Services For Arkansas Medicaid Providers
Medication Assisted Treatment
Effective September 1, 2020, Arkansas Medicaid supports beneficiaries with Opioid Use Disorder . Medication Assisted Treatment is the use of medications in combination with counseling and behavioral therapies for the treatment of substance use disorders. Follow this link to learn more.
AFMCs teams include experienced and knowledgeable physicians, former practice/office managers, registered nurses, billing specialists and hospital and long-term care administrators who know Medicaid inside and out. We understand the daily challenges providers face. Our teams work with providers through telephone, personal office visits and secure HIPAA-compliant, electronic portals to improve the efficiency and quality of the health care your Medicaid clients receive.
What You Should Know About Assisted Living In Arkansas
Assisted living communities in Arkansas may be referred to as residential long-term care facilities or simply residential care facilities. The state differentiates between two levels of care. Level I assisted living communities are for seniors who are fairly independent and need only an occasional hand with the activities of daily living. A Level II community is designed for seniors who require more care than a Level I community provides but do not need the level of care given in a nursing home.
Does Arkansas Have A Medicaid Work Requirement
Arkansas implemented a Medicaid work requirement in 2018, described below in detail. But Federal Judge James Boasberg overturned the Medicaid work requirements in Kentucky and Arkansas as of March 2019, noting that officials had not taken steps to prevent coverage losses stemming from the work requirement.
The Biden administration officially withdrew the states Medicaid work requirement waiver approval in March 2021, although it had not been in effect for two years prior to that.
So Arkansas is no longer removing people from the Medicaid program for failure to comply with the work requirement or reporting requirement, and the people who had already lost their coverage under the work requirement rules were able to re-apply for Medicaid although many may not be aware that their access to Medicaid has been reinstated .
As of March 2021, there were more than 905,000 people enrolled in Arkansas Medicaid and CHIP, which was higher than it had been in the months following implementation of the work requirement, but still lower than it had been in 2018, despite the fact that the COVID pandemic had been ongoing for a year.
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For Veterans And Surviving Spouses
The Aid and Attendance program through the Veterans Administration is a non-service-connected benefit. It is designed to help veterans or their surviving spouse receive the financial support necessary to ensure their continuing care in an assisted living or nursing home setting.
In 2019, the pension will pay up to:
- $2,230 per month for a veteran with a spouse
- $1,881 per month for a single veteran
- $1,209 per month for a surviving spouse
For general requirements and to find assistance for applying, .
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When To Contact Your State Medicaid Agency
In order to assist you in getting a timely response, please contact your State Medicaid Agency for any questions on the following:
If you need assistance in any of the areas noted, you will need to contact the agency for Medicaid/CHIP in your state of residence or the state you have questions about in order to receive assistance. Please contact your state for all state-related Medicaid questions.
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Is A Nursing Home Your Only Choice
Make sure to read through the other residential care housing options included on this page. There may be other alternatives for care in a more residential environment including getting the care and services the person needs at home. Learn more about in-home services.
Adults receiving state-funds to pay for long term care services may also be eligible for the Nurse Delegation Program. With Nurse Delegation, a caregiver may be trained to help with certain nursing type care tasks in your home, Assisted Living Facility, or adult family home. Learn more about Nurse Delegation.
Arkansas Has Accepted Federal Medicaid Expansion
- 917,474 Number of Arkansans covered by Medicaid/CHIP as of May 2021
- 360,623 Increase in the number of Arkansans covered by Medicaid/CHIP fall 2013 to May 2021
- 48% Reduction in the uninsured rate from 2010 to 2019
- 65% Increase in total Medicaid/CHIP enrollment in Arkansas since Medicaid expansion took effect
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How Do You Get A Pcp
The ways to choose a PCP are:
- Go to the doctors office,
- Go to the DHS office in your county, or
- List your choices for a PCP on the Medicaid or ARKids First application.
You must make sure the PCP you choose is a Medicaid or ARKids First provider. If you need a list of PCPs who take Medicaid or ARKids First, call ConnectCare or visit your county DHS office. The list tells you:
- The doctors name.
For Medicaid And Arkids First
You must report within 10 calendar days any changes that might affect your Medicaid or ARKids First eligibility.
This means you must tell DHS within 10 days if:
- the number of people in your household changesfor instance, if someone moves in or out, has a baby, or dies.
- your family income changes.
- you move to a new address.
- anything happens that might affect your eligibility. If you arent sure, contact the DHS office in your county or call 1-800-482-8988.
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Frequently Asked Questions For Providers
For your convenience, weve answered the questions were asked most often. If you have a question about Arkansas Medicaid that isnt answered here, please get in touch with the Provider Assistance Center.
Coronavirus Outbreak Questions
Where can I learn more about the DHS response to COVID-19?
