Public Health Emergency Rule Suspensions

Public Health Emergency Rule Suspensions

As authorized by a series of Executive Orders, beginning with Governor’s Executive Order 20-06 regarding the public health emergency concerning COVID-19, and power delegated to the Governor by Arkansas Code Annotated § 12-75-114, the following agency rules are identified as preventing, hindering, or delaying the agency’s ability to render maximum assistance to the citizens of this state and were suspended for the duration of the declared public health emergency. The authorization to suspend certain rules as detailed below expired March 31, 2021. DHS COVID-19 Response Manuals became effective 7/1/2021.

Child Care:

Minimum Licensing Requirements for Child Care Centers 

  • Section 301(2)(e) & (f) concerning staff-child ratios, is suspended to the extent that providers may maintain staff-child ratios of up to one (1) staff to twenty-two (22) children until May 31, 2020.
  • Section 301(13) concerning group size is suspended until May 31, 2020.
  • Section 303(3) & (4) concerning education and training requirements for staff is suspended until May 31, 2020.

Minimum Licensing Standards for Child Welfare Agencies – Placement

  • Section 210-3 concerning physical exam requirements of foster families prior to initial approval is suspended.

Minimum Licensing Requirements for Out-of-School Time Facilities

  • Section 301(2)(a) concerning staff-child ratios, is suspended to the extent that providers may maintain staff-child ratios of up to one (1) staff to twenty-two (22) children until May 31, 2020.
  • Section 302(2) concerning maximum group size is suspended until May 31, 2020.
  • Section 304(3) & (4) concerning education and training requirements for staff is suspended until May 31, 2020.

Long-Term Care:

Procedures for Determination of Medical Need for Nursing Home Services

  • Rule I, concerning the prohibition on admission of applicants with diagnoses of mental illness or developmental disabilities prior to evaluation and approval by the Office of Long-Term Care is suspended.
  • Rule II, concerning the requirement to complete a Level 2 assessment within seven (7) to nine (9) workdays for applicants diagnosed with a mental illness or developmental disability under the initial screening is suspended.
  • Sections I.A.1 and I.B.1 F-151 concerning completion and review of form 703 for transfers between long-term care facilities are suspended.

Rules for the Arkansas Long-term Care Facility Nursing Assistant Training Program

  • Sections IV, VII(A)(3), and VII(B), are suspended to the extent that they: (1) Require persons acting as nursing assistants to pass an examination, or (2) Prohibit facilities from employing individuals acting as a nursing assistant for more than 120 days unless the individual passes an examination.
  • Section IV.B.5 is suspended to the extent that it limits in-class instruction to one (1) instructor for every 24 students.
  • Section IV.B.4 is suspended to the extent that it requires 16 hours of non-classroom instruction be completed “in a facility”.

Rules for Conducting Criminal Record Checks for Employees of Long-term Care Facilities

  • Section 304 requiring an applicant for employment at a Long-Term Care Facility to provide specific forms and a fingerprint card to law enforcement is suspended.
  • Section 304 requiring law enforcement to complete the forms, place the forms in a sealed envelope, and return the forms to the applicant is suspended.

Medicaid:

Adult Development Day Treatment (ADDT) Provider Manual

  • Section 214.120 concerning the requirement that nursing services be provided at a clinic only is suspended.
  • Sections 202.200 and 217.100 concerning annual evaluations and treatment prescriptions are suspended.

Ambulatory Surgical Center Provider Manual

  • Sections 210.200(A) and 212.000, regarding the definition of an Ambulatory Surgical Center (ASC) as exclusively furnishing outpatient surgical services to patients not requiring hospitalization, are suspended.

ARChoices Provider Manual

  • Section 212.312 concerning annual and semi-annual assessments by agency nurses are suspended to allow for extension of Person-Centered Service Plans (PCSP).

Arkansas Independent Assessment Provider Manual

  • Section 201.000, concerning periodic assessments for behavioral health and developmentally disabled PASSE members is suspended to allow phone assessments by request only, and to extend initial assessment dates for behavioral health PASSE members.

Critical Access Hospital Provider Manual

  • Section 212.419, regarding the prohibition of coverage of swing bed services by the Arkansas Medicaid Program is suspended.

Early Intervention Day Treatment (EIDT) Provider Manual 

  • Sections 202.100, 212.000, and 212.100 concerning annual evaluations and treatment prescriptions are suspended.
  • Section 213.000 concerning the originating site requirements applicable to licensed assistants providing parental consultation and continued therapy services (Physical Therapy, Occupational Therapy, and Speech Therapy) for established patients is suspended. 
  • Section 213.000 concerning the requirement that nursing services be provided at a clinic only is suspended.

