Provider relations – policy and education

Medication Assisted Treatment

Effective September 1, 2020, Arkansas Medicaid supports beneficiaries with Opioid Use Disorder (OUD). Medication Assisted Treatment (MAT) 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.

AFMC’s policy and education outreach specialists serve as the link between health care providers and Arkansas Medicaid. We help providers navigate the Medicaid system and stay up-to-date on policy and procedures.

Our team is a diverse group of professionals, each with several years of managerial experience in clinics and hospitals as well as home health experience and nursing. We visit the following types of providers:

  • Primary care physicians
  • Specialists
  • Hospitals
  • Area Health Education Centers (AHECs)
  • Federally Qualified Health Centers (FQHCs)
  • Rural health clinics
  • Arkansas Department of Health clinics

During the visits, our outreach specialists offer feedback and educational tools as needed to help providers implement quality utilization and improvement.

Our team provides general consultation in the following areas:

  • Medicaid, ARKids First B, and other waivered programs
  • Medicaid policy updates and requirements
  • Episodes of Care assistance and patient-centered medical home education to provide cost-effective, high quality care
  • Emergency room education and in-service
  • Non-emergency transportation education (NET services)
  • Early and periodic screening, diagnosis and treatment (EPSDT)

See our map below to find an outreach specialist in your area.

In addition to Medicaid provider manuals, official notices should be referenced for Medicaid program policy. - Arkansas Medicaid Official Notices

Educational Outreach Updates

Arkansas Physician Medicaid Update

4TH QUARTER, SFY 2021–22 • April 1-June 30, 2022
Download packet (PDF)

This quarter’s topics include but aren’t limited to:

  • Call Center Outreach to Arkansas Medicaid Clients
  • Medicaid Primary Care Provider Referrals
  • Official Notice – Colorectal Screening
  • Procedure Code Linking Tables
3RD QUARTER, SFY 2021–22 • January 1–March 31, 2022
Download packet (PDF)

This quarter’s topics include but aren’t limited to:

  • ConnectCare Provider Escalated Team Correspondence
  • PCMH Performance
  • Pharmacy Benefits Expanded for Adult Medicaid Clients
  • Vaccines for Children (VFC)
2ND QUARTER, SFY 2021–22 • October 1–December 31, 2021
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This quarter’s topics include but aren’t limited to:

  • COVID-19 Rates
  • PCMH Information
  • PASSE Ombudsman
  • Provider Status Changes
  • Educational Opportunities
1ST QUARTER, SFY 2021–22 • July 1–September 30, 2021
Download packet (PDF)

This quarter’s topics include but aren’t limited to:

  • Medicaid Providers Play a Critical Role in COVID-19 Vaccinations
  • Arkansas Health and Opportunity for Me (ARHOME)
  • Arkansas Medicaid Reimburses Three Types of Emergency Department Visits
  • PCP Online Assignment Portal vs. SeeYourDoc.org
4TH QUARTER, SFY 2020–2021 • Apr. 1–June 30, 2021
Download packet (PDF)

This quarter’s topics include but aren’t limited to:

  • Ambulatory Surgical Centers Allowed to Temporarily Enroll as Hospitals
  • Arkansas Medicaid PCP Caseload Management Responsibilities
  • Medication-Assisted Treatment in Arkansas
  • What’s New for Arkansas Medicaid Providers
2ND AND 3RD QUARTER, SFY 2020–2021 • Oct. 1, 2020–March 31, 2021
Download packet (PDF)

COVID-19 Response

For clients:
DHS’s Response to COVID-19 for Clients 

For providers:
DHS’s Response to COVID-19 for Providers 

AFMC’s response:
AFMC COVID-19 Updates and Resources for Providers

AMS’ Response:
Personal protective equipment request form

Behavioral Health

Find Substance Abuse or Mental Health Treatment: 844-763-0198

Medication-Assisted Treatment (MAT) for Opioid Use Disorder

Medicaid Manual updates

Immunizations

Flu and Medicaid vaccine administration payment increase

CDC vaccine website

Medicaid Educational Regional Conference (Virtual)

December 9, 2020 – Behavioral health and waiver providers

December 10, 2020 – Physicians, nurses, office managers, billers, and hospitals

MMIS Medicaid 101 Webinars

Medicaid provider trainings

Recorded trainings

MMIS Portal

MMIS Job Aid – Uploading Documents (Updated)

Patient-centered Medical Home (PCMH)

