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HB 1165

TO PROHIBIT DIFFERENT REIMBURSEMENT RATES FOR SERVICES PERFORMED BY THE SAME TYPE OF PROVIDER IN DIFFERENT SETTINGS WITHIN THE ARKANSAS MEDICAID PROGRAM.

2025 Regular Session Introduced by Lee Johnson

HB 1165 aimed to ensure equal reimbursement rates for identical services by the same providers in different settings, promoting fairness in Arkansas Medicaid.

WITHDRAWN BY AUTHOR
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WeVote Research Nonpartisan
Bill Summary · HB 1165

Summary of House Bill 1165

Bill Information

  • Bill Number: HB 1165
  • Title: To Prohibit Different Reimbursement Rates for Services Performed by the Same Type of Provider in Different Settings within the Arkansas Medicaid Program
  • Status: Withdrawn by Author
  • Introduced: January 16, 2025
  • Classification: Bill

Purpose and Intent

House Bill 1165 aimed to address discrepancies in reimbursement rates within the Arkansas Medicaid Program. Specifically, it sought to ensure that providers of the same type receive equal compensation for identical services, regardless of the setting in which those services are rendered. The bill was introduced to promote equity in reimbursement practices, particularly for behavioral health services.

Key Provisions

The bill proposed the following changes to Arkansas Code Title 20, Chapter 77, Subchapter 1:

  1. Prohibition on Different Reimbursement Rates:

    • The Arkansas Medicaid Program would be prohibited from paying different reimbursement rates for the same services performed by the same type of provider when the only difference is the setting (e.g., a physician's office vs. a behavioral health agency).

  2. Findings of the General Assembly:

    • The bill highlighted several findings, including:
      • Discrepancies in payment rates for physicians based on the service setting.
      • Higher payments for services rendered in a physician's office compared to those provided in behavioral health settings.
      • The same billing codes being used for identical services across different settings.
      • The negative impact of these discrepancies on the provision of behavioral health services in Arkansas.

  3. Implementation:

    • The Department of Human Services would be required to apply for any necessary federal waivers or Medicaid state plan amendments to implement the provisions of the bill.

Impact

If enacted, HB 1165 would have affected:
- Healthcare Providers: Physicians and behavioral health providers would receive equal reimbursement for the same services, potentially improving financial stability for those operating in lower-reimbursement settings.
- Patients: Patients seeking behavioral health services might benefit from improved access to care as providers could be incentivized to offer services in these settings without the financial disadvantage.
- Medicaid Program: The Arkansas Medicaid Program would need to adjust its reimbursement policies and potentially seek federal approval for changes.

Procedural Aspects

  • Legislative Actions:
    • The bill was filed and read for the first time on January 16, 2025.
    • It was referred to the Public Health, Welfare and Labor Committee.
    • On March 17, 2025, the bill was withdrawn by the author, halting its progression through the legislative process.

In summary, while HB 1165 sought to create a more equitable reimbursement system within the Arkansas Medicaid Program, it was ultimately withdrawn before further consideration.

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

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