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For PASSE Providers

For PASSE Providers

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About the PASSE Program

Step 1: Understand PASSE’s Purpose
PASSE stands for Provider-Led Arkansas Shared Savings Entity. It’s a Medicaid managed care program for beneficiaries with a high level of need related to behavioral health (BH) diagnosis or intellectual / developmental disabilities (I/DD). PASSE organizations coordinate care, manage payments, and ensure access to services for their members.

The PASSE will provide most physical health, behavioral health, and specialized developmental disability services for all beneficiaries enrolled as members in their PASSE. Additionally, the PASSE will provide Care Coordination and develop a Person-Centered Service Plan (PCSP) for each member.

The Department of Human Services (DHS) is responsible for oversight of the PASSE organizations and for meeting all assurances under the individual Centers for Medicare and Medicaid Services (CMS) waivers that govern the program.

Step 2: Know the PASSE Organizations
There are four PASSE organizations:

Each PASSE has its own network, policies, and support teams. PASSE providers must enroll separately with each PASSE organization they want to contract with. PASSE members are not enrolled by geographic area, but by a rotation (or personal preference). Providers who want to serve all eligible beneficiaries in their service area will need to enroll with each PASSE organization and comply with each PASSE specific Provider Manual. PASSE Provider Manuals can be found on each respective PASSE website.

Step 3: Review Program Details

  • Read the PASSE Provider Manual for step-by-step instructions on working as a PASSE provider.
  • Read all the Provider Manuals to understand instructions as a provider.
  • For each PASSE that you are enrolled in as a provider, read and understand the PASSE Provider Manual and requirements.

Step 4: Understand Home and Community-Based Services (HCBS)

PASSE organizations provide services to adults and children with mental health needs, substance use disorder, intellectual disabilities, and / or developmental disabilities. In  addition to Medicaid State Plan services, Arkansas provides home and community-based services through two federal authorities (Community and Employment Support waiver and the PASSE 1915i State Plan Amendment detailed below). Home and community-based services help people receive care in their own home or community. HCBS are a way for people to continue to live in their community as independently as possible, instead of receiving care in a long-term care facility. 

  • Review the DHS HCBS home page where we explain all HCBS services offered to individuals enrolled in a PASSE.

Community and Employment Support 1915(c) Waiver

The Community and Employment Support (CES) Waiver provides support for beneficiaries with I/DD with all major life activities. This includes living independently and working at a job with help from an employment coach.

For additional information about services for individuals with I/DD, visit the Division of Developmental Disabilities Services.

PASSE 1915(i) State Plan Amendment

Arkansas Medicaid also makes home and community-based services available to people with complex behavioral health needs through a 1915i State Plan Amendment. Behavioral Health HCBS treat symptoms that cause functional deficits and provide services that help individuals function. Review the HCBS Behavioral Health Simple Fact Sheet and Detailed Fact Sheet.

For information about behavioral health services, visit the Office of Substance Abuse and Mental Health.

Understanding Medicaid

Step 1: Learn About Medicaid
Medicaid is a joint federal and state program that provides health coverage for eligible Arkansans. As a provider, you are responsible for delivering services that meet federal and state Medicaid standards and regulations.

For more information about Arkansas Medicaid, visit the Division of Medical Services page.

Here, you can find additional resources and Helpful Information for Providers.

Step 2: Access Provider Resources

Visit the Arkansas Medicaid Provider Portal to find enrollment forms, billing information, and updates. All PASSE providers must be enrolled as a Medicaid provider first. Online submission is the fastest and most effective way to enroll as an Arkansas Medicaid Provider because:

  • enrollment time decreases — from weeks to days.
  • issues related to the quality of attachments and illegible applications are decreased or eliminated.
  • real-time status updates on applications are available.
  • applications are returned to providers less frequently for clarification or additional information and no associated mailing delays occur.
  • application delays often result in failure to meet revalidation requirements causing a provider to temporarily lose the ability to bill for services.
  • a higher percentage of electronic application submissions are successful.

For the rare occasions when a provider is unable to enroll or update using the portal, the state will review the submission of a paper application.

