Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.17-026 - Episode of Care Provider Manual

Universal Citation: AR Admin Rules 016.06.17-026

Current through Register Vol. 49, No. 9, September, 2024

(1) a statement of the rule's basis and purpose;

(2) the problem the agency seeks to address with the proposed rule, including a statement of whether a rule is required by statute;

(3) a description of the factual evidence that:

(a) justifies the agency's need for the proposed rule; and

(b) describes how the benefits of the rule meet the relevant statutory objectives and justify the rule's costs;

(4) a list of less costly alternatives to the proposed rule and the reasons why the alternatives do not adequately address the problem to be solved by the proposed rule;

(5) a list of alternatives to the proposed rule that were suggested as a result of public comment and the reasons why the alternatives do not adequately address the problem to be solved by the proposed rule;

(6) a statement of whether existing rules have created or contributed to the problem the agency seeks to address with the proposed rule and, if existing rules have created or contributed to the problem, an explanation of why amendment or repeal of the rule creating or contributing to the problem is not a sufficient response; and

(7) an agency plan for review of the rule no less than every ten (10) years to determine whether, based upon the evidence, there remains a need for the rule including, without limitation, whether:

(a) the rule is achieving the statutory objectives;

(b) the benefits of the rule continue to justify its costs; and

(c) the rule can be amended or repealed to reduce costs while continuing to achieve the statutory objectives.

METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATES -OTHER TYPES OF CARE

ATTACHMENT 4.19-B

4.
b. Early and Periodic Screening and Diagnosis of Individuals Under 21 Years of Age and Treatment of Conditions Found
(17) Psychology Services
A. INCENTIVES TO IMPROVE CARE QUALITY, EFFICIENCY, AND ECONOMY
V. APPLICATION: Complete details including technical information regarding specific quality and reporting metrics, performance thresholds and incentive adjustments are available in the Episodes of Care Medicaid Manual available at httj]s:A' www.medicnid,state,ar.us.'lntemetSulutiQiiProvider.'docs.'docsra5px and also at the Arkansas Health Care Payment Improvement Initiative website at http:/Avww.pavmentinitiative.orii/Pages/default.aspx.

Reserved for the potential addition of Episodes of Care subject to incentive adjustments

5.

physicians services

A. INCENTIVES TO IMPROVE CARE QUALITY, EFFICIENCY, AND ECONOMY
V. APPLICATION: Complete details including technical information regarding specific quality and reporting metrics, performance thresholds and incentive adjustments are available in the Episodes of Care Medicaid Manual available at https://www.medicaid.state.ar.us/InternetSolution,'Provider/docs/docs.aspx and also at the Arkansas Health Care Payment Improvement Initiative website at http://www.pavmentinitiative.org/Pages/default.aspx.

Effective for dates of service on or after October 1,2012, the defined scope of services within the following episode(s) of care are subject to incentive adjustments:

(1) Acute Ambulatory Upper Respiratory Infection (URI) Episodes

(2) Perinatal Care Episodes

Effective for dates of service on or after February 1,2013, the defined scope of services within the following episode(s) of care are subject to incentive adjustments:

(1) Congestive Heart Failure (CHF) Episodes

(2) Total Joint Replacement Episodes

Effective for dates of service on or after October 1,2013, the defined scope of services within the following episode(s) of care are subject to incentive adjustments:

(1) Tonsillectomy Episodes

(2) Cholecystectomy Episodes

(3) Colonoscopy Episodes

(4) Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) Episodes

(5) Percutaneous Coronary Intervention (PCI) Episodes

(6) Acute Exacerbation of Asthma Episodes

(7) Coronary Arterial Bypass Graft (CABG) episodes

13.other diagnostic, screening, preventive and rehabilitative services i.e other than those provided elsewhere in this plan
(d) Rehabilitative Services

Rehabilitative Services for Persons with Mental Illness (RSPMI)

Incentives to improve care quality, efficiency, and economy

V. APPLICATION: Complete details including technical information regarding specific quality and reporting metrics, performance thresholds and incentive adjustments are available in the Episodes of Care Medicaid Manual available at https://wwvv.medicaid.state.ar.us''IntenietSolution/Provider/docs.'docs.asDX and also at the Arkansas Health Care Payment Improvement Initiative website at http://www.Davmentinitiative.org/Pages/default.aspx.

Reserved for the potential addition of Episodes of Care subject to incentive adjustments

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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