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Arkansas General Assembly· SB 62Died in Senate Committee at Sine Die adjournment.

An act TO TERMINATE THE ARKANSAS HEALTH AND 10 OPPORTUNITY FOR ME PROGRAM, the official text

Shown verbatim: the complete text as captured from the official PDF posted by the Arkansas General Assembly, fetched 2026-07-23. Page and line markers are part of the official record; nothing is edited or removed. The official bill page.
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                                          SENATE BILL 62

4

5 By: Senator B. King

6

7

8                        For An Act To Be Entitled

9   AN ACT TO TERMINATE THE ARKANSAS HEALTH AND

10  OPPORTUNITY FOR ME PROGRAM; TO TRANSFER ALL

11  BENEFICIARIES IN THE ARKANSAS HEALTH AND OPPORTUNITY

12  FOR ME PROGRAM TO THE TRADITIONAL ARKANSAS MEDICAID

13  PROGRAM; TO REPEAL THE ARKANSAS HEALTH AND

14  OPPORTUNITY FOR ME ACT OF 2021; AND FOR OTHER

15  PURPOSES.

16

17

18                                          Subtitle

19                       TO TERMINATE THE ARKANSAS HEALTH AND

20                       OPPORTUNITY FOR ME PROGRAM; AND TO

21                       TRANSFER ALL BENEFICIARIES IN THE

22                       ARKANSAS HEALTH AND OPPORTUNITY FOR ME

23                       PROGRAM TO THE TRADITIONAL ARKANSAS

24                       MEDICAID PROGRAM.

25

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

27

28  SECTION 1. DO NOT CODIFY. Legislative intent.

29  It is the intent of the General Assembly to:

30  (1) Repeal the Arkansas Health and Opportunity for Me Program;

31  (2) Amend various sections of the Arkansas Code to end

32 Arkansas's participation in the Arkansas Health and Opportunity for Me

33 Program; and

34  (3) Instruct the Governor to submit a waiver to:

35                       (A) Transfer all individuals enrolled and participating in

36 the Arkansas Health and Opportunity for Me Program to the traditional

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1 Arkansas Medicaid program on and after July 1, 2025; and

2                    (B) Terminate the Arkansas Health and Opportunity for Me

3 Program on December 31, 2026.

4

5   SECTION 2. DO NOT CODIFY. Arkansas Health and Opportunity for Me

6 Program -- Notification of termination -- Transfer of enrollees to the Arkansas

7 Medicaid Program.

8   (a) The Department of Human Services shall:

9   (1) Notify all persons enrolled in the Arkansas Health and

10 Opportunity for Me Program as of the effective date of this act that the

11 Arkansas Health and Opportunity for Me Program ends on December 31, 2026;

12  (2) Inform a new enrollee in the Arkansas Health and Opportunity

13 for Me Program after the effective date of this act that the Arkansas Health

14 and Opportunity for Me Program ends on December 31, 2026; and

15  (3) Transfer all persons enrolled in the Arkansas Health and

16 Opportunity for Me Program or any person who enrolled in the Arkansas Health

17 and Opportunity for Me Program after July 1, 2025, to coverage under the

18 traditional Arkansas Medicaid Program on July 1, 2025.

19  (b) The department may prohibit new enrollees in the Arkansas Health

20 and Opportunity for Me Program to begin the transition period before the

21 termination date of December 31, 2026.

22  (c) On the effective date of this act, the department shall submit any

23 Medicaid state plan amendments and federal waivers necessary to eliminate the

24 eligibility in the Arkansas Health and Opportunity for Me Program after

25 December 31, 2026.

26  (d) This section does not prohibit the payment of expenses incurred

27 before December 31, 2026, by persons participating in the Arkansas Health and

28 Opportunity for Me Program.

29

30  SECTION 3. Arkansas Code � 19-5-984(b)(2)(D), concerning the Division

31 of Workforce Services Special Fund, is repealed.

32                   (D) The Arkansas Health and Opportunity for Me Act of

33 2021, � 23-61-1001 et seq., or its successor; and

34

35  SECTION 4. Arkansas Code � 19-5-1146 is repealed.

36  19-5-1146. Arkansas Health and Opportunity for Me Program Trust Fund.

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1   (a) There is created on the books of the Treasurer of State, the

2 Auditor of State, and the Chief Fiscal Officer of the State a trust fund to

3 be known as the "Arkansas Health and Opportunity for Me Program Trust Fund".

4   (b) The fund shall consist of:

5              (1) Moneys saved and accrued under the Arkansas Health and

6 Opportunity for Me Act of 2021, � 23-61-1001 et seq., including without

7 limitation:

8                (A) Increases in premium tax collections; and

9                (B) Other spending reductions resulting from the Arkansas

10 Health and Opportunity for Me Act of 2021, � 23-61-1001 et seq.; and

11             (2) Other revenues and funds authorized by law.

12  (c) The Department of Human Services shall use the fund to pay for

13 future obligations under the Arkansas Health and Opportunity for Me Program

14 created by the Arkansas Health and Opportunity for Me Act of 2021, � 23-61-

15 1001 et seq.

