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SB 222

Cost-sharing Requirements for Diabetes Management

2026 Regular Session Introduced by Kristen Arrington and 1 co-sponsor

SB 222 enhances Medicaid enrollees' decision-making by clarifying provider marketing practices, ensuring they understand their options and network implications.

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Bill Summary · SB 222

Summary of Senate Bill 222 (SB 222)

Purpose and Intent

Senate Bill 222 (SB 222) aims to amend the Medicaid Provider-Led Organized Care Act in Arkansas. The primary intent of the bill is to clarify the marketing practices of direct service providers under the Medicaid program, ensuring that potential and current enrollees are well-informed about their options and the implications of their choices regarding risk-based provider organizations.

Key Provisions

The bill introduces several important provisions:

  1. Marketing Clarity:

    • It establishes that direct service providers have the right to inform existing and potential Medicaid enrollees about their network status with specific risk-based provider organizations.
    • Providers can communicate the consequences of choosing a risk-based provider organization that does not include their services.

  2. Communication Guidelines:

    • It is not considered a marketing violation for providers to discuss their network status during open enrollment periods, provided they inform enrollees of their freedom to choose among different organizations.
    • Providers are allowed to respond to inquiries about network status and open enrollment without being deemed to influence the enrollee's choice, as long as their responses are accurate and not misleading.

  3. Compliance with Federal Regulations:

    • Direct service providers must adhere to the federal managed care rule on marketing activities as specified in 42 C.F.R. § 438.104, effective as of January 1, 2025.
    • The Arkansas Department of Human Services is tasked with revising marketing rules to align with the new provisions outlined in the bill.

Affected Parties

  • Medicaid Enrollees: The bill directly impacts Medicaid beneficiaries by enhancing their ability to make informed decisions regarding their healthcare options.
  • Direct Service Providers: Healthcare providers participating in Medicaid will have clearer guidelines on how they can communicate with enrollees about their network status.

Emergency Declaration

The bill includes an emergency clause, which states that the confusion surrounding provider communications is negatively affecting Medicaid beneficiaries' ability to make informed healthcare decisions. As such, the bill is deemed immediately necessary for the preservation of public health and safety. It will take effect upon approval by the Governor or after the expiration of the veto period.

Legislative Timeline

  • Introduced: February 12, 2025
  • Passed: March 11, 2025
  • Notification of Act: March 18, 2025 (now known as Act 301)

Conclusion

SB 222 represents a significant step towards improving transparency and communication within Arkansas's Medicaid system. By clarifying marketing practices, the bill aims to empower enrollees with the information they need to navigate their healthcare choices effectively.

Compiled from official sources — confirm details with the bill’s official record.

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