Public Health, Welfare and Labor Committee - Joint
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- October 2, 2026
Speaker 2
2:20
y s te m so that those children can continue to be served by Medicaid and the second change is to comply with Act875 in2025 which raised the disability onset age for able account holders from 26 to46. This was a change that had earlier been authorized under federal law and state law passed in 2025, adopted that new onset agent so we have made that change to our policy.
OK are there any questions from members of the committee? seeing
none this rule is reviewed thank you thank you. right, M Pittman Good afternoon. Good afternoon.
Elizabeth pitman, director for division of medicalical Services. thank you and I believe we're skipping over E and going to F, is that correct? add me we're skipping over you pulled that one correct? so we're just
we're on to F yes ma'am rule F is the rule for continuous glucose monitors. This came out of a bill that was passed in 2025 correcting a bill that was passed in 2023. It allows for Cgms to be billed by both pharmacy and durable
medical equipment providers. it is already live with our system per the statute this rule just follows up and clarifies that that is the new rule bothth providers have the same PA process approved by the same vendor Magellan. that information
Speaker 19
4:06
then automatically goes over to our medical billing system and they have the same forms that they will be
using as well. OK are there any questions from members of the committee? Representativewooldridge, do you have a question ma'am thank you
Representative Jeremy Wooldridge
Unverified
4:24
madam chairir. So the PA process I know we debated this
back and forth during the legislative session so is that process the same What about turnaround time? Is it
Speaker 19
4:32
the same turnaround time we are using the same vendor and the same process and the same criteria so yes sir it should all be be the
Speaker 28
4:38
same so we'll we'll use our pharmacy vendor to do the prior authorizations and they have a an API which is the terminology for a connection between the systems that will send that information over to our medical billing system. OK.ollow up if
Representative Jeremy Wooldridge
Unverified
4:51
that's OK. So I I appreciate that. So
Speaker 28
4:54
DME will have access to this pharmacy vendor will it cost them
Representative Jeremy Wooldridge
Unverified
4:59
anything to have access to that they can sign up for that just like anybody else OK so what about the turnaround time that's I think what I'm curious about and some of the DME providers in my community that I visited with are curious about so my understanding you correct me I hope is that it's instantaneous basically for pharmacy
Speaker 19
5:13
that's correct and if they're using the same system it should be as well the problem is it will have to
Speaker 28
5:17
go over to the medical billing system where they will have to bill it. so that's why we're using the attestation to let that member know we're also setting up a
process by which we allow the pharmacy alert the pharmacy that they cannot build that as well so we're also setting up within our system once the DME provider gets that attestation on file that in both sides of the house it knows hey this person is using this provider that's why we're using that attestation to let the member know that they can't just switch back and forth between pharmacy and DME the way that you know a lot of people can because of the way our systems are working to let everybody know they'll have to go through the the attestation process and everything again
Representative Jeremy Wooldridge
Unverified
5:55
right ok so I appreciate that so that's way more information than I understand and I'm grateful for the explanation but here's what I do want to make sure that I'm clear on and what I want you guys to commit to if you will is looking at this system I think that everything we do has potential for unintended consequences if there becomes a lag time having to send this from the pharmacy vendor to this other system what would be steps to correct that they would just need to alert us
to let us know so that we could get with both of our vendors to
Speaker 28
6:21
try to work through and make sure that we
have everything in place that we can to make sure the PA turnaround time itself should not create a lag. it's the same vendor the same turnaround time will apply. it's the way the billing systems work and point a pharmacy adjudicates at point of sale and medical doesn't which is why we're indicating in both that there is a a prior authorization in place to try to make sure that we don't have that problem if there is a problem that comes from that they just need to let us know so we can go back to the drawing table and try to figure it out. I appreciate that thank
Speaker 35
6:50
you very much thank you madam chair thank youpresentative Pilkington
Representative Aaron Pilkington
Unverified
6:55
you're recognized for question thank you chair good afternoon so I saw on the financial impact that's going to be 1.1 million year 1 1.9 million year two for a total of 3 million over two years to implement this rule so can you break down you know what those costs are I mean3 million a bit of a chunk of change to implement this and then of course from year one to year two it's an $800,000 increase on
year three will there be an additional $800,000 increase because that would bring it to3.7 million for this rule or does it cap
out after year two so you kind of walk me through those numbers because that's quite a bit of cash
Speaker 39
7:41
let me see what we've got here explaining that if we don't have it on me, I will get it to you Representative Pilkington. I know I have the fiscal
Speaker 28
7:53
impact statement but I don't know if I
have the breakdown. we typically include the difference in the cost. so you know we there is a
little bit of a difference in how they're paid. so there's a little there and then any systems changes but let me get that breakdown for you specifically.
Representative Aaron Pilkington
Unverified
8:07
OK do we know the difference in cost between using it as a pharmacy benefit or use as a DME benefit? what is the difference in total cost? We do know a taxpayer that we
Speaker 39
8:16
we do know I'll have to get that for you we do know but I don't have it with me.