16

17  SECTION 5. Arkansas Code � 23-61-803(h), concerning the Arkansas

18 Health Insurance Marketplace, is amended to read as follows:

19  (h) The State Insurance Department and any eligible entity under

20 subdivision (e)(2) of this section shall provide claims and other plan and

21 enrollment data to the Department of Human Services upon request to:

22             (1) Facilitate facilitate compliance with reporting requirements

23 under state and federal law; and

24             (2) Assess the performance of the Arkansas Health and

25 Opportunity for Me Program established by the Arkansas Health and Opportunity

26 for Me Act of 2021, � 23-61-1001 et seq., including without limitation the

27 program's quality, cost, and consumer access.

28

29  SECTION 6. Arkansas Code Title 23, Chapter 16, Subchapter 10, is

30 repealed.

31  Subchapter 10 -- Arkansas Health and Opportunity for Me Act of 2021

32

33  23-61-1001. Title.

34  This subchapter shall be known and may be cited as the "Arkansas Health

35 and Opportunity for Me Act of 2021".

36

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1   23-61-1002. Legislative intent.

2   Notwithstanding any general or specific laws to the contrary, it is the

3 intent of the General Assembly for the Arkansas Health and Opportunity for Me

4 Program to be a fiscally sustainable, cost-effective, and opportunity-driven

5 program that:

6   (1) Achieves comprehensive and innovative healthcare reform that

7 reduces the rate of growth in state and federal obligations for providing

8 healthcare coverage to low-income adults in Arkansas;

9   (2) Reduces the maternal and infant mortality rates in the state

10 through initiatives that promote healthy outcomes for eligible women with

11 high-risk pregnancies;

12  (3) Promotes the health, welfare, and stability of mothers and

13 their infants after birth through hospital-based community bridge

14 organizations;

15  (4) Encourages personal responsibility for individuals to

16 demonstrate that they value healthcare coverage and understand their roles

17 and obligations in maintaining private insurance coverage;

18  (5) Increases opportunities for full-time work and attainment of

19 economic independence, especially for certain young adults, to reduce long-

20 term poverty that is associated with additional risk for disease and

21 premature death;

22  (6) Addresses health-related social needs of Arkansans in rural

23 counties through hospital-based community bridge organizations and reduces

24 the additional risk for disease and premature death associated with living in

25 a rural county;

26  (7) Strengthens the financial stability of the critical access

27 hospitals and other small, rural hospitals; and

28  (8) Fills gaps in the continuum of care for individuals in need

29 of services for serious mental illness and substance use disorders.

30

31  23-61-1003. Definitions.

32  As used in this subchapter:

33  (1) "Acute care hospital" means a hospital that:

34                   (A) Is licensed by the Department of Health under � 20-9-

35 201 et seq., as a general hospital or a surgery and general medical care

36 hospital; and

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1                 (B) Is enrolled as a provider with the Arkansas Medicaid

2 Program;

3               (2) "Birthing hospital" means a hospital in this state or in a

4 border state that:

5                 (A) Is licensed as a general hospital;

6                 (B) Provides obstetrics services; and

7                 (C) Is enrolled as a provider with the Arkansas Medicaid

8 Program;

9               (3) "Community bridge organization" means an organization that

10 is authorized by the Department of Human Services to participate in the

11 economic independence initiative or the health improvement initiative to:

12                (A) Screen and refer Arkansans to resources available in

13 their communities to address health-related social needs; and

14                (B) Assist eligible individuals identified as target

15 populations most at risk of disease and premature death and who need a higher

16 level of intervention to improve their health outcomes and succeed in meeting

17 their long-term goals to achieve independence, including economic

18 independence;

19              (4) "Cost sharing" means the portion of the cost of a covered

20 medical service that is required to be paid by or on behalf of an eligible

21 individual;

22              (5) "Critical access hospital" means an acute care hospital that

23 is:

24                (A) Designated by the Centers for Medicare & Medicaid

25 Services as a critical access hospital; and

26                (B) Is enrolled as a provider in the Arkansas Medicaid

27 Program;

28              (6) "Economic independence initiative" means an initiative

29 developed by the Department of Human Services that is designed to promote

30 economic stability by encouraging participation of program participants to

31 engage in full-time, full-year work, and to demonstrate the value of

32 enrollment in an individual qualified health insurance plan through

33 incentives and disincentives;

34              (7) "Eligible individual" means an individual who is in the

35 eligibility category created by section 1902(a)(10)(A)(i)(VIII) of the Social

36 Security Act, 42 U.S.C. � 1396a;

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1   (8) "Employer health insurance coverage" means a health

2 insurance benefit plan offered by an employer or, as authorized by this

3 subchapter, an employer self-funded insurance plan governed by the Employee

4 Retirement Income Security Act of 1974, Pub. L. No. 93-406, as amended;

5   (9) "Health improvement initiative" means an initiative

6 developed by an individual qualified health insurance plan or the Department

7 of Human Services that is designed to encourage the participation of eligible

8 individuals in health assessments and wellness programs, including fitness

9 programs and smoking or tobacco cessation programs;