Activities due by Dec. 31, 2020
2020 PCMH Program policy addendum

PCMH Update/change form

PCMH Pooling form

PCMH Withdrawal form

Questions: pcmh@afmc.org

PCP

PCP selection and change form

Services not requiring a referral, see section 172.100 of all manuals

PCP Referral Form DMS-2610 (Updated)

PCP requirements for Category 06 beneficiaries

Pharmacy

Magellan is the Medicaid pharmacy vendor and operates the Magellan Pharmacy Call center. On Magellan’s website are many tools including the preferred drug list, drug prior authorization criteria, tobacco cessation tools and the smoking cessation counseling checklist.

Prescription drug information

Provider Enrollment

Updating provider enrollment on status changes, section 141.000 of all Medicaid manuals

Top 4 provider enrollment issues when applying on the portal

What’s New

What’s new for Arkansas Medicaid providers

  • Affiliated provider listing available in the provider portal
  • Antigen testing
  • Electronic Visit Verification (EVV) requirements for participation
1ST QUARTER, SFY 2020–2021 • July 1 – Sept. 30, 2020
Download packet (PDF)

COVID-19 Response

DHS’s Response to COVID-19 for Beneficiaries 

  • How to apply for Medicaid services
  • Frequently asked questions
  • DHS contact information
  • Additional topics added as needed

DHS’s Response to COVID-19 for Providers 

  • Care Continuity Emergency Response Reimbursement Payments
  • Hospital direct and non-direct care payments
  • Laboratory/testing
  • Medicaid provider/services requirements
  • Pharmacy and medical devices
  • Rural health centers and federally qualified health centers

Arkansas Medical Society

AFMC COVID-19 Updates and Resources for Providers

Telehealth

Episodes of Care

  • Reports

MMIS Medicaid 101 Webinars

Opioid Addiction Treatment Resources

Patient-centered Medical Home (PCMH)

PCP

Services not requiring a referral

PCP selection and change form

Pharmacy

Magellan

Provider Electronics Solutions (PES)

Sept. 1, 2020, Arkansas Medicaid will no longer accept claims through PES.

Smoking Cessation

What’s New

What’s new for Arkansas Medicaid providers

4TH QUARTER, SFY 2019–2020 • APR. 1–June 30, 2020
Download packet (PDF)

COVID-19 Response

DHS’s Response to COVID-19 for Beneficiaries 

  • How to apply for Medicaid services
  • Frequently asked questions
  • DHS contact information
  • Additional topics being added as needed

DHS’s Response to COVID-19 for Providers 

AFMC COVID-19 Updates and Resources for Providers

ARKids First-B

Beneficiary Education Sessions

Episodes of Care

  • Reports
  • April episode of care reports can be viewed on AHIN on or after April 30, 2020

EPSDT

Opioid Addiction Treatment Resources

Patient-centered Medical Home (PCMH)

  • 2019 – 2020 PCMH Manual Addendum
    https://www.paymentinitiative.org/pcmh-manual-and-additional-resources
  • 2020 PCMH Program Policy Addendum
    https://www.paymentinitiative.org/pcmh-manual-and-additional-resources
  • Activities due by June 30, 2020
  • Questions: pcmh@afmc.org

Pharmacy

Magellan

Smoking Cessation

Third-party Liability

What’s New

What’s new for Arkansas Medicaid providers

3RD QUARTER, SFY 2019–2020 • JAN. 1–MARCH 31, 2020
Download packet (PDF)

ARKids First-B


Beneficiary Education Sessions

Episodes of Care

  • Reports
    • January episode of care reports can be viewed on AHIN on or after Jan. 31, 2020

EPSDT

PASSE

Patient-centered Medical Home (PCMH)

PCP Caseloads

Opioid Addiction Treatment Resources

What’s New

  • What’s new for Arkansas Medicaid providers
    https://medicaid.mmis.arkansas.gov/Provider/Provider.aspx

 

2ND QUARTER, SFY 2019–2020 •OCT. 1 - DEC. 31, 2019
Download packet (PDF)

AHIN Updates

Episodes of Care

  • SFY 2020 second quarter reports
    • SFY 2020 second quarter episode of care reports can be viewed on AHIN on or after Oct. 31, 2019

EPSDT Reason Codes

Exhausted Benefits

Flu Vaccines

Hospital Emergency Department

MMIS

  • Creating a Prior Authorization Request

PASSE

Patient-Centered Medical Home (PCMH)

