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State’s Public Notice and Input Processes for 1115 Demonstration Waiver Project Applications/Renewals/
Amendments

In accordance with federal and state law, the Division of Medical Services (DMS) of the Arkansas Department of Human Services (DHS) must notify the public of its intent to submit to the Centers for Medicare and Medicaid Services (CMS) any new 1115 demonstration waiver project or extension renewal or amendment to any previously approved demonstration waiver project [i.e., ARKids First-B, HIFA, TEFRA, Women’s Health (family planning)] and must make available at least a 30-day public comment period at minimum 30 days prior to submitting to CMS the new 1115 demonstration waiver project or extension renewal or amendment.

Public notices, including the description of the new 1115 Demonstration Waiver project or, extension renewal or amendment to an existing demonstration waiver project to be submitted to CMS, will be posted here along with links to the full public notice and the application/extension/amendment document to be submitted to CMS.

The full public notices will include

  • the address, telephone number and internet address where copies of the new demonstration waiver project or extension or amendment document is available for public review and comment,
  • the postal address where written comments can be sent,
  • the minimum 30-day time period in which comments will be accepted,
  • the locations, dates and times of at least two public hearings convened by the State to seek input, (At least one of the two required public hearings will use telephonic and/or Web conference capabilities to ensure statewide accessibility to the public hearing.)
  • and a link to the CMS website to access comments (HTML, new window) received by CMS during their 30-day public comment period after the application/extension/amendment has been submitted to CMS.

Comments may be provided during scheduled public hearings or in writing during the public comment period. To submit comments, write to

Division of Medical Services
Program Development and Quality Assurance
P.O. Box 1437 (Slot S295)
Little Rock, Arkansas 72203-1437

Locations, dates and times for public hearings will be published below after scheduling is finalized.

If you need this material in an alternative format, such as large print, please contact the Program Development and Quality Assurance Unit at 501-320-6429.

Proposed Amendment to Health Care Independence (aka Private Option) 1115 Waiver
Health Care Independence [HCIW] (aka Private Option) 1115 waiver
CHIP State Plan Amendment to Transition ARKids-B to a CHIP Separate Child Health Program

Proposed Amendment to Health Care Independence (aka Private Option) 1115 Waiver

Updated 8/13/14
The Arkansas Department of Human Services (DHS), Division of Medical Services (DMS) is providing public notice of its intent to submit to the Centers of Medicare and Medicaid Services (CMS) a written request to amend the Health Care Independence 1115 Demonstration Waiver and to hold public hearings to receive comments on the amendments to the Demonstration.

View or print the public notice. (PDF, new window)

View or print the public hearing presentation. (PDF, new window)

Location of Public Hearing File Name File Size
Little Rock LRTranscript080714.pdf 3.4MB
Pine Bluff PBTranscript080814.pdf 3.3MB

View or print the proposed amendment to 1115 Waiver special terms and conditions. (PDF, new window)

Health Care Independence [HCIW] (aka Private Option) 1115 Waiver

The Arkansas Department of Human Services (DHS), Division of Medical Services (DMS) is providing public notice of its intent to submit to the Centers of Medicare and Medicaid Services (CMS) a written application to request approval of a Health Care Independence 1115 Demonstration Waiver and to hold public hearings to receive comments on this Demonstration.

To implement the Arkansas Health Care Independence Act, the State will use premium assistance to purchase qualified health plans (QHPs) offered in the individual market through the Marketplace for individuals eligible for expanded coverage under Title XIX of the Social Security Act who are either (1) childless adults between the ages of 19 and 65 with incomes below 138% of the federal poverty level (FPL) who are not enrolled in Medicare or (2) parents between the ages of 19 and 65 with incomes between 17 and 138% FPL who are not enrolled in Medicare (collectively “Private Option beneficiaries”). Individuals in two groups—(1) those who are medically frail or (2) other individuals with exceptional medical needs for whom coverage through the Marketplace is determined to be impractical, overly complex, or would undermine continuity or effectiveness of care—will not participate in the Demonstration.

Private Option beneficiaries will receive the Alternative Benefit Plan (ABP) through a QHP that they select and have cost sharing obligations consistent with both the State Plan and with the cost-sharing rules applicable to individuals with comparable incomes in the Marketplace.

