The bill amends existing Arkansas law regarding reimbursement rates for home- and community-based services provided by risk-based provider organizations under the Medicaid Provider-Led Organized Care Act. It specifies that reimbursement rates must be mutually agreed upon by the risk-based provider organization and direct service providers, ensuring that these rates are not less than the minimum rates established under a new section, 20-77-2709. This section mandates that an allowance within the capitation rates for these organizations must cover the costs determined by a rate study to be completed by October 1, 2025. The rates from this study will serve as minimums for payments to providers, ensuring efficiency, economy, quality, and equal access for both Medicaid beneficiaries and non-Medicaid individuals.

Additionally, the bill outlines the requirements for the rate study, which must include services from specific waivers and accurately capture provider costs while promoting quality care. The Department of Human Services is tasked with developing cost factors for the study with input from service providers. If the study results in a rate increase greater than 10%, the department may phase in the increase over two years, subject to state appropriations. The bill also requires ongoing reviews of provider rates to ensure they remain adequate and aligned with actual costs.

Statutes affected:
HB 1942: 20-77-2706(d), 20-77-2706(e)
Act 1023: 20-77-2706(d), 20-77-2706(e)