Welcome to Arkansas Medicaid!
As the threat from COVID-19 continues, important information on what DHS is doing about coronavirus as well as reliable, up-to-date information about how the virus is affecting the State can be found on the DHS website.
The Provider-led Arkansas Shared Savings Entity (PASSE) is a new model of organized care that will address the needs of certain Medicaid beneficiaries who have complex behavioral health and intellectual and developmental disabilities service
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Timely Information from Arkansas Medicaid
Medicaid Policies Regarding Hospital Services During Public Health Emergency
Early in the public health emergency, the Centers for Medicare and Medicaid Services announced that it was allowing states to temporarily waive certain federal requirements to help ensure Americans could access care and help hospitals deal with patient surges due to COVID-19. The waiving of rules is called issuing “blanket waivers” of federal requirements. These waivers allow hospitals to use beds as needed and still get reimbursement from Medicaid, with changes described in the Medicaid Policies Regarding Hospital Services During Public Health Emergency fact sheet (Word, new window).
In addition to changes through the blanket waivers, Arkansas Medicaid also temporarily suspended the Medicaid Utilization Management Program review requirement for patients over age 1 after four days of inpatient care. Now, all hospital stays, regardless of length are subject only to retrospective review. This includes transfers between hospitals.
On October 1, 2020, Veritas Capital acquired the Health and Human Services business from DXC Technology, the fiscal agent for Arkansas Medicaid. The name of the new company is Gainwell Technologies. Gainwell Technologies will continue to provide the same level of service to the state of Arkansas and its Medicaid providers. Arkansas Medicaid providers will begin seeing the Gainwell Technologies logo and name on correspondence. Emails from the fiscal agent may be from a gainwelltechnologies.com email address rather than a dxc.com address. Providers will also hear the new name when contacting a call center.
Crossover Claim Edit Changes and Reprocessing
Beginning on December 2, 2020, crossover claim system edit 559 that posts when the coinsurance amount is greater than the paid amount will be replaced with new edit 3617. This edit will post when the coinsurance and deductible amounts are greater than the billed amount. Claims that previously denied for edit 559 since it was implemented on November 7, 2019 will be reprocessed after December 2, 2020. We expect all these claims will be reprocessed by December 31, 2020.
To ensure accurate billing and payment for claims that do not cross over from the Medicare Coordination of Benefits Agreement (COBA) process, you will need to enter information for each service provided on the detail lines of the claim.
Current Demonstration Waiver Projects
The Division of Medical Services will provide public notice and allow input processes for its intent to submit written applications, renewals or amendments to any 1115(a) demonstration waiver projects that will be sent to the Centers of Medicare
and Medicaid Services. Learn more about current demonstration waiver projects.
Arkansas Medicaid Data and Reports for Public Access
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