SB829 Summary

• Amends Arkansas Code §§ 20-77-1702 through 20-77-1718 to enhance Medicaid Fairness Act provisions governing provider appeals, recoupment procedures, and oversight of the Medicaid program.

• Prohibits the Department of Human Services from using technical deficiencies as grounds for recoupment unless mandated by federal statute or regulation, and requires final determination before recoupment occurs with interest accruing at judgment rate from date of written demand.

• Establishes that administrative law judges employed by the Department of Health shall conduct all Medicaid provider administrative appeals, with final decisions not subject to override by the Department of Human Services Director once the federal waiver is approved.

• Requires the department to request additional documentation rather than immediately deny or recoup claims when insufficient documentation exists to determine medical necessity, and prohibits retroactive imposition of physician referral requirements.

• Implements audit timeline requirements (150 days for audit reports, 60 days for reconsideration results) and allows providers to appeal termination decisions to circuit court without exhausting administrative remedies when termination exceeds 15 days.