AR HB1818

Creates a workgroup within the Department of Human Services comprising Medicaid beneficiaries and providers for intellectual/developmental disabilities and behavioral health services to develop quality standards for risk-based provider organizations

Prohibits "gag clauses" that prevent direct service providers who are investors in risk-based provider organizations from publicly advocating on legislation, agency rules, or other matters of public interest, effective January 1, 2026

Limits provider audits to no more than 2 per calendar year (unless fraud suspected), requires 60 days for providers to supply records, and caps audit periods at 12 months from claim submission date

Requires risk-based provider organizations to file detailed annual financial statements by March 1, including total assets, liabilities, claims paid/denied, and payments to in-network and out-of-network providers, with executive summaries submitted to legislative committees

Grants enrollees and direct service providers a private right of action to sue DHS or risk-based provider organizations for equitable relief, with entitlement to reasonable attorneys' fees and costs