All Medicaid providers, including PASSE providers must adhere to and follow all DHS Medicaid Provider Manuals in conjunction with each PASSE’s provider manual. Review the Provider Manuals and Notifications for detailed guidance on covered services, billing codes, and compliance. Familiarity with the policies in these manuals is required and will support providers to deliver quality services and receive reimbursements in a timely fashion. In addition, PASSE providers are required to adhere to and follow the PASSE’s requirements and standards.

If you have questions, contact Provider Relations at the Division of Provider Services and Quality Assurance (DPSQA) for direct support.

Step 3: Stay Informed

Provider Responsibilities in PASSE

Provider responsibilities are outlined in detail in the PASSE Provider Agreement. Some examples of provider responsibilities are listed below.

Step 1: Deliver Allowable Services

  • Only provide services that are allowable for PASSE members (if applicable, receive a prior authorization if required).
  • Verify member eligibility and service eligibility/authorization before delivering care.

Step 2: Comply with Regulations

  • Follow all federal and state Medicaid rules.
  • Follow PASSE requirements and standards.
  • Use the correct billing codes and submit claims according to PASSE guidelines.

Step 3: Submit Claims Accurately and Timely

  • Use electronic claims submission when possible for faster processing.
  • All Medicaid claims must be submitted within 365 days of the date of service.

Step 4: Participate in Care Coordination

  • Work with PASSE care coordinators to develop and implement a Person-Centered Service Plan (PCSP) for each member.
  • Attend care team meetings and provide input on member needs.

Step 5: Maintain Credentialing

  • Complete initial credentialing with each PASSE and participate in regular recredentialing.
  • Keep your licensure, certifications, and contact information up to date.
  • You may need to supply credentialing information to multiple organizations, specifically the Department of Human Services and each PASSE for which you provide services. For links and additional information, refer to the Enrollment and Requirements section, below.

Step 6: Ensure Cultural Competency and Member Protections

  • Provide services in a culturally sensitive manner.
  • Protect member privacy and rights at all times.

Step 7: File Grievances, Appeals, and Complaints

  • If you disagree with a PASSE decision or have concerns, follow the grievance and appeal process outlined in your PASSE’s provider manual. This process is separate from a beneficiary’s grievance and appeals process and is just for providers.

Reference Documents:

Enrollment & Requirements

Step 1: Register as a Medicaid Provider

  • Go to the Arkansas Provider Portal.
  • Complete the online enrollment form and submit required documentation.
  • If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or toll free at (800) 457-4454.

Step 2: Contract and Credential with PASSE Organizations

Step 3: Review and Sign the PASSE Provider Agreement

  • Carefully read the PASSE Provider Agreement for each PASSE that you wish to contract with to understand your obligations.
  • Sign and return the agreement to the PASSE organization(s).

Step 4: Maintain Compliance

  • Participate in ongoing training and updates provided by DHS and PASSE organizations.
  • Regularly review provider manuals and policy updates.

Step 5: Submit Claims and Documentation

  • Use the PASSE’s claims system to submit documentation for services rendered.
  • Ensure all claims are accurate and submitted within required timeframes.

Support & Contact

Step 1: Access Provider Relations & Training

Step 2: Connect with PASSE Organization Provider Services

Step 3: Contact DHS PASSE Provider Line

  • For general questions about PASSE, call 1-844-843-7351.

When and How to Report a Concern

For Abuse, Neglect, or Exploitation

If an incident involves suspected abuse, neglect, or exploitation of a child or an adult, use the specific hotlines: 

  • Child Abuse and Maltreatment Hotline: Call 1-800-482-5964 or use the online portal at mandatedreporter.arkansas.gov.
  • Adult Protective Services Hotline: Call 1-800-482-8049. 

Mandated reporters (such as doctors, teachers, and social workers) are legally required to report suspected maltreatment. 