10  (10) "Health insurance benefit plan" means a policy, contract,

11 certificate, or agreement offered or issued by a health insurer to provide,

12 deliver, arrange for, pay for, or reimburse any of the costs of healthcare

13 services, but not including excepted benefits as defined under 42 U.S.C. �

14 300gg-91(c), as it existed on January 1, 2021;

15  (11) "Health insurance marketplace" means the applicable

16 entities that were designed to help individuals, families, and businesses in

17 Arkansas shop for and select health insurance benefit plans in a way that

18 permits comparison of available plans based upon price, benefits, services,

19 and quality, and refers to either:

20  (A) The Arkansas Health Insurance Marketplace created

21 under the Arkansas Health Insurance Marketplace Act, � 23-61-801 et seq., or

22 a successor entity; or

23  (B) The federal health insurance marketplace or federal

24 health benefit exchange created under the Patient Protection and Affordable

25 Care Act, Pub. L. No. 111-148;

26  (12) "Health insurer" means an insurer authorized by the State

27 Insurance Department to provide health insurance or a health insurance

28 benefit plan in the State of Arkansas, including without limitation:

29  (A) An insurance company;

30  (B) A medical services plan;

31  (C) A hospital plan;

32  (D) A hospital medical service corporation;

33  (E) A health maintenance organization;

34  (F) A fraternal benefits society;

35  (G) Any other entity providing health insurance or a

36 health insurance benefit plan subject to state insurance regulation; or

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1                 (H) A risk-based provider organization licensed by the

2 Insurance Commissioner under � 20-77-2704;

3             (13) "Healthcare coverage" means coverage provided under this

4 subchapter through either an individual qualified health insurance plan, a

5 risk-based provider organization, employer health insurance coverage, or the

6 fee-for-service Arkansas Medicaid Program;

7             (14) "Individual qualified health insurance plan" means an

8 individual health insurance benefit plan offered by a health insurer that

9 participates in the health insurance marketplace to provide coverage in

10 Arkansas that covers only essential health benefits as defined by Arkansas

11 rule and 45 C.F.R. � 156.110 and any federal insurance regulations, as they

12 existed on January 1, 2021;

13            (15) "Member" means a program participant who is enrolled in an

14 individual qualified health insurance plan;

15            (16) "Premium" means a monthly fee that is required to be paid

16 by or on behalf of an eligible individual to maintain some or all health

17 insurance benefits;

18            (17) "Program participant" means an eligible individual who:

19                (A) Is at least nineteen (19) years of age and no more

20 than sixty-four (64) years of age with an income that meets the income

21 eligibility standards established by rule of the Department of Human

22 Services;

23                (B) Is authenticated to be a United States citizen or

24 documented qualified alien according to the Personal Responsibility and Work

25 Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193;

26                (C) Is not eligible for Medicare or advanced premium tax

27 credits through the health insurance marketplace; and

28                (D) Is not determined by the Department of Human Services

29 to be medically frail or eligible for services through a risk-based provider

30 organization;

31            (18) "Risk-based provider organization" means the same as

32 defined in � 20-77-2703; and

33            (19) "Small rural hospital" means a critical access hospital or

34 a general hospital that:

35                (A) Is located in a rural area;

36                (B) Has fifty (50) or fewer staffed beds; and

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1                   (C) Is enrolled as a provider in the Arkansas Medicaid

2 Program.

3

4   23-61-1004. Administration.

5   (a)(1) The Department of Human Services, in coordination with the

6 State Insurance Department and other state agencies, as necessary, shall:

7                   (A) Provide healthcare coverage under this subchapter to

8 eligible individuals;

9                   (B) Create and administer the Arkansas Health and

10 Opportunity for Me Program by:

11                       (i) Applying for any federal waivers, Medicaid state

12 plan amendments, or other authority necessary to implement the Arkansas

13 Health and Opportunity for Me Program in a manner consistent with this

14 subchapter; and

15                       (ii) Administering the Arkansas Health and

16 Opportunity for Me Program as approved by the Centers for Medicare & Medicaid

17 Services;

18                  (C)(i) Administer the economic independence initiative

19 designed to reduce the short-term effects of the work penalty and the long-

20 term effects of poverty on health outcomes among program participants through

21 incentives and disincentives.

22                       (ii) The Department of Human Services shall align

23 the economic independence initiative with other state-administered work-

24 related programs to the extent practicable;

25                  (D) Screen, refer, and assist eligible individuals through

26 community bridge organizations under agreements with the Department of Human

27 Services;

28                  (E) Offer incentives to promote personal responsibility,

29 individual health, and economic independence through individual qualified

30 health insurance plans and community bridge organizations; and

31                  (F) Seek a waiver to reduce the period of retroactive

32 eligibility for an eligible individual under this subchapter to thirty (30)

33 days before the date of the application.

34            (2) The Governor shall request the assistance and involvement of

35 other state agencies that he or she deems necessary for the implementation of

36 the Arkansas Health and Opportunity for Me Program.

