HJAR Jul/Aug 2021

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2021 31 who need more than three prescriptions per month to get those additional prescriptions without the provider having to seek an exten- sion of benefits (EOB). Generally, Arkansas Medicaid approves any EOB request that meets the criteria established for the drug. The increase to six slots will allow adult Med- icaid clients to access needed medications without the extra procedural step of obtain- ing an EOB. Additionally, Act 758 creates an exemption for maintenance medications that are used to treat high blood pressure, high cholesterol, blood disorders, diabetes, or respiratory illness. This exemption means that these maintenance prescriptions will not count against the individual’s six prescription per month limit. Under EPSDT, children age 20 or younger have no limits on the number of prescriptions they can receive per month. This new Act brings the adult drug benefit more in line with the drug benefit for chil- dren on Medicaid. Act 758 requires this new benefit to be in place by January 1, 2022, and Arkansas Medicaid is on track to meet that deadline. Laboratory and X-ray benefits The Legislature also passedAct 891 in the 2021 Session, which increases the laborato- ry and X-ray benefit for adults on Arkansas Medicaid. Traditionally, adults on Medicaid have had a $500 per year limit on lab and X-ray services combined. According tomany Arkansas physicians, this often meant that a Medicaid client could not receive all preven- tative and diagnostic tests needed to provide comprehensive care. Arkansas Medicaid worked with the Legis- lature and underAct 891, Medicaid clients will now have an annual $500 limit for laboratory Elizabeth Pitman Director Division of Medical Services Arkansas Medicaid services and an annual $500 limit for X-ray services, separately. Additionally, the Legis- lature authorizedMedicaid to exempt certain “essential health benefits”from the laboratory and X-ray benefit limit through rule making. Medicaid is looking to the recommendations of the United States Preventative Services Task Force (USPSTF) to create this list. The final list will be promulgated by the statutory deadline of June 1, 2022, and will include such tests as colorectal screening, mammograms, blood pressure and cholesterol screenings. More changes In addition to these more targeted mea- sures, Arkansas Medicaid will be increasing the number of visits to a PCP from 12 per year to 16, thereby increasing Medicaid cli- ents’ access to primary care services and al- lowing them to utilize the expanded benefits described above. Everyone here at the Division of Medical Services is excited about these upcoming changes in the Medicaid program that will increase access to primary care for our adult clients. Over the next year, many new rules will be put out for public comment, andmany new system changes will be implemented. We will be looking to providers to give us feedback on how these new policies and procedures are working to make it easier for Medicaid clients to receive primary care. n SOURCES Center for Medicare and Medicaid Services. (2014, June). EPSDT — A Guide for States: Coverage in the Medicaid Benefit for Children and Adoles- cents. U.S. Department of Health and Human Ser- vices. Retrieved from https://www.medicaid.gov/ sites/default/files/2019-12/epsdt_coverage_guide. pdf Hutchinson, A. (2020, March). Executive Or- der 20–05. State of Arkansas. Retrieved from https://governor.arkansas.gov/images/uploads/ executiveOrders/EO_20-05.pdf Act 829 of the 2021 General Assembly (2021). Retrieved from https://www.arkleg.state.ar.us/ Acts/FTPDocument?path=%2FACTS%2F2021R% 2FPublic%2F&file=829.pdf&ddBienniumSession= 2021%2F2021R Elizabeth Pitman is the director of the Division of Medical Services. She graduated with a joint law degree and master’s in public health in 2009. After spending a brief time in private practice, she worked as an attorney for Child Welfare Services and Adult Protective Services with the Department of Human Services (DHS). Since 2013, she has spent her career working in policy development with both the Arkansas Department of Health and DHS. Elizabeth’s passion and goal is tomake policy that actually works for Arkansans.