§ 20-77-150 — Legislative findings - Supplemental reimbursement rates for preventive services for children - Definitions

(a) The General Assembly finds that: (1) Prevention and early intervention in child health and well-being improves health outcomes and saves money in the long term; (2) A significant proportion of pediatric behavioral healthcare claims in Arkansas occur in primary care settings; (3) Through training and practice transformation, primary care healthcare teams can address preventive behavioral health and family needs through integrated care teams which include licensed mental health staff or non-licensed mental health staff, or both; and (4) The Mental Health and Behavioral Health Working Group in 2022 made a recommendation to incentivize medical homes, through supplemental reimbursement rates, to address prevention and early intervention through universal, team-based enhanced primary care services for children. (b) As used in this section: (1) "Actively participate in" means a physician practice has completed training to implement a team-based, evidence-based pediatric practice transformation model of care and is on track to achieve, or has achieved, model fidelity according to requirements established by an entity that utilizes data and outcomes; and (2) "Team-based, evidence-based pediatric practice transformation model of care" means a research-informed model of primary health care for children that has demonstrated improved physical health, behavioral health, developmental outcomes, and social outcomes for children and their families. (c) The Arkansas Medicaid Program shall: (1) Provide a supplemental reimbursement rate for physician practices enrolled in the patient-centered medical home program that currently and actively participate in a team-based, evidence-based pediatric practice transformation model of care; and (2) Collaborate with experts in pediatric health care to select the team-based, evidence-based pediatric practice transformation models of care most appropriate for use with the patient-centered medical home program. (d) The supplemental reimbursement rate described in subsection (c) of this section shall: (1) Supplement fee-for-service wellness visit rates in a child's medical home from birth until a child's fourth birthday; (2) Support the physician practices enrolled in the patient-centered medical home program to employ interdisciplinary staff required to implement the patient-centered medical home program; and (3) Be reviewed periodically in conjunction with future Medicaid rate reviews for physician services. (e) (1) A physician practice enrolled in the patient-centered medical home program shall work with an entity that utilizes data and outcomes to demonstrate adherence to a team-based, evidence-based pediatric practice transformation model of care focused on young children and families. (2) The Arkansas Medicaid Program shall keep on file a letter, updated annually, verifying that the physician practice enrolled in the patient-centered medical home program actively participates in a team-based, evidence-based pediatric practice transformation model of care. (f) On or before January 1, 2024, the Department of Human Services shall submit and apply for any federal waivers, Medicaid state plan amendments, or other authority necessary to implement this section.

Legislative History

Added by Act 2023, No. 513,§ 1, eff. 8/1/2023.