of this subchapter, unless the context otherwise...

§ 20-77-502. Applicability - (a) Nothing in this subchapter shall apply to any person...

§ 20-77-503. Practice of optometry not affected - Nothing in this subchapter shall be construed to enlarge or...

§ 20-77-504. Penalty - (a) Any person violating this subchapter shall be guilty of...

§ 20-77-505. Injunctions - (a) The circuit courts of this state having general equity...

§ 20-77-506. Right of freedom of choice - (a) Every person eligible for an eye examination, the payment...

§ 20-77-507. List of ocular practitioners - (a) When expending public money for any purpose involving human...

§ 20-77-508. Recommendation of individual practitioner unlawful and nuisance - The recommendation or naming of any particular ocular practitioner or...

Subchapter 7 - Special Needs Trust Revolving Fund

§ 20-77-701. Legislative intent - It is the intent of the General Assembly to provide...

§ 20-77-702. Definitions - As used in this subchapter: (1) “Allowable expense” means charges...

§ 20-77-703. Creation of Special Needs Trust Revolving Fund - (a) There is created in the State Treasury a revolving...

§ 20-77-704. Payment of trust funds - (a) The cotrustees of the Special Needs Trust Revolving Fund...

§ 20-77-705. Conditions for benefits — Changes in benefits - (a) Benefits shall not be awarded: (1) Unless the claim...

§ 20-77-706. Waiver of physician-patient privilege — Examinations and reports - (a) Any person filing a claim under the provisions of...

§ 20-77-707. Application forms — Cooperation by applicant - Each local office of the Department of Human Services shall...

§ 20-77-708. Confidential information - The following information, when submitted to the cotrustees of the...

§ 20-77-709. Powers of cotrustees of Special Needs Trust Revolving Fund — Logistical support - (a) (1) (A) The cotrustees of the Special Needs Trust...

§ 20-77-710. Annual report of cotrustees of Special Needs Trust Revolving Fund - The cotrustees of the Special Needs Trust Revolving Fund shall...

Subchapter 8 - Home Intravenous Drug Therapy Services

§ 20-77-801. Definitions - As used in this subchapter: (1) (A) “Home intravenous drug...

§ 20-77-802. Medicaid payment - (a) The Medicaid payment shall not exceed an amount equal...

§ 20-77-803. Physician clinical management fees - (a) The referring physician prescribing the home intravenous therapy shall...

§ 20-77-804. Limitation on acceptance of and payments for certain referrals - (a) Except as provided in subsection (b) of this section,...

§ 20-77-805. Administration of medication - When the home intravenous drug therapy medication must be administered...

§ 20-77-806. Sales and delivery - No person or entity shall sell intravenous drugs in this...

§ 20-77-807. Sanctions - No payment may be made under this subchapter for home...

§ 20-77-808. Exclusion - The provisions of this subchapter shall not be deemed to...

Subchapter 9 - Medicaid Fraud False Claims Act

§ 20-77-901. Definitions - As used in this subchapter: (1) “Arkansas Medicaid Program” means...

§ 20-77-902. Liability for certain acts - A person shall be liable to the State of Arkansas,...

§ 20-77-903. Restitution, damages, and civil penalties - (a) (1) It shall be unlawful for any person to...

§ 20-77-904. Investigation by Attorney General - (a) If the Attorney General has reasonable cause to believe...

§ 20-77-905. Order compelling testimony or production of evidence — Immunity — Contempt - (a) (1) (A) In any proceeding or investigation under this...

§ 20-77-906. Evidence — Disclosure - (a) If the Attorney General determines that disclosure to the...

§ 20-77-907. Records - (a) (1) A Medicaid provider or person providing healthcare goods...

§ 20-77-908. False claims jurisdiction — Procedure - (a) Any action under this subchapter may be brought in...

§ 20-77-909. Injunctions against fraud - (a) (1) Whenever it appears that any person is engaged...

§ 20-77-910. Suspension of violators - The Secretary of the Department of Human Services may suspend...

§ 20-77-911. Persons providing information regarding false Medicaid claims — Rewards - (a) The court is authorized to pay a person sums,...

§ 20-77-912. Funds for investigations and prosecutions - (a) Under this subchapter and the Medicaid Fraud Act, §...

Subchapter 10 - Donated Dental Services Program of Arkansas

§ 20-77-1001. Creation — Reporting requirement - (a) The Department of Human Services shall establish the Donated...

Subchapter 11 - ARKids First Program Act

§ 20-77-1101. Title - This subchapter shall be known and may be cited as...