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1   (b) Healthcare coverage under this subchapter shall be provided

2 through enrollment in:

3               (1) An individual qualified health insurance plan through a

4 health insurer;

5               (2) A risk-based provider organization;

6               (3) An employer-sponsored health insurance coverage; or

7               (4) The fee-for-service Arkansas Medicaid Program.

8   (c) Annually, the Department of Human Services shall develop

9 purchasing guidelines that:

10              (1) Describe which individual qualified health insurance plans

11 are suitable for purchase in the next demonstration year, including without

12 limitation:

13                 (A) The level of the plan;

14                 (B) The amounts of allowable premiums;

15                 (C) Cost sharing;

16                 (D) Auto-assignment methodology; and

17                 (E) The total per-member-per-month enrollment range; and

18              (2) Ensure that:

19                 (A) Payments to an individual qualified health insurance

20 plan do not exceed budget neutrality limitations in each demonstration year;

21                 (B) The total payments to all of the individual qualified

22 health insurance plans offered by the health insurers for eligible

23 individuals combined do not exceed budget targets for the Arkansas Health and

24 Opportunity for Me Program in each demonstration year that the Department of

25 Human Services may achieve by:

26                        (i) Setting in advance an enrollment range to

27 represent the minimum and a maximum total monthly number of enrollees into

28 all individual qualified health insurance plans no later than April 30 of

29 each demonstration year in order for the individual qualified health

30 insurance plans to file rates for the following demonstration year;

31                        (ii) Temporarily suspending auto-assignment into the

32 individual qualified health insurance plans at any time in a demonstration

33 year if necessary, to remain within the enrollment range and budget targets

34 for the demonstration year; and

35                        (iii) Developing a methodology for random auto-

36 assignment of program participants into the individual qualified health

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1 insurance plans after a suspension period has ended;

2                  (C) Individual qualified health insurance plans meet and

3 report quality and performance measurement targets set by the Department of

4 Human Services; and

5                  (D) At least two (2) health insurers offer individual

6 qualified health insurance plans in each county in the state.

7   (d)(1) The Department of Human Services, the State Insurance

8 Department, and each of the individual qualified health insurance plans shall

9 enter into a memorandum of understanding that shall specify the duties and

10 obligations of each party in the operation of the Arkansas Health and

11 Opportunity for Me Program, including provisions necessary to effectuate the

12 purchasing guidelines and reporting requirements, at least thirty (30)

13 calendar days before the annual open enrollment period.

14          (2) If a memorandum of understanding is not fully executed with

15 a health insurer by January 1 of each new demonstration year, the Department

16 of Human Services shall suspend auto-assignment of new members to the health

17 insurers until the first day of the month after the new memorandum of

18 understanding is fully executed.

19          (3) The memorandum of understanding shall include financial

20 sanctions determined appropriate by the Department of Human Services that may

21 be applied if the Department of Human Services determines that an individual

22 qualified health insurance plan has not met the quality and performance

23 measurement targets or any other condition of the memorandum of

24 understanding.

25          (4)(A) If the Department of Human Services determines that the

26 individual qualified health insurance plans have not met the quality and

27 health performance targets for two (2) years, the Department of Human

28 Services shall develop additional reforms to achieve the quality and health

29 performance targets.

30                 (B) If legislative action is required to implement the

31 additional reforms described in subdivision (d)(4)(A) of this section, the

32 Department of Human Services may take the action to the Legislative Council

33 or the Executive Subcommittee of the Legislative Council for immediate

34 action.

35  (e) The Department of Human Services shall:

36          (1) Adopt premiums and cost-sharing levels for individuals

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1 enrolled in the Arkansas Health and Opportunity for Me Program, not to exceed

2 aggregate limits under 42 C.F.R. � 447.56;

3   (2)(A) Establish and maintain a process for premium payments,

4 advanced cost-sharing reduction payments, and reconciliation payments to

5 health insurers.

6                   (B) The process described in subdivision (e)(2)(A) of this

7 section shall attribute any unpaid member liabilities as solely the financial

8 obligation of the individual member.

9                   (C) The Department of Human Services shall not include any

10 unpaid individual member obligation in any payment or financial

11 reconciliation with health insurers or in a future premium rate; and

12  (3)(A) Calculate a total per-member-per-month amount for each

13 individual qualified health insurance plan based on all payments made by the

14 Department of Human Services on behalf of an individual enrolled in the

15 individual qualified health insurance plan.

16                  (B)(i) The amount described in subdivision (e)(3)(A) of

17 this section shall include premium payments, advanced cost-sharing reduction

18 payments for services provided to covered individuals during the

19 demonstration year, and any other payments accruing to the budget neutrality

20 target for plan-enrolled individuals made during the demonstration year and

21 the member months for each demonstration year.

22                  (ii) The total per-member-per-month upper limit is

23 the budget neutrality per-member-per-month limit established in the approved

24 demonstration for each demonstration year.

25                  (C) If the Department of Human Services calculates that

26 the total per-member-per-month limit for an individual qualified health

27 insurance plan for that demonstration year exceeds the budget neutrality per-

28 member-per-month limit for that demonstration year, the Department of Human

29 Services shall not make any additional reconciliation payments to the health

30 insurer for that individual qualified health insurance plan.