Representative Aaron Pilkington
Unverified
8:21
I'll get it for you. OK yeah some kind of
that just wasn't briefed on this so I would appreciate getting that information before I approve
this rule. thank you are there any other questions from members of the committee? right so you can just send that information to me and I'll make sure to forward it to all the members of
the committee all right any more questions all right seeing none without objection this rule is reviewed thank you adamg
the administration fee for the RSV vaccination for children. This was also the result of an act that passed in 2025 it increases the administration fee only to the same price as what is currently allowed for under the federal regulation for the vaccines for childrenldrengrame. it is an increase to to the administration fee. The vaccine itself is gotten through the vaccines for childrenldren programme
by the provider and so we do not cover that through Medicaid and that's
why that is not included in this happy to take any questions are there any questions from members of the committee Any questions right seeing none
without objection this rule is reviewed. Next item the next rule is the telemedicine exemption forreat triage and transport services. this was another act that was passed by the legislature in
2025. the rule the ET3 programmereat triage and transport allows ambulance providers to treat on
Speaker 28
10:06
site without cons and this rule then carries that forward to allow for them to treat without consulting a physician or behavioral health practitioner in certain circumstances where the medical director has signed off this again was passed by the general assembly in 2025 and this implements it I'm happy to take any questions are there any
questions from members of the committee? Can I see
OK, are there any questions from
members of the committee? seeing none this rule
Speaker 14
10:54
is reviewed. without objection. Aam I item I is the dental rate increase. this is at 1025 of
the general assembly passed again in 2025. Uh, the act had two parts if
Speaker 28
11:04
you'll recall we have discussed this before I believe this act had two parts there was a rate increase for certain populations including children
individuals with special needs and what was described as oral surgeons dental services those
three rate increases have been implemented via this rule. The other piece of that act was to increase the limit for dental benefits for individuals with special needs Cms came back and told us that that was not allowed to define an increased benefit
Speaker 28
11:36
limit tied to a diagnosis like that so we've actually split those two we're carrying the rate increase forward now and we're working with Cms and the dentists on how
to move forward with the other piece of the coverage and so this is just the right piece doing the rate increase for those three populations we did receive numerous comments you probably have those summarized in your packet. I'm happy to take those as the main the main comments were regarding the coverage regarding trying we had an unintentionally dropped the orthodontic rates because when you look at the publication that was being used for this rate increase it it dropped the orthodontic rates from where we were previously
that was not our intent so we it was not the intent of the bill so we excluded orthodontic services from this the language of the bill allowed for that to happen and did not address orthodontic services at all and so we felt that
that meant we should leave orthodontic services alone so we did. the other comment that we received was regarding the oral surgeon's dental services the commenters believed that that applied to a set of codes that is billed by oral surgeons and that any practitioner that built those should be included.
the department's position is that based on the black litter
Speaker 28
12:53
language of the way the bill was written with it saying oral surgeons, dental services we could not use that interpretation and so we have not made that change based on the comments and that's the rule that we're bringing forward today. there is a fiscal impact I believe of about38 million. for this rule yeah 29 million for this year,39 million for next year. and Cms has approved the rate increase so we are ready to
implement with a July 1st start
date. Sorry you had to remember what month it was
so yes OK. thank you I know there's questions about this and I know that the ental association wanted to make some comments so I think what I'll do is go ahead and bring them up to the table just to allow their testimony to be part of the record and I've we've had some discussions about this and looking at the language of
the of the law and represented Mayberry if you'll light back up you're the primary sp on s or of the legislation so you and senator penzo but I'll go ahead and invite the dental association to the table as well to go ahead and give testimony if you'd prefer that'd be fine. Represent Mayberrry you're recognized
thank you madam Chair. I I just first of all wanted to say thank you to DHS because I know that you've been working really hard
on all this and we appreciate the work that you are doing as you've noted there's one still kind of key thing that we're trying to fix and just her mind legislators that sometimes when we have amendments and various things some keywords may not be clarified as much as maybe they should have been but I believe that the intent is just as the dental association will share is that we were trying to increase the fees that would be paid to
dentists who are doing certain procedures for our adult, um, with special needs population and that's where we're kind of we need a little bit more explanation as to how we we've gotten here but I think the overall goal and what we've said the whole time with this bill is that we're trying to help the adult special needs population and I'll let you share. all right if you
will just state your names for the record please bothth of you before you proceed and then you are recognized to proceed with your testimony. Thank you.
Speaker 56
15:29
Yes, I'm doctor Terry Filer. I'm with Arkansas State Dental Association. I'm the senior advisor as well as the executive director of
the Arkansas Mission of mercy. excuse me I'm Trevorhawkins I'm with the Mitchellla Low law firm. I'm a counsel for
Speaker 55
15:54
ASDA Thank you. please proceed I again will compliment thank
Speaker 56
16:00
DHS for helping us through many of these codes where so thankful for because we've gone a lot number of years without any increase in we are to the finish line on this and we're so appreciative of working with our legislators as well as the DHS in this bill in the description of this we
interpret this as increasing a group of procedures which are oral surgeons also do we have about700 general dennis in this in our medicaid program whofo pro provide oral surgeries procedures my degree is DdS I prefer I performed oral surgery procedures in the hospital with
under general anesthesia for years and years my degree is doctor of dental surgery DDS so we do surgery procedures we understood this bill to identify that the surgery procedures could be done by general Denis. I can see that the the way that it is written it says surgeons I am not a surgeon. I am a doctor of dental surgery
and so I perform many of these procedures if you were to look at this group of procedures the CdT from the American Dental association 2026 pages65 through78 it lists procedures fromd7000 tod7,999 so there are quite a few procedures I did a considerable number of those procedures some of them I knew better than not to date them.