End Stage Renal Disease Provider Manual

  • Section 212.419, regarding the prohibition of coverage of swing bed services by the Arkansas Medicaid Program is suspended.

Federally Qualified Health Center (FQHC) Provider Manual

  • Sections 252.140(B) and 262.120 concerning telemedicine prohibitions conducted by Federally Qualified Health Centers (FQHCs) are suspended to the extent established in Provider Guidance Memos DMS-34 and DMS-37.

Hospital Provider Manual

  • Section 212.419, regarding the prohibition of coverage of swing bed services by the Arkansas Medicaid Program is suspended.
  • Sections 212.500 through 212.550 concerning prior authorization requirements related to MUMP review for hospital stays greater than four (4) days are suspended.

Hyperalimentation Provider Manual

  • Sections 220.000 through 223.000 concerning prior authorization requirements for all hyperalimentation services are suspended.

Living Choices Provider Manual

  • Section 211.150 and 212.200 concerning annual and semi-annual assessments by agency nurses are suspended to allow for extension of Person-Centered Service Plans (PCSP). 

Medicaid Provider Manual

  • Section 105.190, regarding the originating site requirements for services provided to established patients by advanced practice registered nurses is suspended.
  • Section 105.190, is suspended as to the originating site requirement to allow all providers who are able to provide telemedicine services to provide those services to a beneficiary in his or her home.
  • Section 141.103 concerning fingerprint submission requirements for high risk providers related to background screening is suspended.

Medical Services Policy Manual

  • Section A-200 concerning an individual’s Medicaid coverage period related to ineligible cases (except for closure requested by client, death, out-of-state residence, incarceration, or when an Arkids B CHIP recipient reaches the age of nineteen) is suspended.
  • Section F-130 concerning good cause requirements for cooperation with the Office of Child Support Enforcement is suspended.
  • Section F-151 concerning form 703 requirements involving transfer of residents between long-term care facilities is suspended.
  • Sections F-172 and F-173 concerning adjustment of TEFRA premiums and case closure for non-payment are suspended.
  • Sections I-110, I-200, I-300, I-320, I-321, I-322, I-323, I-324, I-325, I-326, I-327, and K-106 concerning Medicaid eligibility renewal process and timelines are suspended. 
  • Section L-120 concerning the continuation of assistance or services during the appeal process is suspended.

Occupational, Physical, Speech Therapy Provider Manual

  • Originating site requirements applicable to licensed assistants providing parental consultation and continued therapy services (Physical Therapy, Occupational Therapy, and Speech Therapy) for established patients is suspended in Section 214.210. 

Outpatient Behavioral Health Services (OBHS) Provider Manual

  • Sections 204.000, 214.300, and 214.400 concerning annual evaluations and treatment prescriptions are suspended.
  • Sections 252.113 and 252.114 concerning face-to-face treatment requirements are suspended.
  • Section 252.117 concerning telemedicine service limitations for beneficiaries age twenty-one (21) and over is suspended.
  • Section 252.119 concerning telemedicine service limitations related to substance abuse assessments is suspended.
  • Section 255.001 concerning face-to-face service requirements for crisis intervention is suspended.
  • Section 255.003 concerning Acute Crisis Unit benefit limits of 96 hours per encounter, one encounter per month, and 6 encounters per state fiscal year is suspended.

Personal Care Provider Manual

  • Section 214.200 concerning annual review and renewal of personal care service plans is suspended.

Pharmacy Provider Manual

  • Sections 221.100, 262.310(12), and 262.310(13) concerning patient signature requirements for receipt of medication at a pharmacy is suspended.

Physician/Independent Lab/CRNA/Radiation Therapy Center Medicaid Provider Manual

  • Section 225.100(A), regarding limitations on outpatient laboratory services, is suspended as to claims for any lab or x-ray services related to a COVID-19 diagnosis. 
  • Section 225.100(A), regarding limitations on outpatient laboratory services, is suspended as to claims for COVID-19 antigen laboratory testing using procedure code 87426.
  • Section 225.100(A), regarding limitations on outpatient laboratory services, is suspended as to claims for COVID-19 laboratory testing using procedure codes U0001, U0002, U0003, and U0004.
  • Sections 225.000 and 226.000 concerning annual limitations for physician and outpatient hospital visits are suspended to allow for additional visits for (1) treatment of COVID-19 as documented by COVID-19 diagnosis codes, and (2) physician and nurse practitioner visits to patients in skilled nursing facilities.
  • Section 292.210 concerning places for delivery of services provided by physicians, advanced practice registered nurses, and hospitals is suspended to allow for billing for COVID-19 screening and diagnostic testing at a mobile (drive thru) clinic (Place of Service 15).
  • Section 292.950 concerning prior authorization requirements for viscosupplementation services is suspended.

