Bill
HB 1943
Arkansas HB 1943 reforms Medicaid RBPOs by adding public quality ratings, real-time provider directories, and a staffed beneficiary ombudsman to empower enrollment choices.
Note on source material and status
- The document you supplied contains mixed and conflicting items (an Arkansas bill amending Medicaid provider-led organized care law, an unrelated Illinois appropriation text, and a title about restoring suffrage to an individual). For this summary I focus on the substantive Arkansas-style bill text included in the document (amendments to the Medicaid Provider‑Led Organized Care Act). The header you provided lists the bill as “Died In Committee”; however, the legislative-action chronology in the materials is inconsistent and appears to combine actions from multiple jurisdictions. Please verify the official legislative record in the relevant state for final status.
Purpose and intent
- The bill would amend the Medicaid Provider‑Led Organized Care Act to increase transparency and beneficiary empowerment in risk-based provider organizations (RBPOs). It seeks to improve enrollment and plan-selection processes by requiring publicly accessible quality information, up‑to‑date provider directories, and an adequately staffed beneficiary support/ombudsman office.
Key provisions
- Quality rating system (new Ark. Code § 20-77-2709)
- RBPOs must provide an online basic quality rating system with ratings for each RBPO based on data the RBPO already collects.
- Required measures include (at minimum):
1. Days before initial delivery of home- and community-based services after receiving a waiver slot (Community and Employment Support Waiver).
2. Care coordinator caseload ratios.
3. Member satisfaction survey scores — with specified submeasures for individuals with intellectual/developmental disabilities (IDD) and behavioral health needs (community integration, living-arrangement satisfaction, provider/care-coordinator satisfaction, website/portal satisfaction, overall satisfaction, and employment engagement).
4. % of IDD members receiving follow-up care within 7 days after an ED visit.
5. % of behavioral health members receiving follow-up care within 7 days after an ED visit.
6. % of members age 3–21 with at least one comprehensive well-care visit in the measurement year.
7. Initial contact with a care coordinator within 14 days of enrollment.
8. % of enrolled members receiving monthly contact with a care coordinator.
9. % of newly enrolled members receiving an (text truncation in source; likely intended to specify an initial contact or service).
- Incidence of enrollee complaints/grievances must be tracked and ratings displayed prominently on the Department of Human Services (DHS) website.
Provider directories (new Ark. Code § 20-77-2710)
Beneficiary support office / Ombudsman (new Ark. Code § 20-77-2711)
Rulemaking and effective date
Who would be affected
- Medicaid beneficiaries enrolled in risk‑based provider organizations (especially persons with IDD and behavioral health needs).
- Risk-based provider organizations (administrative and reporting requirements; website/provider-directory maintenance).
- Care coordinators and network providers (caseload transparency; timely status reporting).
- Arkansas Department of Human Services (operational responsibility for beneficiary support and hosting of ratings; potential staffing and IT needs).
- Family members, advocates, and the public (access to comparative information to inform plan selection).
Potential impact and considerations
- Transparency and consumer choice: Public ratings and real‑time directories could help beneficiaries choose RBPOs better aligned with their needs.
- Administrative burden: RBPOs and DHS may need enhanced data collection, reporting systems, website updates, and staffing; there may be associated costs.
- Quality improvement: Specified measures (e.g., ED follow‑ups, care coordinator contact timelines) create incentives to improve care coordination and outcomes.
- Implementation details: Success depends on standardized definitions, data quality, survey design, and adequate DHS rulemaking and enforcement authority.
If you want, I can:
- Create a one‑page fact sheet for beneficiaries summarizing the most relevant consumer-facing provisions, or
- Draft suggested tracking/implementation questions DHS should address when promulgating rules.
Compiled from official sources — confirm details with the bill’s official record.
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