Arkansas PASSE Program – For Medicaid Beneficiaries
Welcome to Arkansas PASSE
The Provider-Led Arkansas Shared Savings Entity (PASSE) program helps eligible Arkansans get coordinated care and support for complex behavioral health and intellectual / developmental disabilities (I/DD). The goal is to help you live independently and thrive in your community.
Quick Links:
- PASSE Simple and Detailed Fact Sheets
- Community and Employment Support Waiver Simple and Detailed Fact Sheets
- Behavioral Health Services Simple and Detailed Fact Sheets
- Medicaid Programs and Eligibility
- Medicaid Welcome Packets
- PASSE Website
- Brochures and Information on Medicaid Services
- Contact the Beneficiary Support Line: 833-402-0672
- How to File a Grievance
About Medicaid
What is Medicaid?
Medicaid is a state and federal program that provides health coverage to eligible Arkansans, including children (ARKids First), pregnant women, seniors, and people with disabilities. Medicaid is different from Medicare, which is for people age 65 and older or with certain disabilities.
- Read more about Medicaid here.
Eligibility Basics:
Medicaid is a health insurance program for Arkansans with lower incomes or do not have access to other health insurance programs. Be ready to provide documents and answer questions about:
- Social Security number and birth date
- Citizenship or immigration status
- Money from jobs and other sources
- The value of cars and other property
- How much you pay for bills
How to Apply for Medicaid
If you have questions about eligibility or would like help to apply, contact your local Division of County Operations Office.
To apply online use the Access Arkansas Portal – Apply or renew online
For additional information about different Medicaid programs, visit Arkansas Health Care Programs.
Understanding the PASSE Program
What is the PASSE Program?
If you are eligible for Medicaid and have certain complex behavioral health or intellectual / developmental disabilities, you may qualify to be in the PASSE program. The PASSE program is a program for Medicaid beneficiaries with certain complex behavioral health or intellectual / developmental disabilities, including those on the Community and Employment Supports (CES) waiver. PASSE organizations coordinate your care and connect you to services. Under Arkansas’ model of managed care, provider-led organizations are responsible for integrating physical health care services, behavioral health services, and specialized home and community based services (HCBS). The PASSE is responsible for building a network of providers to ensure you have access to care.
Goals of the PASSE Program:
- Coordinate care for enrolled members.
- Promote independence through the delivery of services.
- Allow individuals to access home and community-based services.
Who is Eligible for the PASSE Program?
Individuals who qualify for full range Medicaid or a qualifying Medicaid category and meet one of the following may be eligible for the PASSE Program:
- Is on the Developmental Disabilities (DD) Waiver
- Is on the DD Waiver wait list and gets Medicaid state plan services
- Lives in a private DD Intermediate Care Facility
- Has a Behavioral Health (BH) diagnosis and needs services in addition to counseling and medication management
- Has active behavioral health or developmental disabilities Independent Assessment (IA) that identifies the individual as Tier 2 or higher
Independent Assessment and the Tier Logic:
Medicaid beneficiaries may be enrolled in a PASSE if they have complex needs that require coordinated care. Eligibility is determined through the Arkansas Independent Assessment (IA), a standardized evaluation used to identify individuals who need intensive behavioral health or developmental disability services. Based on this assessment, beneficiaries are assigned a Tier level, which reflects the complexity and intensity of their needs. To qualify for PASSE enrollment, individuals must be assessed as Tier 2 or higher, indicating a higher level of need. This includes individuals with behavioral health diagnoses requiring more than basic counseling or medication management, individuals receiving services through the Community and Employment Support (CES) waiver or currently on the CES waiver waitlist, and residents of private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID). The IA ensures that only those who require comprehensive care coordination are enrolled in the PASSE program, allowing for more targeted and effective support.
Current PASSE Organizations:
There are currently 4 organizations that follow the PASSE model. If you are eligible for a PASSE, you can determine which organization you would like to manage your care. After you are enrolled in a PASSE, you can change the PASSE organization in the first 90 days of enrollment. You can also change your PASSE organization for cause or at open enrollment, which is held every October.
