The bill amends the Medicaid Fairness Act to enhance the appeals process for providers in the Arkansas Medicaid Program. Key changes include extending the appeal period from thirty-five days to a minimum of sixty-five days, allowing providers more time to respond to adverse decisions. Additionally, the bill mandates that notices of adverse decisions must include comprehensive information, such as detailed explanations and citations to specific policies and procedures that informed the decision. It also requires the Department of Human Services to publish all relevant protocols and requirements on its website, ensuring transparency and accessibility for providers.

Furthermore, the bill introduces a definition for "third-party entity," which refers to vendors contracted by the Department of Human Services to manage parts of the Medicaid appeals process. It stipulates that these entities must adhere to the same requirements regarding appeal periods, notice provisions, and publication of protocols. The Department is also tasked with revising its policies to align with the new regulations and conducting periodic audits to ensure compliance, with findings to be published annually.

Statutes affected:
Old version SB257 Original - 2-19-2025 10:03 AM: 20-77-1702, 20-77-1705, 20-77-1712
Old version SB257 V2 - 3-19-2025 03:13 PM: 20-77-1702, 20-77-1705, 03-19-2025, 20-77-1712
SB 257: 20-77-1702, 20-77-1705, 20-77-1712
Act 515: 20-77-1702, 20-77-1705, 03-19-2025, 20-77-1712