Bill > SB257

This bill amends the Arkansas Medicaid Fairness Act to improve the provider appeals process by extending the appeal period from 35 to 65 days, requiring more comprehensive information in adverse decision notices, and mandating public transparency of all policies and procedures used in making adverse decisions. The bill recognizes that the current 35-day appeal window is too restrictive for providers, who need time to receive, review, and respond to adverse determinations sent by mail. It requires that notices of adverse decisions now include a detailed explanation of the rationale and specific citations to protocols, procedures, or policy manual references used in making the decision. The bill also mandates that the Department of Human Services publish all current and historical protocols, procedures, and requirements on its website, with specific version dates and archival information. Importantly, the bill stipulates that any undisclosed or unpublished protocols cannot be used to make adverse decisions, with some exceptions for legally protected information, medical research, and provider certification actions. The legislation applies not only to the Department of Human Services but also to any third-party vendors contracted to administer parts of the Medicaid appeals process, and requires the department to conduct and publish annual compliance audits.

Business and Industry, Health and Social Services

https://arkleg.state.ar.us/Bills/Detail?id=sb257&ddBienniumSession=2025%2F2025R