31                  (D) If the Department of Human Services determines that

32 the budget neutrality limit has been exceeded, the Department of Human

33 Services shall recover the excess funds from the health insurer for that

34 individual qualified health insurance plan.

35  (f)(1) If the federal medical assistance percentages for the Arkansas

36 Health and Opportunity for Me Program are reduced to below ninety percent

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1 (90%), the Department of Human Services shall present to the Centers for

2 Medicare & Medicaid Services a plan within thirty (30) days of the reduction

3 to terminate the Arkansas Health and Opportunity for Me Program and

4 transition eligible individuals out of the Arkansas Health and Opportunity

5 for Me Program within one hundred twenty (120) days of the reduction.

6   (2) An eligible individual shall maintain coverage during the

7 process to implement the plan to terminate the Arkansas Health and

8 Opportunity for Me Program and the transition of eligible individuals out of

9 the Arkansas Health and Opportunity for Me Program.

10  (g)(1) A health insurer that is providing an individual qualified

11 health insurance plan or employer health insurance coverage for an eligible

12 individual shall submit claims and enrollment data to the Department of Human

13 Services to facilitate reporting required under this subchapter or other

14 state or federally required reporting or evaluation activities.

15  (2) A health insurer may utilize existing mechanisms with

16 supplemental enrollment information to fulfill requirements under this

17 subchapter, including without limitation the state's all-payer claims

18 database established under the Arkansas Healthcare Transparency Initiative

19 Act of 2015, � 23-61-901 et seq., for claims and enrollment data submission.

20  (h)(1) The Governor shall request a block grant under relevant federal

21 law and regulations for the funding of the Arkansas Medicaid Program as soon

22 as practical if the federal law or regulations change to allow the approval

23 of a block grant for this purpose.

24  (2) The Governor shall request a waiver under relevant federal

25 law and regulations for a work requirement as a condition of maintaining

26 coverage in the Arkansas Medicaid Program as soon as practical if the federal

27 law or regulations change to allow the approval of a waiver for this purpose.

28

29  23-61-1005. Requirements for eligible individuals.

30  (a) An eligible individual is responsible for all applicable cost-

31 sharing and premium payment requirements as determined by the Department of

32 Human Services.

33  (b) An eligible individual may participate in a health improvement

34 initiative, as developed and implemented by either the eligible individual's

35 individual qualified health insurance plan or the department.

36  (c)(1)(A) An eligible individual who is determined by the department

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1 to meet the eligibility criteria for a risk-based provider organization due

2 to serious mental illness or substance use disorder shall be enrolled in a

3 risk-based provider organization under criteria established by the

4 department.

5                     (B) An eligible individual who is enrolled in a risk-based

6 provider organization is exempt from the requirements of subsections (a) and

7 (b) of this section.

8              (2)(A) An eligible individual who is determined by the

9 department to be medically frail shall receive healthcare coverage through

10 the fee-for-service Arkansas Medicaid Program.

11                    (B) An eligible individual who is enrolled in the fee-for-

12 service Arkansas Medicaid Program is exempt from the requirements of

13 subsection (a) of this section.

14  (d) An eligible individual shall receive notice that:

15             (1) The Arkansas Health and Opportunity for Me Program is not a

16 perpetual federal or state right or a guaranteed entitlement;

17             (2) The Arkansas Health and Opportunity for Me Program is

18 subject to cancellation upon appropriate notice;

19             (3) Enrollment in an individual qualified health insurance plan

20 is not a right; and

21             (4) If the individual chooses not to participate or fails to

22 meet participation goals in the economic independence initiative, the

23 individual may lose incentives provided through enrollment in an individual

24 qualified health insurance plan or be unenrolled from the individual

25 qualified health insurance plan after notification by the department.

26

27  23-61-1006. Requirements for program participants.

28  (a) The economic independence initiative applies to all program

29 participants in accordance with the implementation schedule of the Department

30 of Human Services.

31  (b) Incentives established by the department for participation in the

32 economic independence initiative and the health improvement initiative may

33 include, without limitation, the waiver of premium payments and cost-sharing

34 requirements as determined by the department for participation in one (1) or

35 more initiatives.

36  (c) Failure by a program participant to meet the cost-sharing and

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1 premium payment requirement under � 23-61-1005(a) may result in the accrual

2 of a personal debt to the health insurer or provider.

3      (d)(1)(A) Failure by the program participant to meet the initiative

4 participation requirements of subsection (b) of this section may result in:

5                    (i) Being unenrolled from the individual qualified

6 health insurance plan; or

7                    (ii) The loss of incentives, as defined by the

8 department.

9                    (B) However, an individual who is unenrolled shall not

10 lose Medicaid healthcare coverage based solely on disenrollment from the

11 individual qualified health insurance plan.

12             (2) The department shall develop and notify program participants

13 of the criteria for restoring eligibility for incentive benefits that were

14 removed as a result of the program participants' failure to meet the

15 initiative participation requirements of subsection (b) of this section.

