Ark. Code § 20-77-1707

Current with legislation from 2024 Fiscal and Special Sessions.

Section 20-77-1707 - Prior authorizations - Retrospective reviews

If the Department of Human Services requires a provider to justify the medical necessity of a service through prior authorization, the department shall not later take the position that the services were not medically necessary, unless the retrospective review establishes that:

(1) The previous authorization was based upon misrepresentation by act or omission;

(2) The services billed were not provided; or

(3) An unexpected change occurred that rendered the prior-authorized care not medically necessary.

Ark. Code § 20-77-1707

Amended by Act 2013, No. 562,§ 5, eff. 8/16/2013.

Acts 2005, No. 1758, § 1.