and so this is what our intent is that though that we wanted the rate increase for a group of procedures that fall under the title of oral surgery And I'll be glad to take
questions thank you so are there any questions from members of the committee so I I think and it and it could be also a question for DHS or for their
attorneys too but I think the issue is on page one line 30 where it states that it's oral and maxillofacial surgeon instead of surgery. However, and I know that I'm not sure if there is a definition that exists in state code defining an oral and maxi facial surgeon as somebody who has a DdS license that's something DHS can see if I'm not sure if that exists in state code but you know,
regardless ofpt codes or anything like that it's the letter of the law and you as an attorney may want to answer this question too and so my understanding is DHS is reading it as a surge on an oral surgeon is different than a general dentist and that the reading of the language of the law as a black and white of the act was just specific to one
class of providers and not to general dentistry. Do you want to comment on that? Yes,
Speaker 60
19:37
Senator Irvin if that's fine and and you know we're we're looking at
the intent and and that it's pretty clear when you look at the CBT which stands for common dental terminology the the language was pulled from there and we're talking about the services that are provided under that category and if you compare that with you know that's that's a1A B andc are talking also about pediatric dental services, dental services with adults with special needs those aren't
denoted as special categories or particular provider groups under the manual. it's you know it's the services that were intended to carry the weight here and what we were talking about and to answer your question, the Arkansas Dental Practice Act specifically defines the practice of dentistry to include valuation, diagnosis, prevention and treatment of non surgical surgical or related procedures of diseases, disorders and conditions of oral cavity and maxillofacial area adjacent to associated structures including the administration
of anesthetics in connection with those services and so any general licensed dentist can perform the these services and so the kind of the implication of just a plain black letter reading is we're limiting these to39 or around40 oral surgeons in the state rather than the center the se0re0 broad general dentist and and it's common services like extractions and stuff like that that the general dentist that's that's one of the more important services that's provided under this and that any general
dentist could perform and so you're kind of directing them to those40 oral surgeons rather than the broader population but that's the kind of the broader intent of the of the act is what we're
trying to get out there so right now
I understand the intent. I think we all agree on the intent. No but I mean we all agree on this. I have two for full disclosure, I have two sons that have DdS licenses now as of last Monday too one's orthodontist and one's entering
into orthodontic residency so for
the record and so I know the intent and everything that you testified absolutely is accurate. it's just the language of the law itself and I think Representative Mayberry was 100% right because this bill to go through processes of several amendments and and I think the bill was trying to specifically focus on adults with special needs however medicaid can't splice out once you're Medicaid eligible we can't splice that
special needs diagnosis out to receive a better benefit or whatever. I think is is what Cms came down with. So I think that's where the rub is
before I go any further, I I can tell you that I'm committed to making sure that this is fixed moving forward and I think that's probably the sentiment of the legislature that we can fix this going forward so that we don't leave
the general dentist off the list so to speak, Representative Mayberry you're recognized thank you. So let me just kind of ask this question and might need DHS to to kind of fill in so if it is that strict interpretation that DHS wants to use so so we have someone who is performing two different people performing the same procedure. We have an oral surgeon and we have the general dentist doing the exact same extraction and
one will be paid more and one will be paid the
other rate. Is that would that be correct Yes that's what we call a bifurcated rate that would be the two different and the and then so the incentive is who who do we they
send that person to to adequately cover that service so the overall and and without a doubt when this is presented what we kept talking about was the need for dentists to be able to
receive the proper compensation and we were talking about that special needs population, right? now we've kind of separated the oral surgeons from the other and I would think it's it's the same code though if I understand correctly it is the exact same code that both will be doing so is that not sort of and this might bedHS is that not sort of a a a difficult thing to distinguish ok it's the same
code but this doctor's gonna be paid more than this doctor? is that not a difficult paperwork problem? And and then to also follow it up that DHS has the ability to raise a rate without law being specifically without us as lawmakers
specifically saying do that so so I guess that would be the second part of the question is can't DHS just say
ok yes sure let me take the first part of that firstpresentative and so the bifurcated rate to use Mrhawkins' terminology is something we do have the ability to do in our system and actually have in place in many areas a prime example being we pay a nurse practitioner less than we pay a physician for the same CpT code they get 80% of the
physician rate that's just their rate and that's just one example and they'll build the same code but they'll get a different rate and our system does allow for that so that that is not a problem within either the medicaid rules or the medicaid systems the way it operationalizes them and it's something that that is commonly done depending on the licensure level of the person doing the service. we don't commonly have the same level of licensure getting billed separate. but when there's different levels of licensure yes you you will see that to the second point, yes we can raise a rate without a
statute you're absolutely correct. unfortunately we're in a position right now where we're not looking at any budgetary increases absent a mandate to do so I think you've heard us all testify as to that before and so
