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. This aims to improve transparency and efficiency in the appeals process, reducing unnecessary administrative burdens on both providers and the Department of Human Services.

Furthermore, the bill requires the Department of Human Services to publish and maintain all protocols, procedures, and requirements used in making adverse decisions on its website. This includes both current and prior versions of these documents, ensuring that providers have access to historical and current policy requirements. The legislation also stipulates that any internal or unpublished protocols cannot be enforced, thereby invalidating any adverse decisions based on undisclosed criteria. Compliance with these new requirements is also extended to third-party entities involved in the Medicaid appeals process.

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