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016.06.36-211.000. Introduction.

AR ADC 016.06.36-211.000Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 36. Physician/Independent Lab/Crna/Radiation Therapy Center Provider Manual (Refs & Annos)
Section 210.000. Program Coverage.
Ark. Admin. Code 016.06.36-211.000
016.06.36-211.000. Introduction.
Currentness
A. The Arkansas Medicaid Program reimburses enrolled providers for the medical care of Medicaid beneficiaries.
B. Medicaid reimbursement is conditional upon providers' compliance with Program policy as stated in provider manuals, manual update transmittals and official Program correspondence.
C. All Medicaid benefits are based on medical necessity. Refer to the Glossary for a definition of medical necessity.
1. Service coverage will be denied and reimbursement recouped if a service is not medically necessary.
2. The finding of medical necessity may be made by the:
a. Medical Director for the Medicaid Program, the
b. Quality Improvement Organization (QIO)

Credits

Eff. Oct. 1, 2006.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.36-211.000, AR ADC 016.06.36-211.000
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