Speaker 19
26:04
that's sort of the the department's position on any rate increases or or budgetary
increases right now. so OK I I believe that follow up I'm sorry is that ok? OK I believe that that's what the entire testimony was
when we were presenting this and this issue was not brought up in testimony that those doctors, those dentists would not be included with the oral surgeons and so I think it left all of us with the impression that it included everybody and so therefore I just kind of ask DHS that the intention was we're all on board with making this increase and what would
that increase be? what what's left out? how much more are we talking? Oh it's about $1.5 million a year. $1.5 million and and from the dental association how many more um, families will be serviced by keeping dentists continuing to do these extractions and and
Speaker 56
27:19
all. Well again as a saying about700 General Denis participate
in the Medicaid program and you have about40 oral surgeons and Arkansas is obviously a very rural state and so so many general dentists have to be called upon to do those procedures so how many I I don't have a number but I can give you the number of dentists that could do that and if I may I'll step outside a little bit as a former provider we're gonna do it whether the procedures paid at a certain level or not we're gonna take
care of the kids we're gonna take care of the of the families that can't do it so but anyway there's quite
a few more general dentists than than
there are oral surgeons I I appreciate the testimony I just still I'm standing strong that that's what the intent was whether we want to go word for word on what this is you know that'll be up to other legislators and ALc to to decide but you know I feel that the
wording and what we shared with the committee was the intent of it and DHS does have the ability to go beyond what the law says and open it up to all dentists
and I would make that request OK so Jessicaiel is our staff
attorney for public health does a fabulous job by the way. thank you Jessicaeelle. so I'm having her over there research
it but oral and maxilfacial surgeon is not defined in state code which also makes this more complicated so this is what needs to be sci to fix this. It needs to have a definition of oral am mail facial surgeon needs to be defined clearly in state code number 1,2 this legislation needs to be changed to encompass all gen dentistry to include oral and maxual facial surgical procedures.
as as they are practiced under CpT codes or what have you that would then fix the problem from the way I see it because the the the language in the law as Act 1025 is written on line30 does state surgeon and that's not defined except for as a specialty of general dentistry so that's that is the issue here regardless of intent if you're
looking at the black and white language of Act 10:25 and I honestly don't think that there was any intention of that occurring. I think that this was just just happens to all of us so to speak but I understand that it's not ideal for our general dentists but we do want them to practice at the very maximum of their license and make sure that they help all of their population and so those are the two things that need to be
fixed for next session and I personally make a commitment to carry that legislation forward
to address this issue in the future. Representative Wwooldridge you're recognized
Representative Jeremy Wooldridge
Unverified
30:44
thank you madam chairir. I'm just trying to understand I think Representative Mayberry made some good points that I just want clarification on I guess so if this would have been written with and I'm going to ask these to dhS if this would have been written with the correct terminology we would be spending that $1.5 million and paying the other700 dentists correct?
Speaker 17
31:06
yes sir we will follow legislature legislator of mandates yes
Representative Jeremy Wooldridge
Unverified
31:10
sir so now we're debating a technicality on language correct we're not I mean I'm not
debating I'm just simply much like we did with the CTM unfortunately trying to follow the the the law
Representative Jeremy Wooldridge
Unverified
31:23
Sure I understand that sir but I think that the question that I would like an answer to is if you intended to to pay this 1.5 million to Dennis to provide this rate and you have the
unilateral authority to raise the rate and spend the money to pay them ad equ
ate ly why would you not unilateral might not be the right word but we also have to have the funding and so we when we have a legislative mandate we have a way to go and ask for that funding absent that you know we are we are very I know it sounds like not a lot of money I understand that when we talk about the
Speaker 28
31:58
dollars that we talk about but we are unfortunately in a position where we are not able to authorize any
Representative Jeremy Wooldridge
Unverified
32:04
increased expenditures absence and mandate so if this would have been
written with the correct terminology, who would you where would you
Speaker 28
32:10
have had to ask for that money from you
Representative Jeremy Wooldridge
Unverified
32:14
and the you and the governor's office obviously but ok but my point is we've already approved to Representative Mayberry's the intent so there's no need to even make an ask now I'm sorry I don't understand we obviously approved this legislation so our intent was to pay the other700 dentists and spend that
money I don't don't know. I don't, I mean and
unfortunately as DHS we don't try to guess the intent we simply try to carry
the page Representativeoldldripresentative Wardlaw I can answer that for you we we studied this last couple of days knowing this discussion was coming to answer that question is no. black and white letters of the law are the black and white letters of the law the other side of this and I just explained this to Senator Irvin because we wasn't directly talking the last two days but we were the financial impact
is 100% wrong the way it is today because are the inception of it is wrong from the legislators standpoint because once you fix this language, the financial impact will be much greater than where it is today because you're in you're opening it up to700 something more dentists. I think that has to be spoken and understood. I do agree it needs to be fixed. I do agree the intent was that that was there but the language is what the language is and it's not there in the language so you cannot pay those dentists for this