16             (3)(A) A program participant who also meets the criteria of a

17 community bridge organization target population may qualify for additional

18 incentives by successfully completing the economic independence initiative

19 provided through a community bridge organization.

20                   (B) If successfully completing the initiative results in

21 an increase in the program participant's income that exceeds the program's

22 financial eligibility limits, a program participant may receive, for a

23 specified period of time, financial assistance to pay:

24                   (i) The individual's share of employer-sponsored

25 health insurance coverage not to exceed a limit determined by the department;

26 or

27                   (ii) A share of the individual's cost-sharing

28 obligation, as determined by the department, if the individual enrolls in a

29 health insurance benefit plan offered through the Arkansas Health Insurance

30 Marketplace.

31

32     23-61-1007. Insurance standards for individual qualified health

33 insurance plans.

34     (a) Insurance coverage for a member enrolled in an individual

35 qualified health insurance plan shall be obtained, at a minimum, through

36 silver-level metallic plans as provided in 42 U.S.C. � 18022(d) and � 18071,

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1 as they existed on January 1, 2021, that restrict out-of-pocket costs to

2 amounts that do not exceed applicable out-of-pocket cost limitations.

3   (b) As provided under � 23-61-1004(e)(2), health insurers shall track

4 the applicable premium payments and cost sharing collected from members to

5 ensure that the total amount of an individual's payments for premiums and

6 cost sharing does not exceed the aggregate cap imposed by 42 C.F.R. � 447.56.

7   (c) All health benefit plans purchased by the Department of Human

8 Services shall:

9               (1) Conform to the requirements of this section and applicable

10 insurance rules;

11              (2) Be certified by the State Insurance Department;

12              (3)(A) Maintain a medical-loss ratio of at least eighty percent

13 (80%) for an individual qualified health insurance plan as required under 45

14 C.F.R. � 158.210(c), as it existed on January 1, 2021, or rebate the

15 difference to the Department of Human Services for members.

16                   (B) However, the Department of Human Services may approve

17 up to one percent (1%) of revenues as community investments and as benefit

18 expenses in calculating the medical-loss ratio of a plan in accordance with

19 45 C.F.R. � 158.150;

20              (4) Develop:

21                   (A) An annual quality assessment and performance

22 improvement strategic plan to be approved by the Department of Human Services

23 that aligns with federal quality improvement initiatives and quality and

24 reporting requirements of the Department of Human Services; and

25                   (B) Targeted initiatives based on requirements established

26 by the Department of Human Services in consultation with the Department of

27 Health; and

28              (5) Make reports to the Department of Human Services and the

29 Department of Health regarding quality and performance metrics in a manner

30 and frequency established by a memorandum of understanding.

31  (d) A health insurer offering individual qualified health insurance

32 plans for members shall participate in the Arkansas Patient-Centered Medical

33 Home Program, including:

34              (1) Attributing enrollees in individual qualified health

35 insurance plans, including members, to a primary care physician;

36              (2) Providing financial support to patient-centered medical

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1 homes to meet practice transformation milestones; and

2   (3) Supplying clinical performance data to patient-centered

3 medical homes, including data to enable patient-centered medical homes to

4 assess the relative cost and quality of healthcare providers to whom patient-

5 centered medical homes refer patients.

6   (e)(1) Each individual qualified health insurance plan shall provide

7 for a health improvement initiative, subject to the review and approval of

8 the Department of Human Services, to provide incentives to its enrolled

9 members to participate in one (1) or more health improvement initiatives as

10 defined in � 23-61-1003(9).

11  (2)(A) The Department of Human Services shall work with health

12 insurers offering individual qualified health insurance plans to ensure the

13 economic independence initiative offered by the health insurer includes a

14 robust outreach and communications effort which targets specific health,

15 education, training, employment, and other opportunities appropriate for its

16 enrolled members.

17                    (B) The outreach and communications effort shall recognize

18 that enrolled members receive information from multiple channels, including

19 without limitation:

20                      (i) Community service organizations;

21                      (ii) Local community outreach partners;

22                      (iii) Email;

23                      (iv) Radio;

24                      (v) Religious organizations;

25                      (vi) Social media;

26                      (vii) Television;

27                      (viii) Text message; and

28                      (ix) Traditional methods such as newspaper or mail.

29  (f) On or before January 1, 2022, the State Insurance Department and

30 the Department of Human Services may implement through certification

31 requirements or rule, or both, the applicable provisions of this section.

32

33  23-61-1009. Sunset.

34  This subchapter shall expire on December 31, 2026.

35

36  23-61-1010. Community bridge organizations.