The Demonstration will further the objectives of Title XIX by promoting continuity of coverage for individuals (and in the longer run, families), improving access to providers, smoothing the “seams” across the continuum of coverage, and furthering quality improvement and delivery system reform initiatives. Ultimately, the Demonstration will provide truly integrated coverage for low-income Arkansans, leveraging the efficiencies of the private market to improve continuity, access, and quality for Private Option beneficiaries. Additionally, by nearly doubling the size of the population enrolling in QHPs offered through the Marketplace, the Demonstration is expected to drive health care system reform and more competitive premium pricing for all individuals purchasing coverage through the Marketplace.

The Demonstration will be statewide and will operate during calendar years 2014, 2015, and 2016. The State anticipates that approximately 225,000 individuals will be eligible for the Demonstration. The State expects that, over the life of the Demonstration, covering Private Option beneficiaries will be comparable to what the costs would have been for covering the same group of Arkansas adults using traditional Medicaid.

The Demonstration will test hypotheses related to provider access, churning, emergency room use, cost-comparability, usage of Medicaid wrap benefits, quality improvement, preventive services, and uncompensated care costs.

Public comments may be submitted until midnight on July 24, 2013. Comments may be submitted by e-mail to hciw@arkansas.gov.

Document Deadline for Submitting Written Comments File Name File Size Comments, Responses, and Changes to Demonstration Waiver Application File Size
Health Care Independence [HCIW] (aka Private Option) 1115 Waiver – INITIAL DRAFT 7/24/13 InitialHCIWApp.doc 186k View comments regarding the HCIW Application. 10MB
Health Care Independence [HCIW] (aka Private Option) 1115 Waiver – FINAL FinalHCIWApp.pdf 1MB View summary of responses regarding the final HCIW Application. 598k
Arkansas Health Care Independence Program (“Private Option”) Proposed Evaluation for Section 1115 Demonstration Waiver –- FINAL HCIWEvalStrategy.pdf 678k

Post-Award Forum for Arkansas Health Care Independence (aka Private Option) Program

Added 7/11/14
On Friday, June 13, the Arkansas Department of Human Services (DHS) held a Post-Award Forum to provide the public with an opportunity to offer comment on the progress of the Arkansas Health Care Independence Program (commonly known as the Private Option). DHS received a total of 38 comments. These comments reflect the positive impact the Private Option Demonstration has had on individual Arkansans, hospitals and medical providers.

Read the comments and review the Post-Award Forum transcript. (PDF, new window)

Public Hearing Transcripts for Health Care Independence [HCIW] (aka Private Option) 1115 Waiver

View the public hearing presentation by Dr. Andy Allison (PDF, new window) for the proposed 1115 Health Care Independence Waiver (Private Option).

Location of Public Hearing File Name File Size
Little Rock LRTranscript060213.pdf 289k
Fort Smith FSTranscript060813.pdf 337k
Monticello MOTranscript060913.pdf 380k

CHIP State Plan Amendment to Transition ARKids-B to a CHIP Separate Child Health Program

The Arkansas Department of Human Services, Division of Medical Services is providing public notice of its intent to submit to CMS a CHIP State Plan amendment to transition the ARKids First-B program from an 1115(a) demonstration waiver to a CHIP separate child health program, to add additional services to the ARKids First-B benefit package, and to provide notice of a public input hearing.

The ARKids First-B program provides coverage for uninsured children through age 18. ARKids First-B offers a less comprehensive benefit package than the State’s traditional Medicaid program, which is referred to as ARKids First-A, and requires co-payments. The ARKids First-B program utilizes the same provider system as ARKids First-A and operates under a primary care case management model. The objectives of the ARKids First-B program are to integrate uninsured children into the health care delivery system and to provide a limited benefit package comparable to State’s Essential Benefit Plan-equivalent coverage.

On October 6, 2014 from 1:30 p.m. – 2:30 p.m., the Arkansas Department of Human Services, Division of Medical Services will hold a public hearing in Conference Room B on the first floor of the Donaghey Plaza South Building, 700 South Main Street in Little Rock, Arkansas. The purpose of this hearing is to accept public comments on the CHIP state plan amendment document to transition the ARKids First-B program to a CHIP separate child health program and the update to the ARKids First-B Medicaid provider manual to reflect this transition and addition of four services to the ARKids First-B limited benefit package.

You may view ARKids First-B annual report files on this website.

Document Deadline for Submitting Written Comments File Name File Size Comments, Responses, and Changes to Demonstration Waiver Application File Size
CHIP State Plan Amendment to Transition ARKids-B 10/7/14 ARKids-B_SPA_CHIPTransition.doc 581k
ARKids-B Proposed Manual Update 10/7/14 ARKids-BUpdate_Revised Manual_CHIP_Transition.doc 147k