Stricken language will be deleted and underlined language will be added.
Act 865 of the Regular Session
1 State of Arkansas As Engrossed: S3/27/23
2 94th General Assembly A Bill
3 Regular Session, 2023 SENATE BILL 53
4
5 By: Joint Budget Committee
6
7 For An Act To Be Entitled
8 AN ACT TO MAKE AN APPROPRIATION FOR PERSONAL SERVICES
9 AND OPERATING EXPENSES FOR THE DEPARTMENT OF HUMAN
10 SERVICES - DIVISION OF MEDICAL SERVICES FOR THE
11 FISCAL YEAR ENDING JUNE 30, 2024; AND FOR OTHER
12 PURPOSES.
13
14
15 Subtitle
16 AN ACT FOR THE DEPARTMENT OF HUMAN
17 SERVICES - DIVISION OF MEDICAL SERVICES
18 APPROPRIATION FOR THE 2023-2024 FISCAL
19 YEAR.
20
21
22 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
23
24 SECTION 1. REGULAR SALARIES - OPERATIONS. There is hereby established
25 for the Department of Human Services - Division of Medical Services for the
26 2023-2024 fiscal year, the following maximum number of regular employees.
27
28 Maximum Annual
29 Maximum Salary Rate
30 Item Class No. of Fiscal Year
31 No. Code Title Employees 2023-2024
32 (1) N249N DHS DIVISION DIRECTOR 1 GRADE SE02
33 (2) N027N DHS DEPUTY DIRECTOR ADULT SERVICES 1 GRADE SE01
34 (3) L016N REGISTERED PHARMACIST 4 GRADE MP05
35 (4) L009C NURSE MANAGER 1 GRADE MP03
36 (5) L027C REGISTERED NURSE SUPERVISOR 3 GRADE MP02
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1 (6) L038C REGISTERED NURSE 9 GRADE MP01
2 (7) D006N STATE SYSTEMS ARCHITECT 1 GRADE IT10
3 (8) D007C INFORMATION SYSTEMS MANAGER 2 GRADE IT08
4 (9) D030C INFORMATION SYSTEMS COORDINATOR 1 GRADE IT07
5 (10) D038C SENIOR SOFTWARE SUPPORT ANALYST 1 GRADE IT06
6 (11) D061C INFORMATION SYSTEMS COORDINATION SPEC 1 GRADE IT05
7 (12) D058C COMPUTER OPERATIONS COORDINATOR 1 GRADE IT04
8 (13) D068C INFORMATION SYSTEMS ANALYST 1 GRADE IT04
9 (14) A019N DHS DEP CHIEF FIN OFFICER-MEDICAL SVCS 1 GRADE GS15
10 (15) G286C DMS DEPUTY DIRECTOR 1 GRADE GS15
11 (16) P077C DHS COMM & COMMUNITY ENGAGEMENT OFCR 1 GRADE GS14
12 (17) N100N DHS/DMS ADD - MEDICAL SERVICES 1 GRADE GS14
13 (18) N110N DHS ASST DIR CONTRACT MONITORING UNIT 1 GRADE GS13
14 (19) N128N DHS ASST DIR QUALITY ASSURANCE 1 GRADE GS13
15 (20) D026N DHS ELIGIBILITY SYSTEM PROGRAM MGR 1 GRADE GS13
16 (21) G025C ATTORNEY SUPERVISOR 1 GRADE GS12
17 (22) N168N DHS DIR HOME & COMMUNITY BASED SVCS 1 GRADE GS12
18 (23) A016C DHS DMS BUSINESS OPERATIONS MANAGER 8 GRADE GS12
19 (24) G073C ATTORNEY 1 GRADE GS10
20 (25) L010C DHS DMS MEDICAL ASSISTANCE MANAGER 4 GRADE GS10
21 (26) G099C DHS PROGRAM ADMINISTRATOR 17 GRADE GS09
22 (27) R021C BUDGET ANALYST 1 GRADE GS08
23 (28) G152C DHS PROGRAM MANAGER 8 GRADE GS08
24 (29) A081C AUDITOR 1 GRADE GS07
25 (30) G183C DHS PROGRAM COORDINATOR 7 GRADE GS07
26 (31) C037C ADMINISTRATIVE ANALYST 2 GRADE GS06
27 (32) R027C BUDGET SPECIALIST 1 GRADE GS06
28 (33) C013C MEDICAL SERVICES REPRESENTATIVE 1 GRADE GS06
29 (34) C036C ADMINISTRATIVE REVIEW ANALYST 1 GRADE GS05
30 (35) L070C HEALTH CARE ANALYST 4 GRADE GS05
31 (36) C056C ADMINISTRATIVE SPECIALIST III 4 GRADE GS04
32 (37) A098C FISCAL SUPPORT SPECIALIST 1 GRADE GS04
33 MAX. NO. OF EMPLOYEES 96
34
35 SECTION 2. EXTRA HELP - OPERATIONS. There is hereby authorized, for
36 the Department of Human Services - Division of Medical Services for the 2023-
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1 2024 fiscal year, the following maximum number of part-time or temporary
2 employees, to be known as "Extra Help", payable from funds appropriated
3 herein for such purposes: ten (10) temporary or part-time employees, when
4 needed, at rates of pay not to exceed those provided in the Uniform
5 Classification and Compensation Act, or its successor, or this act for the
6 appropriate classification.