service until that language is fixed I wish it wasn't this way and I wish it was in there but it's not and it's 100% correct the way DHS has it today based on the language of the bill regardless of the intent Well I appreciate that
Representative Jeremy Wooldridge
Unverified
33:52
clarification that's basically what I'm trying to understand and learn is is is there you know I'm I guess looking at how do you solve a problem with what you have in front of you and if there is an avenue or a pathway for you to raise a rate and that solves a problem six months in advance. I just want to make
sure we were exploring every angle so that's helpful
thank you thank you any other questions from members of the committee? all right. seeing none thank you. this rule is reviewed. I will state though that we have
testimony not necessarily an objection but testimony on the on the rule itself but it does stand reviewed. thank you thank you for being here and thank you for your testimony and I
appreciate you coming forward and we
Speaker 14
34:40
will work together on this issue. thank you so
much OK, ex item ti ll me this next role is again something that was passed in 2025's legislative session this was to increase access to physical therapy services per the bill in that bill it increased access to physical therapy services in a clinic based setting the bill only limited it to physical therapy however there was no fiscal impact to doing so we reviewed the documentation provided by
occupational therapists as well immediately following the passage of that legislation de ter m in ed that it likewise would not result in a fiscal impact increase and
have included occupational therapy in it as well. I'm happy to take any
questions. are there any questions from members of the committee on item J. Any questions? all right seeing none this rule stands reviewed without objection. thank you itemdam Ky
item K is the healthalthy mom's healthy babies bill which was passed in 2025 as well. It also includes the lactation consultants bill that was passed in 2025. this piece of rulemaking is quite large and it does quite a number of things but a summary is that it allows for a doullas and lactation consultants to bill for Medicaid services provided to Medicaid clients. It also includes remote monitoring we were already providing blood pressure cuffs and continuous glucose monitors to pregnant women but poor per healthy
moms and healthy babies this covers the remote monitoring and we lifted any limits per that bill as well on ultrasounds and fetal nonstress tests for highpers pregnancies and other pregnancies and so that is this rule in front of you today and happy to take any questions we did receive numerous comments. I'm not sure that we would be here for hours if I tried to summarize them all but we did make several changes in response to those comments related to how the benefits are provided I will say the one comment that we received
regarding not paying higher rates we did not change the rates we did however go back and do another study with our actuaries looked at all the surrounding states again and determined that our rates that we had proposed were on on par with where we needed to be. and happy to take any questions. OK
Are there any questions regarding this rule? I mean I think this is also like another example of a difference in rates but it's also based on what's being provided and level of and I think anyway, I appreciate your comments on this. are there any other questions from members of the committee? seeing none without objection this item stands reviewed
um, OK. Miss Pitman we're I'm gonna take a motion to expunge a vote by which we reviewed the glucose monitoring so that representative wardlaw can ask some questions because we've already done that but he wants to ask some questions so I'm gonna go topresentativewooldridge to take your motion make that motion so we're expunging the vote by which I reviewed without objection the rule regarding a glucose monitoring billing and then is their 2nd 2nd all those in favor say aye
and opposed I have it uhpresentative wardlaw you are recognized for questions. thank you. thank you M Pitman you
madam Chair. This is a subject I have a little experience in. I used to be in the DME business for full disclosure not in it now have nothing to do with it but I was going to run the billpresentative Woolridge ran. he ran it and I'm glad he ran it. great bill. but the understanding behind his bill when he ran it is it would put DME providers back in the same billing system that they've
always used through Medicaid in the same PA system everything's will be the same. there was an amendment added in the senate that added two words basically and the second word was paperwork and the assurance we got from DHS with that would not change the fact that it would be billed the same as any other DME equipment and we took that amendment we we passed it in the house after he came back from the senate and went with it. this rule explicitly separates that
billing back out to the same system that pharmacy uses and forces DME to use that system yes it does and that's a problem it also sets in here a PA system that makes a customer wait two weeks from a DME store and they would wait 24 hours from a pharmacy store the whole purpose of that bill was to make those two platforms equal again the way they were prior to the rule that was
passed last year so why are we doing this and why are you you're not staying black and white here so it's hard to be consistent when you're black and white on the dentist and we back you up to be
black and white and then you go completely gray over here so what are we doing to clarify we are going back to the MMIS billing system and we are doing a 24 hour turnaround time on PAs so what we are doing is the PA will be submitted to Magellan and I can have Cynthia explain exactly or directorneuhofel our pharmacy director explaining exactly how
that will happen. Magellan are prime therapeutics now I'm sorry they used to be Magellan is our pharmacy vendor and they will be reviewing everyone's PA's with the same 24 hour turnaround time that everybody that they do for
all pharmacyPs providers submit to AFMC for their PAs and the whole premises behind the bill was they were going to stay on the same system as all other DMA items and now what you're saying is they're gonna go through pharmacy for these and that's my whole point. you're forcing them to do something
Speaker 31
40:51
they're not used to. they don't do on a daily basis.
