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Arkansas Code Title 20. Public Health and Welfare § 20-77-1707. Prior authorizations--Retrospective reviews

Current as of March 28, 2024 | Updated by Findlaw Staff

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.

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Cite this article: FindLaw.com - Arkansas Code Title 20. Public Health and Welfare § 20-77-1707. Prior authorizations--Retrospective reviews - last updated March 28, 2024 | https://codes.findlaw.com/ar/title-20-public-health-and-welfare/ar-code-sect-20-77-1707/

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