This bill amends the Arkansas Medicaid Program regulations by requiring additional approvals before the Department of Human Services (DHS) can take certain actions. Specifically, it mandates that DHS must seek and receive approval from both the Governor and the Chief Fiscal Officer of the State before increasing reimbursement rates or adopting any rules that would obligate state general revenues. Furthermore, the bill stipulates that any expansion of coverage or increase in costs to the state must be approved by a two-thirds vote from either the Legislative Council or the Joint Budget Committee if the General Assembly is in session.

The bill also introduces new reporting requirements for the DHS, stating that if reimbursement rates are decreased, the department must report to the Legislative Council with justification for the decrease. Additionally, it clarifies that existing Medicaid state plan amendments or federal waivers that are already in effect will not be affected by these new requirements. Overall, the legislation aims to enhance legislative oversight and control over the financial implications of the Arkansas Medicaid Program.