yes sir we understand that but we cha I mean we're changing
Speaker 19
40:57
OKok but you can't understand that the law didn't do that. Well yes sir what I'm saying is once that PA is reviewed so that they can be consistent have the same criteria and the same turnaround times because AFMC reviews under a different contract with different criteria and understand their contract understand their criteria will then go into MIs so that they can bill using the medical system to get paid for their claims. you're missing the point
so the whole point of the bill was that they build the same as they build the other DE items uit quit varying that's what the bill did because the rules split them. We agreed on the rule last summer and it split them so we ran a bill to put it back the way it was prior and now you're still splitting them with this rule I'm not going to let this rule go through as long as it splits them they should bill under the samedMMI system that DME builds
Speaker 102
41:54
them their stuff there their PAs billing that they're
not yes sir they the billing will have your own chart you sent out it does not do that it sends them through a different billing system than they're used to billing underh
Speaker 19
42:04
through the prior authorization the billing is going through MMIs that's not what it says
here I've got in your signatures on this letter that I'm sitting here reading and it's not in this packet is that the official notice I'm sorry it is it goes into effect on June 1 which we're June 3 rd today
and and talking about it which I find kind of weird that you're putting it in effect before we ever review it it's another problem I got with it
Speaker 102
42:38
our senate's effective June 1,2026. Yes sir we we couldn't back the system's changes out so we went on ahead under the language of the law and and
put it into place. You didn't go on with the law because the law
done exactly what I've already referenced the law opened it up for them to be the same thing they've always been and not have to be under the rule that passed last year that split them out.
yes sir and they're not we are putting them back under the medical billing system. Well I'm going to hold this until you can prove that to me because that's not what these charts show. it shows them having to build it under a pharmacy code under medical and that's not what the law was intended to do or written to do and I've already read the law to make sure I could say that today because I knew we had stuff that was the
Speaker 19
43:19
other way around. yes sir and I agree they are meant to build back under Hicks pics codes under the MMA
madam chair I will hold this rule until council two weeks from now to make sure that
it follows the letter of the law. are there
any other questions from members of the committee? all right OK all right thank you I appreciate that and we will move
on to item l Welcome. itemdml is the adverse decisions rule also a piece of legislation passed in 2025.
this adverse decisions rule did several things one of which that is being implemented by this rule change here is to change the time frame
for providers to appeal from 35 to65 days. and that is what this rule does. I'm happy
to take any questions so does that change though they still are paid at they can they can delay but they are they're their payment's not delayed
basically they have to elect to to continue got you to
receive payment but yes ma'am they can OK got it are
there any other questions from members of the committee? all right seeing none this item will stand reviewed without objection. item M and I think yeah ok thank you miss pitman appreciate it.
Speaker 111
45:08
right if you'll state your name for the record, please proceed Hi good afternoon I'mlinnda White I'm the deputy director for the division of provider Services and quality assurances and this rule is related to the Arkansas long term care facility nursing assistant training program so this rule the changes were due to Act 105 of2025. there are some technical corrections in this bill. there
are changes to the requirements for the primary instructors for thecA programs and it also increases the annual training hours for the primary instructors there is no fiscal impact and there is no known opposition. It also repeals the man internal management requirements for the criminal background checks those are still being conducted under another rule so it doesn't affect that it's just the management piece and I'll
be happy to take questions right are there any questions from members of the committee on this rule? right
seeing none this item will stand reviewed without objection thank you itemtem N Miss Stone
Speaker 117
46:43
Good afternoon Paula Stone Department of Human Services director of office of substance abuse and mental healthalth. this rule is because of actct301 of2025 and the acts sought to ensure that the potential and actual enrollees of the risksbased providergan organization which is our passes have the right to know whether direct service provider is or will be in network. So our rule has three component parts that says
that there is no marketing violation if a direct service provider informs the client of their network status in any of the passes those providers are also not prohibited from answering questions from any of their clients and they are not required to provide separate information about their network static separate from anything that they provide for open enrollment any questions I can answer. thanks.
thank you are there any questions from members of the committee
do you have any comments on the on the general comments that
Speaker 117
48:10
you received about the language we did receive two comments and made adjustments to the rule related to those comments
got ity I see that OK any other questions right seeing none without objection this rule is reviewed without objection OK, item oh thank you Miss
Speaker 124
48:58
r t ie Sellers director for the division for healthalthdvancement at Department of Health. Thank you. Craigsmith attorney for the department of healthalth thank you madam chairir our first rule is a new rule that we are proposing to enact not act 965 of2025 for the certification of communitybased doulla in Arkansas. this role was open for public comment a few were received generally positive comments in support of the and in support of the rules
as a note the department has been available to receive and process applications for doulas for several months now while we were promulgating the rules and with
that open to any questions thank you thank you appreciate the work uhpresentative Pilkington you recognized
Representative Aaron Pilkington
Unverified
49:48
thank you madam chairir. just curious how many dual applications have we currently received we've received7.
