Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.13-016 - Arkansas Private Option (Health Care Independence Act of 2013)
Current through Register Vol. 49, No. 9, September, 2024
5. Alternative Benefit Plan (ABP)
Effective for dates of service on or after January 1, 2014, the Arkansas Medicaid program will cover inpatient acute hospital days in excess of twenty-four days (during a state fiscal year) for those beneficiaries covered under the Alternative Benefit Plan (APB). The per diem rate for ABP inpatient acute hospital days twenty-five and above will be 400 dollars per day. The intent of the policy change is to increase access to care in all hospitals in the state of Arkansas. Inpatient Acute hospital days under twenty-five will be reimbursed in accordance with the methodology set forth in Attachment 4.19A page 1. Except as otherwise noted in the Plan, this rate is the same for both governmental and private providers of inpatient acute hospital services.
Effective for dates of service on or after January 1, 2014, the Arkansas Medicaid program will cover inpatient rehabilitation hospital days in excess of twenty-four days (during a state fiscal year) for those beneficiaries covered under the Alternative Benefit Plan (ABP). The per diem rate for ABP inpatient rehabilitation hospital days twenty-five and above will be 400 dollars per day. The intent of the policy change is to increase access to care in all hospitals in the state of Arkansas. Inpatient rehabilitation hospital days under twenty-five will be reimbursed in accordance with the methodology set forth in Attachment 4.19A page 9a. Except as otherwise noted in the State Plan, this rate is the same for both government and private providers of inpatient rehabilitation hospital services.
METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATES -INPATIENT HOSPITAL SERVICES
ATTACHMENT 4.19-A
29. Alternative Benefit Plan (ABP)
All required ABP services and immunizations not
specifically identified in the following are covered and reimbursed in
accordance with the methodologies described elsewhere in the State Plan. The
state's reimbursement methodologies otherwise set forth in the State Plan meet
the minimum ABP requirements under the Affordable Care Act (ACA). All APB and
non-ABP are rates published on the agency's website
29. Alternative Benefit Plan (ABP)
Reimbursement for ages 19 and over will be based on 80% of the 2014 Arkansas Blue Cross Blue Shield rate for this immunization. Reimbursement for ages 18 and under will be based on the Arkansas Medicaid Vaccines for Children (VFC) reimbursement rate for non-ABP beneficiaries as of January 1, 2014.