As the threat from COVID-19 continues, important information on what the Arkansas Department of Human Services 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. Learn more about DHSs response to COVID-19.
Billing Policy Questions
What services are covered by Arkansas Medicaid?
Medicaid pays for a wide range of medical services. The Division of County Operations assists in determining if Medicaid pays for a specific service. Many benefits have limits, especially for adults, which may be daily, weekly, monthly or annually. There are also services that have an overall dollar amount limit per time period. Some services require a referral from the clients PCPs. Services may be rendered by both private and public providers.
Where can I see changes to policy and other provider-related notifications?
As new information is issued, provider bulletins and notifications are posted on Whats new for Arkansas Medicaid Providers along with manual updates, official notices and RA messages. Be sure to check this page often for important provider-related information and policy changes.
Assisted Living Laws And Regulations In Arkansas
Assisted living communities in Arkansas have state-enforced rules and regulations to ensure that the facilities are clean and well-maintained and the residents receive proper care. The Arkansas Department of Human Services, the Division of Medical Services and the Office of Long-Term Care license and regulate the states assisted living communities to ensure compliance.
Assisted Living Service Plan Requirements
When residents are admitted, the assisted living community is required to conduct a thorough assessment to determine their care needs. This assessment must be conducted on an annual basis, ensuring that as residents needs change, their care plan changes to accommodate.
Assisted Living Admission Requirements
In Arkansas, an assisted living community cannot admit or retain someone who is not independently mobile. Every resident must have the physical and mental ability to leave the building within three minutes. Communities also cannot admit a senior who has a feeding or intravenous tube, is completely incontinent or needs nursing services beyond what the community provides on a day-to-day basis.
Residents cannot pose a danger to themselves or to others, and they cannot be admitted if they have a mental illness or substance addiction. Finally, a community can turn away a prospective resident if that persons religious, cultural or dietary regimens cannot be reasonably met.
A resident may only be discharged if the community can no longer meet medical needs.
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Assisted Living Choices Waiver
People who are nursing home-eligible and wish to reside in an assisted living facility may qualify for the Assisted Living Choices program. Assisted Living Choices is a Medicaid waiver which allows for 24-hour personal care services to be covered for a limited number of people, helping nursing home-eligible recipients avoid being institutionalized. Other forms of assistance are available through this program, including:
- Extended prescription drug coverage for non-Medicare residents
- Periodic nursing evaluations and services
- Medication oversight and administration
- Therapeutic, social, and recreational activities
Who is Eligible?
Those who require intermediate-level nursing home care are eligible, but individuals requiring skilled care are not. Adults who have no physical disabilities must be 65 or older to qualify.
- There is a $2,000 asset cap for individuals, and the assets of married couples are considered individually.
- Only countable assets are considered, including bank accounts, cash, and mutual funds.
- There is a $2,250 income cap for individuals, with no separately designated amount for couples.
How to Apply
Applications can be filed at your local Department of Human Services office, or the process can be initiated over the phone by calling the Choices in Living Resource Center at 801-3435.
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Benefits And Drawbacks Of Assisted Living In Maumelle
- Property taxes in Maumelle are very low, but the states sales tax rate is high. Social Security income is not subject to state income tax, and other types of retirement income are only partially taxed.
- The air quality in Maumelle is very good with low levels of ozone and particle pollution. This may be beneficial for seniors, particularly those with respiratory or cardiovascular conditions.
- The Maumelle area has no facilities from which to choose in the event of a medical emergency or illness, with the nearest major hospital located in North Little Rock.
- The overall cost of living in Maumelle is only about 2% higher than the U.S. average but roughly 18% higher than the state average, which may be a consideration for Arkansas natives living on a tight retirement budget. The cost of housing is about 11% higher than the national average, which may drive up assisted living costs.
- As is typical of Arkansas, Maumelle has a warm climate with hot summers and relatively mild winters, which may suit seniors who are sensitive to cold weather. The hottest months of the year are July and August when highs are in the 90s, and the coolest month of the year is January when highs are around 50 degrees.
- The combined property and violent crime rates in Maumelle are lower than the national average, with a majority of the citys crime being property-related. This may appeal to seniors seeking a safe community for their retirement years.
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Concordia Nursing And Rehab
When looking for dementia care facilities in Bella Vista, Arkansas, you will find Concordia Nursing And Rehab as an excellent luxury memory care option that is located at 7 Professional Drive in the 72714 zip code area. It has a total capacity of 102 Alzheimers and dementia units and provides amenities that include secure campus to prevent wandering, special dementia and Alzheimers programs to increase feelings of comfort and emergency pullcords in bedrooms and bathrooms. Concordia Nursing And Rehab provides dementia and Alzheimers care not only to Bella Vista residents, but also to all Benton county residents as well.