Representative Nicole Clowney
Unverified
49:55
we have6 that have been approved and one's in
process. OK. Do we expect more or we hope so OK appreciate it thank you what about the the
Representative Nicole Clowney
Unverified
50:11
community health workers how many do we have of them we've received we have received zero applications and we've only had one phone call
inquiring and it was not for us it was for reimbursement. OK all right thank you all right any other questions, comments? All right. see none without
Speaker 122
50:31
objection this rule is reviewed. Item p yes ma'am this rule is another new
Speaker 124
50:39
rule. this is enacting Act435 of2025 regarding certification of community health workers similarly stated this was open for public commente were received were generally on the scope of practice which cannot be addressed by rules outlined in the act itself and then as stated we prepared to receive
applications for some time now while we were promulg ating these
rules as well and with that open to any questions but you haven't received any applications. OK so which makes me question why this person made the comment that they made to to expand this is not a question for you this is just a comment from me to expand services when we have zero applications I'm like so you know, I I just I want people to understand you know in the healthcare spectrum and the healthcare
landscape that we have in the state of Arkansas. let's all work cooperatively as best we can. there's space for everybody and everybody has different needs and so let's try to accommodate them that's not a question for you it's just a comment based on the comments of
that were received on these different rules be intentional and thoughtful when we're making our
comments and public comment. All right, any other questions seeing none without objection this rule is reviewed. Item Q
Speaker 133
52:29
Good afternoon I'm I'm Charles Bedell with the Oite department of healthalth division of healthalth protection the cosmetology massage therapy and
body as section. for being here please
Speaker 124
52:42
proceed thank you ma'am. The next rules are the proposed amendments to the rules for cosmetology and body art in Arkansas the proposed amendments are to comply with Act484 regarding the posting of the National humanmantraffickingsource
hotline as well as other minor changes and reviewing licenger for multiple modalities of body art rules for open for public comment no comments were received so with that can open to
any questions OK thank you. Any questions from members of the committee all right seeing none appreciate you
being here. adam stands reviewed without objection. Item R thank you ma'am
Speaker 124
53:24
these rules are the rules for massage therapy in Arkansas
these were to enact the changes pursuant to Act265 regarding the interstate massage therapy compact Act44 regarding the national humanman Traffickingsource hotline and Act629 regarding registration for establishments rules were open for public comment a few were received generally were items that could not be changed by rule there are outlined in statute are there
any questions from members of the committee
all right seeing none this item stands reviewed without objection? Items
Speaker 142
54:29
thank you for being here sir. Good afternoon Rebecca Davisnvironmental EI supervisor with Arkansas department of
Speaker 122
54:35
Health. Thank you The next rules are the rules pertaining to leadbased paint activities pursuant to
Speaker 124
54:42
rule changes by the EPA the department has mandated to enact certain changes regarding our rules for leadba paint activity regarding risk assessments of basements etc. and those these changes are pursuant to those EPA rule changes the rules were open for public comment and no comments were received
thank you are there any questions so this is based on
what changed at the federal level EPA level OK any questions from members of the committee seeing none without objection this rule is reviewed. thank you itemtem T
Shane David rannch chief healthalytes licensing and certification Department of Health you
Speaker 122
55:54
Adelia Oldenbrook radiation control section thank you The next rules are the changes
Speaker 124
55:58
for the rules for control of ionizing radiation these amendments first started with Act854 regarding diagnostic mammography as well as other changes that are recommended or requested by the US nuclear
regulatory Commission these roles were open for public comment. there were several comments received generally are comments requesting changes that would require a law change or notes that were unrelated to the proposed amendments but that the program will take an advisement for future changes with that
open to any questions are there any questions
for members of the committee seeing none this item will stand reviewed without
Speaker 122
56:40
objection thank you ma'am. The next rules
Speaker 124
56:43
are the rules pertaining to radiologic technology licener these roles were amended to enact Act695 of2025 regarding qualifications for certain limited scope licenger as well as other clean up language the rules were open for public comment a few comments were received again generally noting requesting changes that either require law change or did not relate to the current proposed amendments but would be taken under advise ment for future changes
all right thank you are there any questions regarding this rule seeing none without objection this rule stand reviewed itemtem V thank you both
Speaker 124
57:59
branch manager for the department of health. thank you for being here The last rules we have are the rules for mobile homes and recreational vehicle parks these amendments are introduced to update regarding industry norm and changes for the current living standards and facilities regarding mobile homes in Rv parks
Speaker 138
58:18
these comments were open for public comment one comment was
received and and notes were taken for future OK
Representative Wayne Long
Unverified
58:34
right any questions? Representative Long? thank you madam chairirman Mr. Paul could you tell me a little bit about what what the changes were as far
Speaker 150
58:43
as the water usage per day or what what were the changes we didn't long we didn't change much on the water uses we did clarify between
Speaker 156
58:55