Program for All-Inclusive Care for the Elderly (PACE)

  • Section 212.200 and 215.200 concerning annual and semi-annual assessments by agency nurses are suspended to allow for extension of Person-Centered Service Plans (PCSP).

Prosthetics Medicaid Provider Manual

  • Sections 212.209 to 212.210, 220.000 through 221.600, and 242.153 concerning prior authorization requirements related to Mic-key tubes and supplies are suspended.
  • Sections 220.000 through 221.600 and 242.110 concerning prior authorization requirements related to insulin pumps and supplies and oxygen are suspended.
  • Sections 220.000 through 221.600 and 242.130 concerning prior authorization requirements related to incontinence supplies are suspended.
  • Sections 220.000 through 221.600 and 242.150 concerning prior authorization requirements related to formula are suspended.
  • Sections 220.000 through 221.600 and 242.170 concerning prior authorization requirements related to Apnea Monitors are suspended.
  • Section 242.191 requiring face-to-face physician’s evaluations for applicable DME, Prosthetics, and Orthotics is suspended.

Provider-Led Arkansas Shared Savings Entity (PASSE) Program Manual

  • Section 282.001 regarding behavioral assistance services being limited to children or youth is suspended.

Rural Health Clinic (RHC) Provider Manual

  • Section 211.300 concerning telemedicine prohibitions conducted by Rural Health Clinics (RHCs) is suspended to the extent established in Provider Guidance Memos DMS-34 and DMS-37.

Therapeutic Community Certification Manual

  • Sections 113, 114, 115, 116, 118, 119, and 120 referencing the number of weekly hours for provision of services by a physician, professional services, or qualified behavioral health paraprofessional are suspended.

Transportation Provider Manual

  • Sections 213.000, 204.000, and 205.000(A)(2) concerning pick-up and delivery locations and physician certification prior to transport by non-emergency ground ambulance are suspended.

Supplemental Nutrition Assistance Program (SNAP):

Supplemental Nutrition Assistance Program (SNAP) Policy

  • Section 810, concerning quality control reviews for the sample months of March, April, and May is suspended until June 30, 2020.
  • Section 840, concerning face-to-face interviews for quality control reviews is suspended until March 31, 2021.
  • Section 1623 concerning good cause requirements for cooperation with the Office of Child Support Enforcement is suspended until June 30, 2020.
  • Section 8120 concerning disallowance of telephone applications with an alternative signature process is suspended until September 30, 2020.
  • Sections 8200, 8250, 8260, 9420, 9430, 10500, 10511, and 10520, concerning interview requirements for application, recertification, approval, and expedited service are suspended until June 30, 2020.
  • Section 10500, 10511, and 10520, concerning interview requirements for recertification are suspended until March 31, 2021.
  • Sections 10610 and 10630 regarding certifications are suspended until June 30, 2020
  • Sections 11100 and 11630, concerning SNAP households subject to periodic reporting verification purposes are suspended until June 30, 2020.
  • Section 13100 regarding supplemental benefits will be suspended to allow maximum SNAP benefits to be granted to recipients until March 31, 2021.
  • Section 1622.2 concerning the requirement of present participation or future participation during the term is suspended until June 30, 2021.

Transitional Employment Assistance (TEA):

TEA Program Policy Manual

  • Section 5000 regarding verification rules is suspended so that current beneficiaries will receive TEA benefits until June 30, 2020 (updated February 3, 2021).
  • Section 2140 concerning good cause requirements for cooperation with the Office of Child Support Enforcement is suspended until June 30, 2020 (per guidance from the Administration of Children and Families)(updated September 10, 2020).
  • Sections 2004 – 2004.1 regarding face-to-face or telephone interview requirement for eligibility determination are suspended.
  • Sections 2003 (TEA) and 10101 (Work Pays) regarding disallowance of telephone applications with an alternative signature process are suspended.
  • Section 10105 regarding renewal rules for existing beneficiaries in Work Pays to receive benefits is suspended until June 30, 2020 (updated February 3, 2021).
  • Section 4101.2 regarding annual renewal rules for existing beneficiaries to receive benefits is suspended until June 30, 2020 (updated February 3, 2021). 

Youth Services:

Division of Youth Services (DYS) Operations Manual

  • Sections 7445.1-7445.3 regarding in-person visitation, is suspended.

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