Learn more about PASSE.
Member Benefits
Each PASSE organization is required to provide enrolled members with medically necessary services that they are eligible for. PASSE members have access to all State Plan services and may also qualify for certain Home and Community-Based Services (HCBS). Examples of those services are listed below.
State Plan Services:
| Personal Care | Speech Therapy | Physical Therapy | Inpatient Psychiatric Services |
| Primary Care Physician | Physician Specialists | Nursing Services | Outpatient Behavioral Health Services |
| Durable Medical Equipment | Pharmacy | Family Planning | Health Counseling |
| Occupational Therapy | Hospital Services |
Home & Community-Based Services (HCBS):
| Respite | Community Transition Services | Adaptive Equipment |
| Supported Employment | Supplemental Support | Environmental Modifications |
| Supportive Living | Specialized Medical Supplies | Consultation |
| Supportive Housing | Adult Rehabilitation Day Treatment | Therapeutic Communities |
| Behavior Assistance | Child and Youth Support Services | Partial Hospitalization |
| Peer Support | Supportive Life Skills Development | Substance Abuse Detoxification |
| Family Support Partners | Mobile Crisis Intervention | Residential Community Reintegration |
| Pharmaceutical Counseling | Therapeutic Host Home | |
| Crisis Intervention | Recovery Support Partners |
Services Covered by Medicaid, but not included in PASSE services:
When you’re enrolled in a PASSE, most of your services will be coordinated and managed by your PASSE. However, there are a few services that are not managed by the PASSE. These services are listed below:
- Non-emergency transportation
- Services provided at school that are covered in an individual education plan (IEP)
- Transplants
- Transportation to and from an Early Intervention Day Treatment (EIDT) and Adult Development Day Treatment (ADDT)
- Skilled nursing facility services (Note: Limited Rehabilitation Stay is not considered an excluded skilled nursing facility service.)
- Assisted living facility services
- Full admission to a Human Development Center (HDC) (Note: Respite stays and conditional admission at HDCs are not excluded services and are covered though the PASSE.)
- Waiver services provided to the elderly and adults with physical disabilities through the ARChoices in Homecare program
- Routine vision benefits (such as eye exams and glasses)
- Routine dental benefits
Care Coordination:
Your PASSE assigns a care coordinator who helps you create a person-centered service plan (PCSP) and connects you to needed services. Each of your health care providers will contribute to the person-centered service plan and help you to meet your needs and goals.
A representative from the PASSE must contact each enrolled member within 15 business days after the effective date of enrollment. Care coordinators must keep ongoing contact with each enrolled member they work with. The care coordinator will make contact at least once monthly and must have a face-to-face meeting every quarter.
PASSE Member Resources:
- Arkansas Total Care Member Resources
- CareSource PASSE Member Resources
- Empower Healthcare Solutions Member Portal
- Summit Community Care Member Materials
Renew Medicaid Coverage:
Medicaid members must renew their coverage every year. You can renew your coverage here.
Support & Contact
PASSE Ombudsman Office:
It is the responsibility of the PASSE Ombudsman Office to ensure that compassion, respect, trust, and integrity – all core values of the Arkansas Department of Human Services – (DHS) are demonstrated in resolving issues or complaints from beneficiaries who are PASSE members. Please visit the PASSE Ombudsman website here.
How to Report Concerns
At the Arkansas Department of Human Services, we take the integrity of our programs, employees, and partners seriously. If there are problems, we want to know about them so that we can investigate and address them properly.
Fraud Hotline for suspected fraud:
Please call 1-(800)-422-6641 or email [email protected].
Child Abuse and Maltreatment Hotline for suspected neglect, abuse, or maltreatment of children:
Please call 1-800-482-5964.
TDD: 1-800-843-6349.
Adult Protective Services Hotline for suspected neglect, abuse, or maltreatment of adults:
Please call 1-800-482-8049.
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.