a a situation where you have pretreated effluent and the current pill line situation most of what the changes are were related to old language that included old terminology and there was some language in the rule about maximum lengths of Rvs etc. that made no sense for the department of healthalth to try to regulate we did clarify some things on RPZs and when they're needed and when they're not that's reduced pressure zones for water systems
and again took out a lot of
Representative Wayne Long
Unverified
59:29
old language we really didn't know what it meant for sure. how much
Speaker 156
59:34
water usage are you allowing on the the RVs I believe it's in that rule there in our own site role it's uh60 gallons per day pretreated and it was not pretreated it's 120 gallons a day and I'm going off memory so but I believe that's correct
Representative Wayne Long
Unverified
59:50
and you now that what I've observed a lot of people are just living permanently in RB parks now
you you've seen any increase in number of failures due to the
Speaker 156
1:00:05
increased amount of water usage I don't know that we're having a lot of increase in water usage but we did try to distinguish that there are three potential kinds of RV parks or mobile home parks one being the standard mobile home one being a mix, one being a true recreational vehicle part for recreational purposes and then as all of you know you ran into situations where we have large building projects etc. that go on and
there are temporary parks that come in that don't necessarily need all the accouterments of of the normal re recreational part so we we tried to clarify that if they have both public water and I mean water and sewer at each connection they don't necessarily have to have some of the other parts that you would see at a state park and and etc you know the mobile home parks are are they
Representative Wayne Long
Unverified
1:00:51
still based upon the number of bedrooms yes sir they're sized on the number of
Speaker 156
1:00:56
veterans. OK thank you thank you madam chairman
are there any other questions from members of the committee? all right thank you
for your work on this seeing none without
objection this rule stands reviewed thank you ma'am all right all right folks really appreciate the folks that traveled to our meetings that we held in conway, and other places through the state thought they were great meetings we will try to continue to do that around the state we enjoy
visiting our hospitals out there so look to the schedule for that. Is there any other business to come before the committee? All right see none without a I mean CNN. we are adjourned
Agenda
B. Consideration to Approve the May 19, 2026, and May 21, 2026, Meeting Minutes [Exhibits B1-B2]
C. Department of Human Services (DHS), Division of County Operations (DCO), Review of Rule, Updates to Presumptive Eligibility [Exhibit C] ̶ Mary Franklin, Director, DCO, DHS
D. DHS, DCO, Review of Rule, Fictive Kin Addition and Act 875 ABLE Account Age [Exhibit D] ̶ Mary Franklin, Director, DCO, DHS
F. DHS, DMS, Review of Rule, Continuous Glucose Monitors Billing Amendment [Exhibit F] ̶ Elizabeth Pitman, Director, DMS, DHS
G. DHS, DMS, Review of Rule, RSV Administration Fee for Children [Exhibit G] ̶ Elizabeth Pitman, Director, DMS, DHS
H. DHS, DMS, Review of Rule, Telemedicine Exemption for Triage, Treat, and Transport Services [Exhibit H] ̶ Elizabeth Pitman, Director, DMS, DHS
I. DHS, DMS, Review of Rule, Dental Rates Increase [Exhibit I] ̶ Elizabeth Pitman, Director, DMS, DHS
J. DHS, DMS, Review of Rule, Arkansas Medicaid Reimbursement for Physical and Occupational Therapy in Clinic-Based Settings [Exhibit J] ̶ Elizabeth Pitman, Director, DMS, DHS
K. DHS, DMS, Review of Rule, Maternal Health Providers and Remote Monitoring [Exhibit K] ̶ Elizabeth Pitman, Director, DMS, DHS
L. DHS, DMS, Review of Rule, Adverse Decisions [Exhibit L] ̶ Elizabeth Pitman, Director, DMS, DHS
M. DHS, Division of Provider Services and Quality Assurance, Review of Rule, Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program & REPEAL Rules for Conducting Criminal Records Checks for Employees of Long-Term Care Facilities [Exhibit M] ̶ Linda White, Division Administrator, Division of Provider Services and Quality Assurance, DHS
N. DHS, Review of Rule, Marketing Activities by Managed Care Network Providers & REPEALS: APM 905 – Social Services Block Grant Program Manual; PUB-408 – Notice of Privacy Practices [Exhibit N] ̶ Paula Stone, Director, Office of Substance Abuse and Mental Health, DHS
O. Arkansas Department of Health (ADH), Division for Health Advancement, Review of Rule, Rules Pertaining to Doula Certification [Exhibit O]
P. ADH, Division for Health Advancement, Review of Rule, Rules Pertaining to Community Health Workers [Exhibit P]
Q. ADH, Division for Health Protection, Cosmetology, Body Art, and Massage Therapy Section, Review of Rule, Rules for Cosmetology and Body Art in Arkansas [Exhibit Q] ̶ Craig Smith, Attorney, ADH
R. ADH, Division for Health Protection, Cosmetology, Body Art, and Massage Therapy Section, Review of Rule, Rules for Massage Therapy in Arkansas [Exhibit R ] ̶ Craig Smith, Attorney, ADH
S. ADH, Lead-Based Paint Program, Environmental Epidemiology Section, Review of Rule, Rules Pertaining to Lead-Based Paint Activities [Exhibit S]
T. ADH, Division for Health Protection, Radiation Control Section, Review of Rule, Rules for Control of Sources of Ionizing Radiation [Exhibit T]
U. ADH, Division for Health Protection, Radiation Control Section, Review of Rule, Rules Pertaining to Radiologic Technology Licensure [Exhibit U]
V. ADH, Division for Public Health Practice, Environmental Health Branch, Review of Rule, Rules Pertaining to Mobile Home and Recreational Vehicle Parks [Exhibit V]
W. Other Business
X. Adjournment
Documents
No documents posted.
Speakers
Speaker 2
Senator Missy Irvin Chair
Unverified
Representative Jeff Wardlaw Chair
Unverified
Speaker 19
Representative Jeremy Wooldridge
Unverified
Speaker 28
Speaker 35
Representative Aaron Pilkington
Unverified
Speaker 39
Speaker 14
Representative Julie Mayberry Chair
Unverified
Speaker 56
Speaker 55
Speaker 60
Speaker 17
Speaker 75
Speaker 31
Speaker 102
Speaker 111
Speaker 117
Speaker 94
Speaker 124
Representative Nicole Clowney
Unverified
Speaker 122
Speaker 133
Speaker 142
Speaker 150
Speaker 138
Representative Wayne Long
Unverified
Speaker 156