Child Health Management Services
Child Health Management Services (CHMS) cinics provide both developmental and medically focused treatment for children who are Arkansas Medicaid beneficiaries and who meet the qualifying criteria. These services are available in a day school setting and include physician and nursing services, physical therapy, occupational therapy, speech therapy, nutrition, early childhood developmental teaching and psychological services. CHMS services are intended for children with the most significant medical and/or developmental diagnoses who require multidisciplinary treatment.
Prior authorization is required for all treatment services provided in a Child Health Management Services clinic. To request prior authorization, please send the following documentation to AFMC along with the completed DMS-102. Request for Authorization of Child Health Management Services form:
- A treatment plan signed by the CHMS medical director and the child’s PCP that includes all services to be provided in the clinic
- The most recent evaluations along with documentation to support the child’s current medical and/or developmental status
- CHMS enrollment orders signed and dated by the CHMS medical director and the PCP
- DMS-640 prescription for occupational, physical, speech therapy
Notice of adverse actions, reconsideration, appeals and hearings
If AFMC is unable to fully approve any requested service, all applicable parties are notified in writing of the review determination along with detailed instructions on how to request an appeal.
The provider may request reconsideration of the denial within 35 calendar days of the date on the denial letter. Requests must be made in writing and include a copy of the denial letter and additional documentation to substantiate the medical necessity of the requested services. Requests received after 35 calendar days of the denial date will not be accepted for reconsideration.
If the denial decision is reversed during the reconsideration review, an approval is forwarded to the provider specifying the approved units and services. If the denial decision is upheld, the provider and the Medicaid beneficiary will be notified in writing of the review determination. Reconsideration is available only once per prior authorization request.
Fair hearing requests
The Medicaid beneficiary may request a fair hearing of a denied review determination made by either the Utilization Review Department of Human Services (DHS) or AFMC. The fair hearing request must be in writing and sent to the Appeals and Hearings Section of DHS within 35 calendar days of the date on the denial letter.
Providers may refer to section 190.000 of the Arkansas Medicaid Provider Manual for more information. Medicaid Provider Fair Hearing requests must be sent to Arkansas Department of Health, Medicaid Provider Appeals Office, 4815 West Markham Street – Slot 31, Little Rock, AR 72205.
Requests should be submitted to:
P.O. Box 180001
Fort Smith, AR 72918-0001
For complete qualifying criteria, you may view the Arkansas Medicaid manual for Child Health Management Services here.
AFMC ReviewPoint® is an alternate method of submitting requests and/or medical records.