An act TO ADD DEFINITIONS TO THE MEDICAID FAIRNESS 10 ACT TO ENSURE THAT ALL RULE ENFORCEMENT ACTIONS ARE 11 APPEALABLE, the official text

Stricken language would be deleted from and underlined language would be added to present law.

1 State of Arkansas                         A Bill
2 95th General Assembly

3 Regular Session, 2025                                           HOUSE BILL 1172

4

5 By: Representatives L. Johnson, Gramlich

6

7

8                        For An Act To Be Entitled

9            AN ACT TO ADD DEFINITIONS TO THE MEDICAID FAIRNESS

10           ACT TO ENSURE THAT ALL RULE ENFORCEMENT ACTIONS ARE

11           APPEALABLE; AND FOR OTHER PURPOSES.

12

13

14                                          Subtitle

15                       TO ADD DEFINITIONS TO THE MEDICAID

16                       FAIRNESS ACT TO ENSURE THAT ALL RULE

17                       ENFORCEMENT ACTIONS ARE APPEALABLE.

18

19 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

20

21  SECTION 1. Arkansas Code � 20-77-1702(2)(B), concerning the definition

22 of "adverse action" within the Medicaid Fairness Act, is amended to read as

23 follows:

24                       (B) To constitute an adverse decision, an agency decision

25 need not have a monetary penalty attached but must have or a direct monetary

26 consequence to the provider, including an enforcement action.

27

28  SECTION 2. Arkansas Code � 20-77-1702, concerning the definitions

29 within the Medicaid Fairness Act, is amended to add an additional subdivision

30 to read as follows:

31           (20) "Enforcement action" means an action or decision by the

32 department or its reviewers or contractors that affects a Medicaid provider

33 in regard to the enforcement of a rule of the department.

34

35  SECTION 3. Arkansas Code Title 20, Chapter 77, Subchapter 17, is

36 amended to add an additional section to read as follows:

    *JMB124*                                                   01/16/2025 1:35:03 PM JMB124
                                                                          HB1172

1   20-77-1719. Adverse actions resulting from enforcement actions.

2   In addition to the requirements of this subchapter regarding an adverse

3 action, the Department of Human Services shall ensure that an adverse action

4 resulting from an enforcement action meets the following minimum

5 requirements:

6   (1)(A) A provider shall be given no less than forty-eight (48)

7 hours' notice of a scheduled, routine monitor visit to conduct an

8 organization-wide one (1) time per licensing or certification period in a

9 single audit event.

10                 (B) An inspection visit to conduct an investigation of a

11 complaint of non-compliance received from a third party shall not require

12 notice as described under subdivision (1)(A) of this section;

13  (2)(A) A provider may challenge a violation in any enforcement

14 action by filing a reconsideration request setting forth the reasons the

15 alleged violation resulting in an enforcement act is invalid.

16                 (B) The reconsideration request shall be ruled upon by the

17 enforcement entity within thirty (30) calendar days of receipt of the

18 reconsideration request under subdivision (2)(A) of this section.

19                 (C) If the reconsideration request under subdivision

20 (2)(A) of this section is not ruled upon within the time frame under

21 subdivision (2)(B) of this section, the violation shall be vacated by

22 operation of law; and

23  (3) If a provider's reconsideration request under subdivision

24 (2) of this section is not approved, the provider may administratively appeal

25 the violation.

26

27

28

29

30

31

32

33

34

35

36

                          2  01/16/2025 1:35:03 PM JMB124