§ 20-77-1102. Purpose - The purpose and intent of this subchapter is to establish...

§ 20-77-1103. Definitions - For purposes of this subchapter: (1) “Family” means a family...

§ 20-77-1104. Waiver — Rules — Definitions - (a) As used in this section: (1) (A) “Healthcare coverage”...

§ 20-77-1105. Funding - (a) Funding for the uninsured children's program shall be derived...

Subchapter 12 - Medicaid Program for Low-Income Disabled Working Persons

§ 20-77-1201. Title - This subchapter shall be known and may be cited as...

§ 20-77-1202. Purpose - The purpose and intent of this subchapter is to establish...

§ 20-77-1203. Definitions - As used in this subchapter, unless the context otherwise requires:...

§ 20-77-1204. Administration — Regulation - (a) The Department of Human Services is authorized to apply...

§ 20-77-1205. Funding - (a) Funding for the low-income disabled working person category of...

Subchapter 13 - Medical Assistance Programs Integrity Law

§ 20-77-1301. Title - This subchapter may be cited as the “Medical Assistance Programs...

§ 20-77-1302. Legislative intent and purpose - (a) This subchapter is enacted to combat and prevent fraud...

§ 20-77-1303. Definitions - As used in this subchapter, the following terms shall have...

§ 20-77-1304. Claims review and administrative sanctions - (a) (1) Pursuant to rules promulgated in accordance with the...

§ 20-77-1305. Settlement - The Secretary of the Department of Human Services may agree...

Subchapter 14 - Prescription Drug Access Improvement Act

§ 20-77-1401. Title - This subchapter shall be known and may be cited as...

§ 20-77-1402. Purpose - The purpose and intent of this subchapter is to authorize...

§ 20-77-1403. Definitions - As used in this subchapter: (1) [Repealed.] (2) “Medicaid” means...

§ 20-77-1404. Prescription drug benefit Medicaid waiver - The Department of Human Services may apply to the Centers...

§ 20-77-1405. Waiver application - Any waiver application submitted by the Department of Human Services...

Subchapter 15 - Community-Based Healthcare Access Programs

§ 20-77-1501. Legislative findings and intent - (a) The General Assembly finds that: (1) The State of...

§ 20-77-1502. Definitions - As used in this subchapter: (1) “Community-based” means based in,...

§ 20-77-1503. Program administration — Member agreements — Definition - (a) A community-based health cooperative shall administer a community-based healthcare...

§ 20-77-1504. Coordination with local health education center programs - Whenever feasible, community-based health cooperatives shall participate actively with area...

§ 20-77-1505. Donations by community-based health cooperatives - A community-based health cooperative may make donations for the public...

§ 20-77-1506. Program report - (a) In order to demonstrate community-based healthcare access program viability...

§ 20-77-1507. Community-based health cooperatives' activity deemed not to be practice of medicine - No community-based health cooperative shall be deemed to be engaged...

§ 20-77-1508. Immunity and liability - No liability on the part of and no cause of...

§ 20-77-1509. Community-based health cooperative deemed not to be public utility or regulated industry - (a) (1) Community-based health cooperatives shall not be considered or...

Subchapter 17 - Medicaid Fairness Act

§ 20-77-1701. Legislative findings and intent - (a) The General Assembly finds that: (1) Healthcare providers who...

§ 20-77-1702. Definitions - As used in this subchapter: (1) “Abuse” means a pattern...

§ 20-77-1703. Recoupment - (a) (1) The Department of Human Services shall not use...

§ 20-77-1704. Provider administrative appeals allowed - (a) The General Assembly finds it necessary to: (1) Clarify...

§ 20-77-1705. Explanations for adverse decisions required - Each denial or other deficiency that the Department of Human...

§ 20-77-1706. Reimbursement at an alternate level instead of complete denial - (a) (1) (A) Subject to § 20-77-1707 for retrospective reviews,...

§ 20-77-1707. Prior authorizations — Retrospective reviews - If the Department of Human Services requires a provider to...

§ 20-77-1708. Medical necessity - (a) There is a presumption in favor of the medical...

§ 20-77-1709. Promulgation before enforcement - (a) The Department of Human Services may not use state...

§ 20-77-1710. Delivery of files - (a) If the Department of Human Services makes an adverse...

§ 20-77-1711. Copies of records to be supplied to department — Exception - (a) Except as provided in subsection (b) of this section,...

§ 20-77-1712. Notices - When the Department of Human Services sends letters or other...

§ 20-77-1713. Deadlines - (a) The Department of Human Services may not issue a...

