Definition

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  1. (a) As used in this section, “rule impacting state Medicaid costs” means a proposed rule as defined by § 25-15-202(9), or a proposed amendment to an existing rule as defined by § 25-15-202(9), that would, if adopted, adjust Medicaid reimbursement rates, Medicaid eligibility criteria, or Medicaid benefits, including without limitation a proposed rule or a proposed amendment to an existing rule seeking to:

    1. (1) Reduce the number of individuals covered by the Arkansas Medicaid Program;

    2. (2) Limit the types of services covered by the program;

    3. (3) Reduce the utilization of services covered by the program;

    4. (4) Reduce provider reimbursement;

    5. (5) Increase consumer cost sharing;

    6. (6) Reduce the cost of administering the program;

    7. (7) Increase the program revenues;

    8. (8) Reduce fraud and abuse in the program;

    9. (9) Change any of the methodologies used for reimbursement of providers;

    10. (10) Seek a new waiver or modification of an existing waiver of any provision under Title XIX of the Social Security Act, 42 U.S.C. § 1396-1 et seq., including a waiver that would allow a demonstration project;

    11. (11) Participate or seek to participate in the waiver authority of Section 1115(a)(1) of the Social Security Act, 42 U.S.C. § 1315(a)(1), that would allow operation of a demonstration project or program;

    12. (12) Participate or seek to participate in a request under Section 1115(a)(2) of the Social Security Act, 42 U.S.C. § 1315(a)(2), for the United States Secretary of Health and Human Services to provide federal financial participation for costs associated with a demonstration project or program;

    13. (13) Implement managed care provisions under Section 1932 of the Social Security Act, 42 U.S.C. § 1396u-2; or

    14. (14) Participate or seek to participate in the projects or programs of the Center for Medicare and Medicaid Innovation.

  2. (b) “Rule impacting state Medicaid costs” does not include a modification, addition, or elimination of the medical codes used within the Arkansas Medicaid Program that are issued by the Centers for Medicare and Medicaid Services, including without limitation:

    1. (1) Current Procedural Terminology codes;

    2. (2) Healthcare Common Procedure Coding System codes;

    3. (3) International Classification of Diseases codes;

    4. (4) National Uniform Billing Committee Official UB-04 Data Specifications Manual codes; and

    5. (5) National Correct Coding Initiative codes.


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