Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.14-017 - Methods and Standards for Establishing Payment Rates - Family Planning Services
Current through Register Vol. 49, No. 9, September, 2024
METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATES -OTHER TYPES OF CARE
ATTACHMENT 4.19-B
4.
Reimbursement is based on the lesser of the amount billed or the maximum Title XIX (Medicaid) charge allowed. State developed fee schedule rates are the same for both public and private providers.
At the beginning of each calendar year, the State Agency will negotiate with the affected provider group representatives to arrive at a mutually acceptable increase or decrease from the maximum rate. Market forces, such as private insurance rate, medical and general inflation figures, changes in practice costs and changes in program requirements, will be considered during the negotiation process. Any agreed upon increase or decrease will be implemented at the beginning of the following State Fiscal Year, July 1, with any appropriate State Plan changes.
Effective for claims with dates of service January 1, 2014 and after, the intrauterine device (lUD) is reimbursed based on 100% of the manufacturer's list price as of April 15,2011. Effective for claims with dates of service October 1, 2014 and after, the 52 mg Levongestrel-Releasing Intrauterine Contraceptive System is reimbursed based on 100% of the manufacturer's list price as of November 18, 2013. Effective for claims with dates of service October 1, 2014 and after, the 13.5 mg Levongestrel-Releasing Intrauterine Contraceptive System is reimbursed based on 100% of the manufacturer's list price as of January 1, 2013.