§ 20-77-1714. Hospital claims - (a) When more than one (1) hospital provides services to...

§ 20-77-1715. Federal law - (a) If any provision of this subchapter is found to...

§ 20-77-1716. Promulgation of rules - The Department of Human Services may promulgate rules to implement...

§ 20-77-1717. Timelines for audits - (a) If a Medicaid provider audit by the federal Medicaid...

§ 20-77-1718. Termination — Appeals - (a) A Medicaid provider that is aggrieved by an adverse...

Subchapter 18 - Arkansas Long-Term Care Partnership Program

§ 20-77-1801. Findings - The General Assembly finds that in order to alleviate the...

§ 20-77-1802. Definitions - As used in this subchapter: (1) “Long-term care facility” means...

§ 20-77-1803. Arkansas Long-Term Care Partnership Program — Created - (a) The Arkansas Long-Term Care Partnership Program is created within...

§ 20-77-1804. Applicability - This subchapter does not supersede the obligations under the Long-Term...

§ 20-77-1805. Continuity of asset protection - If this subchapter is repealed, any Medicaid asset protection afforded...

Subchapter 19 - Assessment Fee on Hospitals to Improve Healthcare Access

§ 20-77-1901. Definitions - As used in this subchapter: (1) “Division” means the Division...

§ 20-77-1902. Assessment - (a) (1) An assessment is imposed on each hospital except...

§ 20-77-1903. Program administration - (a) The Director of the Division of Medical Services of...

§ 20-77-1904. Hospital Assessment Account - (a) (1) There is created within the Arkansas Medicaid Program...

§ 20-77-1905. Exemptions - (a) The following hospitals shall be exempt from the assessment...

§ 20-77-1906. Quarterly notice and collection - (a) (1) The annual assessment imposed under § 20-77-1902 shall...

§ 20-77-1907. Notice of assessment - (a) (1) The Division of Medical Services of the Department...

§ 20-77-1908. Medicaid hospital access payments - (a) To preserve and improve access to hospital services, for...

§ 20-77-1909. Effectiveness and cessation - (a) The assessment imposed under § 20-77-1902 shall cease to...

§ 20-77-1910. State plan amendment - (a) The Division of Medical Services of the Department of...

Subchapter 20 - ARKids First Medical Assistance Programs Enrollment and Retention Improvement Program

§ 20-77-2001. Findings - The General Assembly finds that: (1) Almost two-thirds (2/3) of...

§ 20-77-2002. Administration - (a) In administering the ARKids First A and B programs,...

§ 20-77-2003. ARKids First enrollment and renewals - (a) The Department of Human Services shall perform the initiatives...

Subchapter 21 - Medicaid Eligibility Verification System

§ 20-77-2102. Medicaid Eligibility Verification System — Definitions - (a) The Department of Human Services shall establish and maintain...

Subchapter 22 - Healthcare Quality and Payment Policy Advisory Committee

§ 20-77-2201. Title - This subchapter shall be known and may be cited as...

§ 20-77-2202. Definitions - As used in this subchapter: (1) “Data, records, reports, and...

§ 20-77-2203. Healthcare Quality and Payment Policy Advisory Committee — Created — Membership - (a) The Healthcare Quality and Payment Policy Advisory Committee is...

§ 20-77-2204. Purpose - The purpose of the Healthcare Quality and Payment Policy Advisory...

§ 20-77-2205. Medicaid payment and reimbursement rules related to development of episodes of care - (a) (1) The Department of Human Services shall not adopt...

§ 20-77-2206. Powers and duties of Healthcare Quality and Payment Policy Advisory Committee - The Healthcare Quality and Payment Policy Advisory Committee shall: (1)...

§ 20-77-2207. Confidentiality - (a) To the extent that the data, records, reports, and...

Subchapter 23 - Home Caregiver Training

§ 20-77-2301. Findings — Intent - (a) The General Assembly finds that: (1) Although a direct-care...

§ 20-77-2302. Definitions - As used in this subchapter: (1) “Caregiver services” means services...

§ 20-77-2303. Training requirement - (a) A person who applies for employment to provide caregiver...

§ 20-77-2304. Exemptions - An individual may provide caregiver services without the training required...

§ 20-77-2305. Rules - The Department of Health shall adopt rules to implement this...

Subchapter 25 - Office of Medicaid Inspector General

§ 20-77-2501. Purpose - The purpose of this subchapter is to: (1) Consolidate staff...

§ 20-77-2502. Definitions - As used in this subchapter: (1) (A) “Abuse” means provider...