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1        (a) The Department of Human Services shall develop requirements and

2 qualifications for community bridge organizations to provide assistance to

3 one (1) or more of the following target populations:

4        (1) Individuals who become pregnant with a high-risk pregnancy

5 and the child, throughout the pregnancy and up to twenty-four (24) months

6 after birth;

7        (2) Individuals in rural areas of the state in need of treatment

8 for serious mental illness or substance use disorder;

9        (3) Individuals who are young adults most at risk of poor health

10 due to long-term poverty and who meet criteria established by the Department

11 of Human Services, including without limitation the following:

12                  (A) An individual between nineteen (19) and twenty-four

13 (24) years of age who has been previously placed under the supervision of

14 the:

15                  (i) Division of Youth Services; or

16                  (ii) Department of Corrections;

17                  (B) An individual between nineteen (19) and twenty-seven

18 (27) years of age who has been previously placed under the supervision of the

19 Division of Children and Family Services; or

20                  (C) An individual between nineteen (19) and thirty (30)

21 years of age who is a veteran; and

22       (4) Any other target populations identified by the Department of

23 Human Services.

24       (b)(1) Each community bridge organization shall be administered by a

25 hospital under conditions established by the Department of Human Services.

26       (2) A hospital is eligible to serve eligible individuals under

27 subdivision (a)(1) of this section if the hospital:

28                  (A) Is a birthing hospital;

29                  (B) Provides or contracts with a qualified entity for the

30 provision of a federally recognized evidence-based home visitation model to a

31 woman during pregnancy and to the woman and child for a period of up to

32 twenty-four (24) months after birth; and

33                  (C) Meets any additional criteria established by the

34 Department of Human Services.

35       (3)(A) A hospital is eligible to serve eligible individuals

36 under subdivision (a)(2) of this section if the hospital:

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1                   (i) Is a small rural hospital;

2                   (ii) Screens all Arkansans who seek services at the

3 hospital for health-related social needs;

4                   (iii) Refers Arkansans identified as having health-

5 related social needs for social services available in the community;

6                   (iv) Employs local qualified staff to assist

7 eligible individuals in need of treatment for serious mental illness or

8 substance use disorder in accessing medical treatment from healthcare

9 professionals and supports to meet health-related social needs;

10                  (v) Enrolls with the Arkansas Medicaid Program as an

11 acute crisis unit provider; and

12                  (vi) Meets any additional criteria established by

13 the Department of Human Services.

14                  (B) The hospital may use funding available through the

15 Department of Human Services to improve the hospital's ability to deliver

16 care through coordination with other healthcare professionals and with the

17 local emergency response system that may include training of personnel and

18 improvements in equipment to support the delivery of medical services through

19 telemedicine.

20     (4) A hospital is eligible to serve eligible individuals under

21 subdivision (a)(3) of this section if the hospital:

22                  (A) Is an acute care hospital;

23                  (B) Administers or contracts for the administration of

24 programs using proven models, as defined by the Department of Human Services,

25 to provide employment, training, education, or other social supports; and

26                  (C) Meets any additional criteria established by the

27 Department of Human Services.

28     (c) An individual is not required or entitled to enroll in a community

29 bridge organization as a condition of Medicaid eligibility.

30     (d) A hospital is not:

31     (1) Required to apply to become a community bridge organization;

32 or

33     (2) Entitled to be selected as a community bridge organization.

34

35     23-61-1011. Health and Economic Outcomes Accountability Oversight

36 Advisory Panel.

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1   (a) There is created the Health and Economic Outcomes Accountability

2 Oversight Advisory Panel.

3   (b) The advisory panel shall be composed of the following members:

4             (1) The following members of the General Assembly:

5                    (A) The Chair of the Senate Committee on Public Health,

6 Welfare, and Labor;

7                    (B) The Chair of the House Committee on Public Health,

8 Welfare, and Labor;

9                    (C) The Chair of the Senate Committee on Education;

10                   (D) The Chair of the House Committee on Education;

11                   (E) The Chair of the Senate Committee on Insurance and

12 Commerce;

13                   (F) The Chair of the House Committee on Insurance and

14 Commerce;

15                   (G) An at-large member of the Senate appointed by the

16 President Pro Tempore of the Senate;

17                   (H) An at-large member of the House of Representatives

18 appointed by the Speaker of the House of Representatives;

19                   (I) An at-large member of the Senate appointed by the

20 minority leader of the Senate; and

21                   (J) An at-large member of the House of Representatives

22 appointed by the minority leader of the House of Representatives;

23            (2) The Secretary of the Department of Human Services;

24            (3) The Arkansas Surgeon General;

25            (4) The Insurance Commissioner;

26            (5) The heads of the following executive branch agencies or

27 their designees:

28                   (A) Department of Health;

29                   (B) Department of Education;

30                   (C) Department of Corrections;

31                   (D) Department of Commerce; and

32                   (E) Department of Finance and Administration;

33            (6) The Executive Director of the Arkansas Minority Health

34 Commission; and

35            (7)(A) Three (3) community members who represent health,

36 business, or education, who reflect the broad racial and geographic diversity

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1 in the state, and who have demonstrated a commitment to improving the health

2 and welfare of Arkansans, appointed as follows:

3                   (i) One (1) member shall be appointed by and serve

4 at the will of the Governor;

5                   (ii) One (1) member shall be appointed by and serve

6 at the will of the President Pro Tempore of the Senate; and

7                   (iii) One (1) member shall be appointed by and serve

8 at the will of the Speaker of the House of Representatives.