For Fraud or Other Concerns

  • Fraud Hotline (Medicaid, SNAP, TEA, etc.): Call 1-800-422-6641 or email [email protected].
  • General Misconduct/Integrity Concerns: Use the DHS Integrity form on the AR DHS website.
  • Complaints about a Nursing Home: File a complaint with the Arkansas DHS Office of Long Term Care by contacting the Arkansas Long-Term Care Ombudsman Program, which administers advocacy services for residents and handles complaints, at 501-682-8155. You can also file a complaint online on the website.
  • Medicaid Fraud, Waste, and Abuse: Contact the Office of Medicaid Inspector General. Visit their website or call 855-527-6644.
  • Attorney General of Arkansas: The Office of the Arkansas Attorney General works with consumers and businesses to address marketplace concerns, including disputes between consumers and businesses about goods and services. Visit their website.

In an immediate emergency or if a life is in danger, contact local law enforcement or dial 9-1-1 first. 

Incident Reporting for Home and Community-Based Services Providers Long-Term Care Facilities, Early Intervention Day Treatment (EIDT), and Adult Development Day Treatment (ADDT) Centers

Home and community-based service providers (HCBS), long-term care facilities, Early Intervention Day Treatment (EIDT), and Adult Development Day Treatment (ADDT) providers must report incidents and accidents through the Enterprise Licensing System (ELS) online portal. Paper reports are no longer accepted. 

Incident Reporting for CES Waiver, HCBS, ICF, and PRTF Providers

Medicaid providers who provide Community and Employment Support (CES) Waiver, HCBS, Intermediate Care Facility, and/or psychiatric residential treatment facilities services are required to report critical incidents.

A critical incident may endanger or negatively impact the mental and/or physical well-being of a beneficiary.  When a critical incident occurs involving a PASSE member, the Provider/PASSE must report the critical incident within the required time frame defined by DHS. Types of reportable incidents include:

  • Death of beneficiary
  • The use of any restrictive intervention, including seclusion, or physical, chemical, or mechanical restraint on a beneficiary.
  • Suspected maltreatment or abuse of a beneficiary.
  • Any injury to a beneficiary that:
    • Requires the attention of an Emergency Medical Technician, a paramedic, or physician
    • May cause death
    • May result in a substantial permanent impairment
    • Requires hospitalization
  • Threatened or attempted suicide by a beneficiary. 
  • The arrest of a beneficiary, or commission of any crime by a beneficiary.
  • Any situation in which the whereabouts of a beneficiary is unknown for more than two (2) hours (i.e. elopement and/or wandering), or where services are interrupted for more than two (2) hours.
  • Any event where a staff member threatens a beneficiary.
  • Unexpected occurrences involving actual or risk of death or serious physical or psychological injury to a beneficiary.
  • Medication errors made by staff that cause or have the potential to cause serious injury or illness to a beneficiary, including, but not limited to, loss of medication, unavailability of medication, falsification of medication logs, theft of medication, a missed dose, wrong dose, a dose being administered at the wrong time, by the wrong route, and the administration of the wrong medication.
  • Any violation of a beneficiary’s rights that jeopardizes the health, safety, or quality of life of the beneficiary.
  • Any incident involving property destruction by a beneficiary.
  • Vehicular accidents involving a beneficiary.
  • Biohazard incidents involving a beneficiary.
  • An arrest or conviction of a staff member providing direct care services.
  • Any use or possession of a non-prescribed medication or an illicit substance by a beneficiary.
  • Any other event that might have resulted in harm to a beneficiary or could have reasonably endangered the health, safety, or welfare of the beneficiary.

Updates from DHS

Stay Current. Stay Compliant.

Stay informed on policy changes, reporting deadlines, and program announcements from Arkansas DHS.

Announcements and Policy Changes

Sign up to receive key emails from DHS.

Training & Events

  1. Review the DHS Calendar
  2. Review the DHS Training and Education offerings

Reports & Publications

DHS publishes key Medicaid Reports and Publications on a regular basis. Reports published include the PASSE Accreditation Status, the External Quality Review Technical Reports, and the Managed Care Program Annual Report, among others.

Frequently Asked Questions

Find Answers to Common Questions

How do I enroll as a PASSE provider?
→ Visit the Provider Enrollment Portal and follow the step-by-step instructions.

What services are covered and excluded?
→ Review the PASSE Provider Manual for a full list of covered and excluded services.

How do I submit claims?
→ Use your PASSE’s claims submission system and follow the guidelines in the provider manual.