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HB 1818

TO CREATE THE MEDICAID PROVIDER-LED CARE TRANSPARENCY AND ACCOUNTABILITY ACT.

2025 Regular Session Introduced by Breanne Davis and 1 co-sponsor

HB 1818 aimed to enhance Medicaid care for individuals with disabilities by improving accountability, coordination, and transparency among provider organizations.

WITHDRAWN BY AUTHOR
0
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Bill Summary · HB 1818

Summary of House Bill 1818: Medicaid Provider-Led Care Transparency and Accountability Act

Bill Number: HB 1818
Introduced: March 17, 2025
Status: Withdrawn by Author (April 14, 2025)
Authors: Representative L. Johnson, Senator B. Davis

Purpose and Intent

House Bill 1818 aimed to establish the Medicaid Provider-Led Care Transparency and Accountability Act in Arkansas. The primary goal of the bill was to enhance the quality of care provided by risk-based provider organizations within the Medicaid system, particularly for individuals with intellectual and developmental disabilities and behavioral health needs. The legislation sought to create a framework for accountability, transparency, and improved care coordination.

Key Provisions

The bill proposed several significant changes and initiatives, including:

  1. Creation of a Workgroup:

    • The Department of Human Services (DHS) would form a workgroup consisting of Medicaid beneficiaries and providers to develop standards for risk-based provider organizations to improve care quality.

  2. Care Coordination:

    • Risk-based provider organizations would be required to pay direct service providers for care coordination from their capitated rates.
    • Enhanced education and training for care coordinators would be developed in consultation with the workgroup.

  3. Prohibition of Gag Clauses:

    • Contracts between risk-based provider organizations and direct service providers could not include provisions that prevent providers from advocating publicly on matters of public interest.

  4. Quality Initiatives:

    • DHS would mandate external quality reviews to collect data on service quality metrics for risk-based provider organizations.
    • Penalties would be imposed on organizations that fail to initiate services for individuals with disabilities within 60 days of assignment.

  5. Standardized Credentialing:

    • Risk-based provider organizations would be required to standardize credentialing processes for various therapists through the Medicaid portal.

  6. Audit Fairness:

    • The bill proposed measures to ensure fair audit practices, including limits on the number of audits per year and requirements for reasonable notice and time to respond to audit requests.

  7. Transparency and Reporting:

    • Risk-based provider organizations would be required to file annual reports with DHS detailing their operations and compliance with the new standards.

Impact

If enacted, HB 1818 would have affected:
- Medicaid Beneficiaries: Improved care coordination and quality of services for individuals with intellectual and developmental disabilities and behavioral health needs.
- Direct Service Providers: Enhanced compensation for care coordination and protection against restrictive contract clauses.
- Risk-Based Provider Organizations: Increased accountability through standardized practices, quality metrics, and audit processes.

Procedural Aspects

  • The bill was filed and read for the first time on March 17, 2025, with subsequent actions leading to its referral to the Public Health, Welfare, and Labor Committee.
  • Ultimately, the bill was withdrawn by its author on April 14, 2025, before further legislative action could take place.

This summary provides an overview of the intended reforms and regulatory changes proposed in HB 1818, highlighting its potential impact on the Medicaid system in Arkansas.

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

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