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HB 1818

Professions and occupations; licensed social workers; terms and titles modified; effective date.

2025 Regular Session Introduced by Carl Newton

The bill would require DHS oversight of Medicaid risk-based provider organizations, standardize care coordination funding, credentialing, gag-clause bans, and quality reporting to

Second Reading referred to Rules
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Bill Summary · HB 1818

Summary — HB 1818

Note: The available document appears to combine text from more than one bill and more than one state. The bill text chiefly contains an Arkansas proposal titled the "Medicaid Provider‑Led Care Transparency and Accountability Act" but the header and portions of the file also include (unrelated) Illinois Property Tax Code language and an initial title referencing an appropriation for Hinds County. This summary focuses on the substantive Arkansas Medicaid provisions found in the submitted text, and it highlights inconsistencies in the record.

Title / Purpose

Medicaid Provider‑Led Care Transparency and Accountability Act (as inserted into Arkansas Code Title 20, Chapter 77, Subchapter 30). The bill’s stated aim is to increase transparency, accountability, and quality for Medicaid “risk‑based provider organizations” (RPOs) serving individuals with intellectual and developmental disabilities (I/DD) and behavioral health needs.

Status and procedural history

  • Introduced: January 13, 2025 (multiple entries indicate additional filings and related actions on Jan–Apr 2025).
  • Committee actions/hearings: Readings and committee referrals occurred in March 2025; public hearing and testimony March 26, 2025.
  • Withdrawn by author: April 14, 2025.
  • Final status shown: Died in Committee (February 26, 2025 entry — the file mixes timelines).
    Because the document is conflated with content from other states, these dates reflect the mixed record provided.

Key provisions (selected)

  • Workgroup (§20‑77‑3002): Creates a DHS workgroup including Medicaid beneficiaries and I/DD and behavioral health providers to develop standards for improving quality of care; may be a subcommittee of the Medicaid Advisory Committee.
  • Care coordination (§20‑77‑3003): RPOs must pay direct service providers for care coordination from the capitated rate DHS pays the RPO. RPOs may subcontract care coordination, but not federal “conflict‑free” functions (eligibility evaluations, functional assessments, person‑centered plan development). Requires enhanced training for care coordinators and alignment of person‑centered plan meetings with provider renewal dates.
  • Gag‑clause prohibition (§20‑77‑3004): RPOs cannot forbid investor direct service providers from publicly advocating positions that conflict with the RPO; conflicting contractual provisions are void.
  • Quality initiatives & metrics (§20‑77‑3005): DHS must require external quality review organizations to collect specific quality metrics (including Home‑ and Community‑Based Services Quality Measure Set) and consult the workgroup. RPOs must initiate I/DD services within 60 days of assignment or face penalties. Authorizes assistive/enabling technologies (including smart home tech) and remote staffing models. Directs development of value‑based payment initiatives, evidence‑based services for high utilizers, and a non‑medical transportation billing code distinct from supported living transportation.
  • Rates for complex conditions: RPOs must set appropriate direct service rates for individuals with complex conditions in the Community Support System Provider Program rather than using default supported living rates.
  • Credentialing (§20‑77‑3006): DHS must require standardized credentialing across RPOs, obtaining therapist credential information via the Medicaid portal and using CAQH for additional data if needed.
  • Audit fairness (§20‑77‑3007): Requires secure online portals for audit document submission (or reimbursement for copying at $0.20/page while a portal is unavailable). Limits audits to no more than two requests per calendar year absent complaint/suspicion, provides at least 60 days for providers to produce records and to respond to preliminary audit findings, and limits audit look‑back to 12 months from claim submission. Confirms Medicaid Fairness Act continues to apply to RPOs.
  • Transparency & reporting (§20‑77‑3008): Provision begins but is truncated in the provided text — requires annual filing of "full and true statement" with DHS (complete requirements not available in the excerpt).

Who is affected

  • Risk‑based provider organizations (RPOs) participating in Medicaid programs serving I/DD and behavioral health populations.
  • Direct service providers (therapists, support providers, I/DD and behavioral health service providers), especially those who are RPO investors.
  • Medicaid beneficiaries with I/DD and behavioral health needs in Arkansas.
  • Department of Human Services, external quality review organizations, and payers/administrators responsible for credentialing and audits.

Potential impacts

  • Could increase oversight, public reporting, and quality monitoring of RPOs and improve timeliness and coordination of I/DD services.
  • May shift financial flows (clarifying that care coordination is paid from capitated rates and requiring RPOs to set higher rates for complex cases).
  • Strengthens provider protections (limits audits, bans gag clauses) and standardizes credentialing.
  • Encourages use of assistive technologies and remote staffing models, potentially expanding service delivery options.

Observations / Caveats

  • The legislative file is conflated with unrelated Illinois Property Tax Code amendments and an appropriation title for Hinds County; readers should be cautious and consult the official state legislative records (Arkansas General Assembly and/or the clerk’s office) for the authoritative bill text and final status.
  • The transparency/reporting section is truncated in the provided excerpt; full reporting obligations and penalties are therefore not summarized here.

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

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