An act TO AMEND THE HEALTHCARE CONTRACTING 10 SIMPLIFICATION ACT, the official text

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

1 State of Arkansas              As Engrossed: H2/10/25
2 95th General Assembly
                                       A Bill

3 Regular Session, 2025                                              HOUSE BILL 1287

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5 By: Representative L. Johnson

6 By: Senator Irvin

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8                                For An Act To Be Entitled

9   AN ACT TO AMEND THE HEALTHCARE CONTRACTING

10  SIMPLIFICATION ACT; TO DEFINE "DOWNCODE" UNDER THE

11  HEALTHCARE CONTRACTING SIMPLIFICATION ACT; TO REQUIRE

12  NOTIFICATION BY CONTRACTING ENTITIES OF DOWNCODING

13  CERTAIN HEALTHCARE SERVICES; AND FOR OTHER PURPOSES.

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16                                    Subtitle

17                       TO AMEND THE HEALTHCARE CONTRACTING

18                       SIMPLIFICATION ACT; TO DEFINE "DOWNCODE"

19                       UNDER THE HEALTHCARE CONTRACTING

20                       SIMPLIFICATION ACT; AND TO REQUIRE

21                       NOTIFICATION BY CONTRACTING ENTITIES OF

22                       DOWNCODING.

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

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26  SECTION 1. Arkansas Code � 23-99-1202, concerning definitions used

27 under the Healthcare Contracting Simplification Act, is amended to add an

28 additional subdivision to read as follows:

29  (14) "Downcode" means to change a claim to a lower-cost

30 healthcare service than what was contained in the original claim that a

31 healthcare provider submitted or billed to a contracting entity.

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33  SECTION 2. Arkansas Code Title 23, Chapter 99, Subchapter 12, is

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

35  23-99-1211. Notice required for downcode of claim.

36  A contracting entity that downcodes a claim submitted by a healthcare

    *ANS040*                                                      02-10-2025 10:10:48 ANS040
    As Engrossed: H2/10/25                          HB1287

1 provider shall provide notice to the healthcare provider of the downcoding

2 within thirty (30) days of processing the claim.

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4                           /s/L. Johnson

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