7
8 SECTION 3. APPROPRIATION - OPERATIONS. There is hereby appropriated,
9 to the Department of Human Services, to be payable from the paying account as
10 determined by the Chief Fiscal Officer of the State, for personal services
11 and operating expenses of the Department of Human Services - Division of
12 Medical Services for the fiscal year ending June 30, 2024, the following:
13
14 ITEM FISCAL YEAR
15 NO. 2023-2024
16 (01) REGULAR SALARIES $6,527,589
17 (02) EXTRA HELP 201,892
18 (03) PERSONAL SERVICES MATCHING 2,257,092
19 (04) OVERTIME 2,241
20 (05) MAINT. & GEN. OPERATION
21 (A) OPER. EXPENSE 1,813,290
22 (B) CONF. & TRAVEL 40,099
23 (C) PROF. FEES 700,000
24 (D) CAP. OUTLAY 0
25 (E) DATA PROC. 0
26 (06) DATA PROCESSING SERVICES 1,299,600
27 TOTAL AMOUNT APPROPRIATED $12,841,803
28
29 SECTION 4. APPROPRIATION - GRANTS. There is hereby appropriated, to
30 the Department of Human Services, to be payable from the paying account as
31 determined by the Chief Fiscal Officer of the State, for grant payments of
32 the Department of Human Services - Division of Medical Services for the
33 fiscal year ending June 30, 2024, the following:
34
35 ITEM FISCAL YEAR
36 NO. 2023-2024
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1 (01) ARKIDS B PROGRAM $207,222,020
2 (02) HOSPITAL AND MEDICAL SERVICES 8,034,125,877
3 (03) PRESCRIPTION DRUGS 509,386,547
4 (04) PRIVATE NURSING HOME CARE 957,142,061
5 (05) CHILD AND FAMILY LIFE INSTITUTE 2,100,000
6 (06) INFANT INFIRMARY 2,588,441
7 (07) PUBLIC NURSING HOME CARE 217,529,350
8 TOTAL AMOUNT APPROPRIATED $9,930,094,296
9
10 SECTION 5. APPROPRIATION - NURSING HOME CLOSURE COSTS. There is hereby
11 appropriated, to the Department of Human Services - Division of Medical
12 Services, to be payable from the Long-Term Care Trust Fund, for the payment
13 of relocation costs of residents in long-term care facilities, maintenance
14 and operation of a facility pending correction of deficiencies or closure,
15 and reimbursement of residents for personal funds lost for the fiscal year
16 ending June 30, 2024, the following:
17
18 ITEM FISCAL YEAR
19 NO. 2023-2024
20 (01) EXPENSES $4,500,000
21
22 SECTION 6. APPROPRIATION - LONG-TERM CARE FACILITY RECEIVERSHIP. There
23 is hereby appropriated, to the Department of Human Services, to be payable
24 from the Long Term Care Facility Receivership Fund Account, for the payment
25 of expenses of long-term care facility receivers as authorized by law of the
26 Department of Human Services - Division of Medical Services - Long-Term Care
27 Facility Receivership for the fiscal year ending June 30, 2024, the
28 following:
29
30 ITEM FISCAL YEAR
31 NO. 2023-2024
32 (01) EXPENSES $100,000
33
34 SECTION 7. APPROPRIATION - NURSING HOME QUALITY GRANTS. There is
35 hereby appropriated, to the Department of Human Services, to be payable from
36 the Long-Term Care Trust Fund, for Nursing Home Quality Care Grants of the
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1 Department of Human Services - Division of Medical Services - Nursing Home
2 Quality Grants for the fiscal year ending June 30, 2024, the following:
3
4 ITEM FISCAL YEAR
5 NO. 2023-2024
6 (01) NURSING HOME QUALITY GRANTS AND AID $4,000,000
7
8 SECTION 8. SPECIAL LANGUAGE — CODE AMENDMENT. Arkansas Code Title 20,
9 Chapter 77, Subchapter 4, is amended to add an additional section to codify
10 special language in appropriation acts to read as follows:
11 20-77-407. Pharmaceutical dispensing fee survey.
12 (a) No more than two (2) years before making any changes to the
13 current pharmaceutical dispensing fee, the Department of Human Services shall
14 conduct an independent survey utilizing generally accepted accounting
15 principles to determine the cost of dispensing a prescription by pharmacists
16 in Arkansas.
17 (b)(1) Only factors relative to the cost of dispensing shall be
18 surveyed under subsection (a) of this section.
19 (2) The factors surveyed under subsection (a) of this section
20 shall not include actual acquisition costs, average profit, or any
21 combination of actual acquisition costs or average profit.