The Cost Of Assisted Living
According to Genworths 2018 Cost of Care survey, Arkansas median cost for one months stay in a private, single room is nearly $1,000 less than the national average. Of the states that border Arkansas, only Missouri has a lower monthly cost at $2,844.
Fort Smith has the lowest average monthly cost for assisted living in the state about $1,500 less than the state average and over $2,000 less than the national average. On the other end of the spectrum, Fayettevilles average is about $300 more than the state average.
The average cost of assisted living in Arkansas compares favorably to the cost of nursing home and in-home care in the state. However, it is typically more expensive than adult day healthcare and independent living.
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Help Paying For Nursing Home Care
Medicaid does cover nursing home care for individuals who Arkansans who meet both medical needs and financial criteria. This is called Long Term Services and Supports . You will need to fill out the application, which can be found on our website, and then submit it and any other needed documents to your local county office.
Arkansas Medicaid Enrollment Numbers
Although Medicaid expansion resulted in a significant increase in enrollment in the first few years, enrollment had stabilized by 2016. Total enrollment as of January 2017 stood at more than a million people, but had . The state attributed the decrease in enrollment to a stronger economy and the states review of enrollees eligibility.
By January 2019, Arkansas Medicaid enrollment had dropped to under 850,000 people, due in part to the states implementation of a Medicaid work requirement in mid-2018. As of October 2018, there were 252,642 people covered under expanded Medicaid in Arkansas . In July 2018, before people began to be cut from the program due to the work requirement, there were more than 270,000 Arkansas Works enrollees.
But in the second half of 2018, over 18,000 people in Arkansas lost their health coverage as a result of the work requirement .
By 2020, enrollment in Arkansas Medicaid had rebounded significantly, due to the suspension of the Medicaid work requirement as well as the widespread job losses caused by the COVID pandemic. Total enrollment in Arkansas Medicaid/CHIP stood at 905,019 as of March 2021. And 277,284 people were enrolled in Arkansas Works as of June 2020, although that had grown to an estimated 317,000 by early 2021 .
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Amenities In Arkansas Dementia Care
Along with remarkably affordable room costs, Arkansass memory care facilities feature a wide range of high-quality amenities. Like most nursing homes and assisted living facilities in the state, meals are served daily, housekeeping, and other routine tasks like assistance getting in and out of bed, bathing, using the restroom, and more are assured in a memory care community.
Regular activities are scheduled and encouraged by staff to help each resident acclimatize to the community. Residents are always treated with respect, privacy and care and family members are kept up to date with any rapid changes in health, habits or personality.
A common symptom with dementia and Alzheimers is that the patient can change demeanor in a heartbeat. Staff are not only trained and equipped to handle these changes but are also prompt in communicating with family about their loved ones well-being.
Leisure is also encouraged at Arkansas dementia care homes. The activities and interactions are designed to make new residents feel as comfortable and secure in their new environment.
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Similar Program New Name
After 2016, Medicaid expansion in Arkansas was called Arkansas Works instead of the Private Option. But it was widely noted that the fundamental mechanics of the new program were very similar to the Arkansas Health Care Independence Program, which was the name of the Arkansas waiver program from 2014 through 2016. Arkansas still uses Medicaid funds to purchase private coverage for eligible enrollees in the exchange, which was the basic premise of the Private Option in the first place.
But lawmakers who were opposed to the Private Option were able to end it and replace it with Arkansas Works in many cases, fulfilling campaign promises but without the ramifications that would ensue if the state were to kick 300,000+ people off their health insurance .
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Your Primary Care Physician
A primary care physician, also called a PCP, is a doctor who takes care of you and helps you stay healthy. Your PCP will provide most of your health care. Your PCP will keep a record of your health and your health care. If you need special care for a health problem, your PCP will make the arrangements and tell you where to go. You will need your PCPs okay, called a referral, in order for Medicaid or ARKids First to pay.
Help Paying Your Rent
DHS has two programs that can help you pay your rent if you are struggling due to the COVID-19 pandemic. The Arkansas Rent Relief Program launches May 17 and you can apply starting that day at ar.gov/rentrelief. The other assistance is paid for through the federal Emergency Solutions Grant Program. You must apply with the organization in your county that is handling this program for DHS. You can find a list on our website.
If you live in Benton, Pulaski, or Washington counties, these counties have their own rent relief programs and are already accepting applications. You can apply online: Benton, Pulaski, or Washington.
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Facility Scope Of Care
All ALFs are staffed by 24-hour caregivers to respond to residents immediate needs and assist with activities of daily living. Facilities should offer mobility assistance, grooming, bathing, dressing and incontinence care, as well as medication assistance. Along with providing personal care services, facilities must host social and recreational activities for residents, and provide supportive services such as housekeeping and transportation to appointments. ALFs are also required to provide residents with three balanced meals, snacks and fluids each day. Additionally, facilities with ASCUs must offer services and programming specific to the needs of memory care residents.