§ 20-77-2503. Office of Medicaid Inspector General — Created - The Office of Medicaid Inspector General is created within the...

§ 20-77-2504. Medicaid Inspector General — Appointment — Qualifications - (a) (1) The Medicaid Inspector General shall be appointed by...

§ 20-77-2505. Office of Medicaid Inspector General — Powers and duties - The Office of Medicaid Inspector General shall: (1) Prevent, detect,...

§ 20-77-2506. Medicaid Inspector General — Duties - The Medicaid Inspector General shall, in consultation with the Secretary...

§ 20-77-2507. Cooperation of agency officials and employees - (a) (1) The Medicaid Inspector General shall request information, assistance,...

§ 20-77-2508. Transfer of duties and resources - (a) The duties, functions, records, personnel, property, unexpended balances of...

§ 20-77-2509. Reports required of Medicaid Inspector General — Definition - (a) The Medicaid Inspector General shall, no later than October...

§ 20-77-2510. Department of Human Services consultation with Office of Medicaid Inspector General - (a) The Department of Human Services shall consult with the...

§ 20-77-2511. Provider compliance program - (a) The General Assembly finds that: (1) Medical assistance providers...

§ 20-77-2512. Applicability of Medicaid Fairness Act - The Medicaid Fairness Act, § 20-77-1701 et seq., applies to...

§ 20-77-2513. Enterprise Fraud Program - (a) To realize savings to the Arkansas Medicaid Program and...

Subchapter 26 - Arkansas Lay Caregiver Act

§ 20-77-2601. Title - This act shall be known and may be cited as...

§ 20-77-2602. Definitions - As used in this subchapter: (1) “Aftercare” means assistance that:...

§ 20-77-2603. Designation of caregiver - (a) (1) A hospital shall provide each patient or, if...

§ 20-77-2604. Compensation to caregiver - (a) A caregiver designated under this subchapter shall not accept...

§ 20-77-2605. Notification to caregiver - (a) If a patient has designated a caregiver, the hospital...

§ 20-77-2606. Consultation with caregiver — Discharge plan - (a) (1) As soon as practicable before the discharge of...

§ 20-77-2607. Construction — Immunity - (a) This subchapter shall not: (1) Confer upon the caregiver...

Subchapter 27 - Medicaid Provider-Led Organized Care Act

§ 20-77-2701. Title - This subchapter shall be known and may be cited as...

§ 20-77-2702. Legislative intent and purpose - (a) As the single state agency for administration of the...

§ 20-77-2703. Definitions - As used in this subchapter: (1) “Associated participant” means an...

§ 20-77-2704. Licensure by Insurance Commissioner - (a) The Insurance Commissioner may license for participation in the...

§ 20-77-2705. Excluded services - (a) Except as provided in subsection (b) of this section,...

§ 20-77-2706. Characteristics and duties of risk-based provider organization - (a) A risk-based provider organization shall: (1) Be authorized to...

§ 20-77-2707. Reporting and performance measures - (a) (1) On a quarterly basis, a risk-based provider organization...

§ 20-77-2708. Waiver and rulemaking authority - The Department of Human Services: (1) Shall submit an application...

Subchapter 28 - Assessment Fee and Program on Medical Transportation Providers

§ 20-77-2801. Legislative findings and intent - (a) The General Assembly finds that: (1) Emergency medical services...

§ 20-77-2802. Definitions - As used in this subchapter: (1) “Air ambulance services” means...

§ 20-77-2803. Medical transportation provider assessment - (a) (1) Except as provided in this subchapter, an assessment...

§ 20-77-2804. Program administration - (a) The Director of the Division of Medical Services of...

§ 20-77-2805. Medical Transportation Assessment Account - (a) (1) There is created within the Arkansas Medicaid Program...

§ 20-77-2806. Exemptions - (a) The following medical transportation providers are exempt from the...

§ 20-77-2807. Quarterly notice and collection - (a) (1) The annual medical transportation provider assessment imposed under...

§ 20-77-2808. Notice of assessment - (a) (1) The Division of Medical Services of the Department...

§ 20-77-2809. Emergency medical transportation access payments - (a) To preserve and improve access to medical transportation services,...

§ 20-77-2810. Effectiveness — Cessation - (a) The medical transportation provider assessment imposed under § 20-77-2803...

§ 20-77-2811. State plan amendment - (a) The Division of Medical Services of the Department of...

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Arkansas Code Subtitle 5 - Social Services Chapter 77 - Medical Assistance

Arkansas Code
Subtitle 5 - Social Services
Chapter 77 - Medical Assistance