22 (c)(1) The survey results obtained under this section shall be the
23 basis for establishing the dispensing fee paid to participating pharmacies in
24 the Medicaid prescription drug program in accordance with federal
25 requirements.
26 (2) The dispensing fee shall be no lower than the cost of
27 dispensing as determined by the survey conducted under this section.
28 (d) This section does not prohibit the department from increasing the
29 dispensing fee at any time.
30
31 SECTION 9. SPECIAL LANGUAGE. NOT TO BE INCORPORATED INTO THE ARKANSAS
32 CODE NOR PUBLISHED SEPARATELY AS SPECIAL, LOCAL AND TEMPORARY LAW.
33 MEDICAL SERVICES - GENERAL MEDICAID RATE METHODOLOGY PROVISIONS.
34 (a) Rates established by the Division of Medical Services for the services
35 or programs covered by this Act shall be calculated by the methodologies
36 approved by the Centers for Medicare and Medicaid Services (CMS). The
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1 Division of Medical Services shall have the authority to reduce or increase
2 rates based on the approved methodology. Further, the Division of Medical
3 Services shall have the authority to increase or decrease rates for good
4 cause including, but not limited to: (1) Identification of provider(s) who
5 can render needed services of equal quality at rates less than traditionally
6 charged and who meet the applicable federal and state laws, rules and
7 regulations pertaining to the provision of a particular service;
8 (2) Identification that a provider or group of providers has consistently
9 charged rates to the Arkansas Medicaid Program greater than to other
10 purchasers of medical services of similar size;
11 (3) The Division determines that there has been significant changes in the
12 technology or process by which services are provided by a provider or group
13 of providers which has affected the costs of providing services, or;
14 (4) A severe economic downturn in the Arkansas economy which has affected the
15 overall state budget of the Division of Medical Services.
16 The Division of Medical Services shall make available to requesting
17 providers, the CMS's inflationary forecasts (CMS Market Basket Index). Rates
18 established with cost of living increases based on the CMS Market Basket
19 Index or other indices will be adjusted annually except when the state budget
20 does not provide sufficient appropriation and funding to affect the change or
21 portion thereof.
22 (b) Any rate methodology changes proposed by the Division of Medical
23 Services both of a general and specific nature, shall be subject to prior
24 approval by the Legislative Council or Joint Budget Committee.
25 Determining the maximum number of employees and the maximum amount of
26 appropriation and general revenue funding for a state agency each fiscal year
27 is the prerogative of the General Assembly. This is usually accomplished by
28 delineating such maximums in the appropriation act(s) for a state agency and
29 the general revenue allocations authorized for each fund and fund account by
30 amendment to the Revenue Stabilization law. Further, the General Assembly has
31 determined that the Department of Human Services – Division of Medical
32 Services may operate more efficiently if some flexibility is provided to the
33 Department of Human Services – Division of Medical Services authorizing broad
34 powers under this section. Therefore, it is both necessary and appropriate
35 that the General Assembly maintain oversight by requiring prior approval of
36 the Legislative Council or Joint Budget Committee as provided by this
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1 section. The requirement of approval by the Legislative Council or Joint
2 Budget Committee is not a severable part of this section. If the requirement
3 of approval by the Legislative Council or Joint Budget Committee is ruled
4 unconstitutional by a court of competent jurisdiction, this entire section is
5 void.
6 The provisions of this section shall be in effect only from July 1, 2022
7 2023 through June 30, 2023 2024.
8
9 SECTION 10. SPECIAL LANGUAGE. NOT TO BE INCORPORATED INTO THE ARKANSAS
10 CODE NOR PUBLISHED SEPARATELY AS SPECIAL, LOCAL AND TEMPORARY LAW. FUND
11 USAGE AUTHORIZED. The Arkansas Children's Hospital may request the Department
12 of Human Services - Division of Medical Services to retain in the Department
13 of Human Services Grant Fund account an amount not to exceed $2,100,000 from
14 funds made available by this Act in the Child and Family Life Institute line
15 item of the Grants appropriation to be used to match federal funds used for
16 supplemental Medicaid payments to Arkansas Children's Hospital. These
17 retained funds shall not be recovered to transfer to the General Revenue
18 Allotment Reserve Fund.
19 The provisions of this section shall be in effect only from July 1, 2022
20 2023 through June 30, 2023 2024.
21
22 SECTION 11. SPECIAL LANGUAGE. NOT TO BE INCORPORATED INTO THE ARKANSAS
23 CODE NOR PUBLISHED SEPARATELY AS SPECIAL, LOCAL AND TEMPORARY LAW. ARKANSAS
24 HEALTH AND OPPORTUNITY FOR ME AND ARKANSAS HEALTH INSURANCE MARKETPLACE
25 RESTRICTIONS. (a) As used in this section, "Arkansas Health and Opportunity
26 for Me" means Arkansas Health and Opportunity for Me established under the
27 Arkansas Health and Opportunity for Me Act of 2021, Arkansas Code § 23-61-
28 1001 et seq.
29 (b)(1) Determining the maximum number of employe