SB542
To Amend The Medicaid Provider-led Organized Care Act; To Improve The Enrollment And Selection Process In Risk-based Provider Organizations; And To Empower Beneficiaries With Information.
Last Action (May 5, 2025): Died in Senate Committee at Sine Die adjournment.
Sponsors
AI-Generated Summary
Senate Bill 542 amends the Medicaid Provider-Led Organized Care Act to increase transparency and improve the enrollment process for risk-based provider organizations (RBPOs) in Arkansas. It mandates that the Department of Human Services display a web-based quality rating system for these organizations, measuring performance metrics such as care coordinator caseloads, wait times for services, and member satisfaction survey results. The bill requires RBPOs to maintain and update real-time provider network directories on both their own and the Department of Human Services' websites. Additionally, it establishes a dedicated beneficiary support system and an ombudsman office to assist Medicaid enrollees with plan selection, information gathering, and informal dispute resolution. The legislation authorizes the Department of Human Services to promulgate implementing rules and sets an effective date of January 1, 2026.
Potential Impact Analysis
Who Might Benefit?
The primary beneficiaries are Arkansas Medicaid enrollees, particularly individuals with intellectual and developmental disabilities and those with behavioral health needs, who will gain access to better information, performance transparency, and support services for navigating their healthcare plans. Care providers and advocates for these populations also benefit from more accessible data regarding network changes and quality standards, which can facilitate better coordination of care.
Who Might Suffer?
Risk-based provider organizations (RBPOs) are the entities most directly impacted, as they will face increased administrative and operational burdens to collect and report detailed quality metrics, update provider directories within strict 10-day timeframes, and ensure compliance with new transparency requirements. This may result in increased compliance costs or administrative overhead for these organizations.
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