9                   (B) Members serving under subdivision (b)(7)(A) of this

10 section may receive mileage reimbursement.

11         (c)(1) The Secretary of the Department of Human Services and one (1)

12 legislative member shall serve as the cochairs of the Health and Economic

13 Outcomes Accountability Oversight Advisory Panel and shall convene meetings

14 quarterly of the advisory panel.

15         (2) The legislative member who serves as the cochair shall be

16 selected by majority vote of all legislative members serving on the advisory

17 panel.

18         (d)(1) The advisory panel shall review, make nonbinding

19 recommendations, and provide advice concerning the proposed quality

20 performance targets presented by the Department of Human Services for each

21 participating individual qualified health insurance plan.

22         (2) The advisory panel shall deliver all nonbinding

23 recommendations to the Secretary of the Department of Human Services.

24         (3)(A) The Secretary of the Department of Human Services, in

25 consultation with the State Medicaid Director, shall determine all quality

26 performance targets for each participating individual qualified health

27 insurance plan.

28                  (B) The Secretary of the Department of Human Services may

29 consider the nonbinding recommendations of the advisory panel when

30 determining quality performance targets for each participating individual

31 qualified health insurance plan.

32         (e) The advisory panel shall review:

33         (1) The annual quality assessment and performance improvement

34 strategic plan for each participating individual qualified health insurance

35 plan;

36         (2) Financial performance of the Arkansas Health and Opportunity

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1 for Me Program against the budget neutrality targets in each demonstration

2 year;

3               (3) Quarterly reports prepared by the Department of Human

4 Services, in consultation with the Department of Commerce, on progress

5 towards meeting economic independence outcomes and health improvement

6 outcomes, including without limitation:

7               (A) Community bridge organization outcomes;

8               (B) Individual qualified health insurance plan health

9 improvement outcomes;

10              (C) Economic independence initiative outcomes; and

11              (D) Any sanctions or penalties assessed on participating

12 individual qualified health insurance plans;

13              (4) Quarterly reports prepared by the Department of Human

14 Services on the Arkansas Health and Opportunity for Me Program, including

15 without limitation:

16              (A) Eligibility and enrollment;

17              (B) Utilization;

18              (C) Premium and cost-sharing reduction costs; and

19              (D) Health insurer participation and competition; and

20              (5) Any other topics as requested by the Secretary of the

21 Department of Human Services.

22       (f)(1) The advisory panel may furnish advice, gather information, make

23 recommendations, and publish reports.

24              (2) However, the advisory panel shall not administer any portion

25 of the Arkansas Health and Opportunity for Me Program or set policy.

26       (g) The Department of Human Services shall provide administrative

27 support necessary for the advisory panel to perform its duties.

28       (h) The Department of Human Services shall produce and submit a

29 quarterly report incorporating the advisory panel's findings to the President

30 Pro Tempore of the Senate, the Speaker of the House of Representatives, and

31 the public on the progress in health and economic improvement resulting from

32 the Arkansas Health and Opportunity for Me Program, including without

33 limitation:

34              (1) Eligibility and enrollment;

35              (2) Participation in and the impact of the economic independence

36 initiative and the health improvement initiative of the eligible individuals,

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1 health insurers, and community bridge organizations;

2   (3) Utilization of medical services;

3   (4) Premium and cost-sharing reduction costs; and

4   (5) Health insurer participation and completion.

5

6   23-61-1012. Rules.

7   The Department of Human Services shall adopt rules necessary to

8 implement this subchapter.

9

10  SECTION 7. Arkansas Code � 26-57-604(a)(1)(B)(ii), concerning the

11 allowance of a credit to be applied against the insurance premium tax, is

12 amended to read as follows:

13                       (ii) However, the credit shall not be applied as an

14 offset against the premium tax on collections resulting from an eligible

15 individual insured under the Arkansas Health and Opportunity for Me Act of

16 2021, � 23-61-1001 et seq., the Arkansas Health Insurance Marketplace Act, �

17 23-61-801 et seq., or individual qualified health insurance plans, including

18 without limitation stand-alone dental plans, issued through the health

19 insurance marketplace as defined by � 23-61-1003.

20

21  SECTION 8. Arkansas Code � 26-57-610(b)(2), concerning the disposition

22 of the insurance premium tax, is amended to read as follows:

23  (2) The taxes based on premiums collected under the Arkansas

24 Health and Opportunity for Me Act of 2021, � 23-61-1001 et seq., the Arkansas

25 Health Insurance Marketplace Act, � 23-61-801 et seq., or individual

26 qualified health insurance plans, including without limitation stand-alone

27 dental plans, issued through the health insurance marketplace as defined by �

28 23-61-1003 shall be:

29  (A) At the time of deposit, separately Separately

30 certified by the commissioner to the Treasurer of State at the time of

31 deposit for classification and distribution under this section; and

32  (B) Transferred to the Arkansas Health and Opportunity for

33 Me Program Trust Fund and used as required by the Arkansas Health and

34 Opportunity for Me Program Trust Fund;

35

36

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