Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.06-025 - Section I - All Arkansas Medicaid Provider Manuals
Universal Citation: AR Admin Rules 016.06.06-025
Current through Register Vol. 49, No. 9, September, 2024
171.000 Primary Care Physician Participation
171.100 PCP-Qualified Physicians and Single-Entity Providers
A. Obstetricians and gynecologists may choose
whether or not to be PCPs.
B. All
other PCP-qualified physicians and clinics must enroll as PCPs, except for
physicians who certify in writing that they are employed exclusively by an Area
Health Education Center (AHEC), a Federally Qualified Health Center (FQHC), a
Medical College Physicians Group, or a hospital (i.e., they are
"hospitalists").
C. PCP-qualified
physicians are those whose sole or primary specialty is
1. Family Practice
2. General Practice
3. Internal Medicine
4. Obstetrics and gynecology
5. Pediatrics and Adolescent
Medicine
D. Physicians
with multiple specialties may elect to enroll as PCPs if a secondary or
tertiary specialty in their Medicaid provider file is listed in part C
above.
E. PCP-qualified clinics and
health centers (single-entity PCPs) are
1.
AHECs
2. FQHCs
3. The family practice and internal medicine
clinics at the University of Arkansas for Medical Sciences
171.130 EPSDT Agreement Requirement
A. A PCP applicant must
sign an agreement to participate as a screening provider in the Child Health
Services (EPSDT) Program.
B.
Internists, obstetricians, gynecologists, and physicians who customarily carry
a caseload of patients who are 21 years of age or older are not required to
furnish EPSDT screens.
1. Their participation
in the Child Health Services (EPSDT) Program is optional.
2. They must, however, sign Child Health
Services (EPSDT agreements if they elect to be screening providers.
C. PCP-qualified single-entity
providers must execute Child Health Services (EPSDT) agreements.
171.320 Child Health Services (EPSDT) Requirements
A. A PCP
must monitor and maintain the Child Health Services (EPSDT) screening
periodicity of each of his or her enrollees under the age of 21, regardless of
who screens those enrollees. The periodic EPSDT screening schedule recommended
by the American Academy of Pediatrics can be found in section
215.100 of the Child Health
Services/Early and Periodic Screening, Diagnosis and Treatment
manual.
B. A PCP may refer his or
her enrollees to other providers for EPSDT screens and related lab work.
1. Screening providers must report the
results to the referring PCP.
2.
The PCP must coordinate and monitor subsequent referrals, treatment or
testing.
Disclaimer: These regulations may not be the most recent version. Arkansas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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