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AR HB1314

Bill

Status

Passed

4/10/2025

Primary Sponsor

Lee Johnson

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Origin

House of Representatives

95th General Assembly (2025 Regular)

AI Summary

  • Creates the "Arkansas Medical Audit Bill of Rights Act" establishing protections for healthcare providers when audited by insurance companies, third-party payors, or claims administrators

  • Requires auditors to provide at least 1 week advance notice before initial audits, limits routine audits to 2 per calendar year, and caps audit scope to 50 claims or 0.25% of prior year claims billed

  • Prohibits classifying clerical or recordkeeping errors as fraud without proof of intent, and bars auditors from using extrapolation to calculate recoupments or penalties

  • Mandates audits involving clinical judgment be conducted by or in consultation with a healthcare provider of the same specialty as the provider being audited

  • Exempts Arkansas Medicaid Program audits conducted by the Department of Human Services and any audits involving alleged fraud, willful misrepresentation, or abuse

Legislative Description

To Amend The Law Concerning Certain Audits Of Healthcare Providers; And To Create The Arkansas Medical Audit Bill Of Rights Act.

Last Action

Notification that HB1314 is now Act 512

4/10/2025

Committee Referrals

Insurance & Commerce3/31/2025
Insurance and Commerce1/29/2025

Full Bill Text

No bill text available