  • 2020 PCMH Enrollment dates: Oct. 1–Nov. 12
  • Quarterly Reports
    • Addendum
    • Manual
  • Activities due by Dec. 31 – Pages 6, 11–16
    • Care plans for high priority patients
    • Patient literacy assessment tool
    • Ability to receive patient feedback
    • Care instructions for high priority patients
    • 10-day follow up after an acute inpatient
    • Developmental/behavior health assessment for children and adolescents
  • Questions: pcmh@afmc.org

PCP Caseloads

Upcoming Conferences

  • Arkansas Medicaid Educational Conference: Dec. 17, Embassy Suites Little Rock
  • Division of Provider Services and Quality Assurance (DPSQA) Educational Conference: Dec. 18, Embassy Suites Little Rock

 

1ST QUARTER, SFY 2019–2020 • JULY 1 - SEPT. 30, 2019
Download packet (PDF)

Dual Eligibles

Dual eligible benefit plans having no Medicaid benefits

Episodes of Care

SFY 2020 first quarter reports

  • SFY 2020 1st quarter episode of care reports can be viewed on AHIN on or after July 31, 2019.

Exhausted Benefits

MMIS

PASSE

Patient-Centered Medical Home (PCMH)

Pharmacy

Magellan

Provider Enrollment

Therapy

Voice Response System (VRS)

4TH QUARTER, SFY 2018–2019 • APRIL 1 - JUNE 30, 2019
Download packet (PDF)

Arkansas Works

  • Non-Emergency Transportation
    • NET broker map

DMS-2609 PCP Selection/Change Form

  • PCP assignment not needed for IAPB or Medicare primary

Extension of Benefits

Immunization Schedule

Medicaid Management Information System (MMIS)

  • Outreach Specialists map

Medicaid Non-Emergency Transportation (NET)

PASSE

  • NET for PASSE members
    • NET broker map
  • PASSE choice counseling for members: 1-833-402-0674
  • Tools for PASSE members and providers

PASSE Contacts

  • DHS PASSE Provider Line………………………………1-888-889-6451
  • Arkansas Total Care……………………………………….1-866-282-6280
  • Empower Healthcare Solutions………………………..1-855-429-1028
  • Summit Community Care………………………………..1-844-462-0022

Patient-Centered Medical Home (PCMH)

Physician Assistant — Direct Supervision

Provider Enrollment

Referrals

Telemedicine

Title V Children with Special Health Care

Needs Webinar (2/7/19)

3RD QUARTER, SFY 2018–2019 • JANUARY 1 - MARCH 31, 2019
Download packet (PDF)

Arkansas Health Care Payment Improvement Initiative (AHCPII)

Episodes of Care

  • Tonsil update

PCMH

  • Addendum
  • Manual

Arkansas Works

New age range

County resources

Educational tools

Connect Care

Benefit plan 06

  • IABP: PCP assignment NOT required

Crosswalk

DMS-2609 PCP selection/change form

Dismissal of a beneficiary

Dual eligible beneficiary

Foster care

Voice response system

Extension of Benefits: Benefit Limit

Review Point

No paper, no phone calls, no fax machines, secure submission

RA message – vendor change

PASSE

Delay

Provider Handbook

Provider Resources

Provider Enrollment

Needed documents for application

Webinar (November 2018)

Referrals

Emergency department

1ST AND 2ND QUARTERS, SFY 2018–2019 • JULY 1–DEC 31, 2018
Download packet (PDF)

What’s New

Arkansas Take Back

  • Permanent site

Arkansas Works

  • Recipients can lose eligibility
  • Educational tools
  • Work requirements: Activities/exemptions

Behavioral Health

County Codes (DMS-2608)

Episodes of Care (EOC)

  • URI – AFMC Resources

PASSE

PCMH News

Arkansas Health Care Payment Improvement Initiative (AHCPII)

  • AHCPII website

Patient Centered Medical Home (PCMH)

  • PCMH 24/7 Best Practices
  • PCMH Contacts
  • PCMH manual and program policy addendum
    • Health literacy tools
    • PCMH Recovery of Practice Support
    • PCMH Research, Reconsideration and Appeals
    • History Button and Medical Neighborhood Report

Practice transformation

Episodes of Care

  • Episodes of Care (Algorithms) and Update – Performance Period and Final Report Dates

Links

Contact an outreach specialist