20-77-2205. Medicaid payment and reimbursement rules related to development of episodes of care.

20-77-2205. Medicaid payment and reimbursement rules related to development of episodes of care. (a)(1) The Department of Human Services shall not adopt a rule under the Arkansas Administrative Procedure Act, § 25-15-201 et seq., related to the development of episodes of care for patient-centered physician services, hospital services, and long-term care services and supports, including without limitation the episodes-of-care target prices and quality metrics, without first submitting the proposed rule to the Healthcare Quality and Payment Policy Advisory Committee for review. (2) Concurrent with a submission of a draft rule to the committee under subdivision (a)(1) of this section, the department shall issue a public notice of the draft rule for which the department shall: (A) Include in the notice a statement of the terms or substance of the draft rule and the specific provider category or categories affected; (B) Mail the notice to any person who requests notice of a submission of a draft rule to the committee under subdivision (a)(1) of this section; and (C) Post the notice on the department’s website in a section dedicated to the committee. (3) Concurrent with a submission of a draft rule to the committee under subdivision (a)(1) of this section, the department shall post the draft rule on its website in a section dedicated to the committee during the entire period the draft rule is under consideration by the committee. (4) The department shall provide to a person who requests the information a meeting notice that identifies the time and place of each committee and subcommittee meeting and the draft rules under consideration by the committee or subcommittee at each meeting. (b)(1) At least forty-five (45) days before initiating the promulgation process under the Arkansas Administrative Procedure Act, § 25-15-201 et seq., for a rule related to the development of episodes of care for patient-centered physician services, hospital services, or long-term care services and supports, including without limitation the episodes-of-care target prices and quality metrics, the department shall submit the draft rule to the committee for review and advice. (2)(A) If the draft rule pertains to a healthcare provider listed in § 20-77-2202(2) whose provider category is not represented on the committee, the committee shall seek representation by designated representatives of the statewide provider association or associations for that provider category for the purpose of review and advice. (B) The committee shall: (i) Provide at least twenty-five (25) days for the representatives of the affected healthcare providers to review and comment on the draft rule; and (ii) Afford the representatives the opportunity to participate in committee and subcommittee deliberations on the draft rule. (C)(i) The committee shall not provide advice to the department without seeking the input of the affected healthcare providers. (ii) If the committee does not reach agreement with a provider association on a draft rule pertaining to a healthcare provider not represented on the committee, the committee shall prepare a written report that objectively states the information and viewpoints presented but does not advise the department concerning how to proceed on the draft rule. (c) A rule required to be submitted to the committee under subsection (b) of this section that is adopted without following this section is void. (d)(1) The committee shall issue and deliver a written advisory statement to the department within thirty (30) calendar days after the department's submission of the proposed rule to the committee. (2) If the department fails to follow the advice of the committee with respect to a proposed rule under this section, the department, before beginning the promulgation process, shall prepare a written report setting out the advice of the committee and an explanation of the reason that the department decided not to follow the committee's advice with regard to the rule. (3) The department shall make available for public review the report required under subdivision (d)(2) of this section and the text of the proposed rule during the public comment period. (4) The department may begin the promulgation process for the proposed rule if the committee does not issue and deliver a written advisory statement to the department within thirty (30) calendar days after the department's submission of the proposed rule to the committee. (e) After the public comment period, the department shall retain and make available for public review the report required under subdivision (d)(2) of this section and the text of any final rule issued.