HJAR Jan/Feb 2023

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2023 45 Nell Smith Assistant Director Division of Medical Services have to pay, for every three-month period during the year. That cap is based on the client’s family’s income and where it falls within the Federal Poverty Level guidelines, so it is specific to the clients and their circumstances. Once the client’s family reaches that cap, they will not have to pay any more copays that period. At the end of the quarter, the clients start pay- ing copays again. There are different cap amounts based on a client’s income: • 20%-40% FPL = $27 per quarter. • 40%-60% FPL = $54 per quarter. • 60%-80% FPL = $81 per quarter. • 80%-100% FPL = $108 per quarter. • 100%-120% FPL = $135 per quarter. • 120%-138% FPL = $163 per quarter. These caps are calculated based on the household income, so if a client has a fam- ily member who also must pay copays, that family member’s copays will also count to- ward the quarterly cap. Arkansas Medicaid will send clients a letter telling them when they reach their cap. Arkansas Medicaid believes that a healthy Arkansas is a thrivingArkansas. These chang- es are designed to strike a fair balance be- tween clients’ investment in their health and well-being and a good faith effort byArkan- sas Medicaid to limit the financial impact on Arkansas families. To learn more about Medicaid cost sharing in Arkansas, please visit humanservices.arkansas.gov. n Nell Smith has two master’s degrees — one in journalism and the other in public health. She combined those interests at the start of her career, working as a journalist covering healthcare for newspapers in Illinois andArkansas.She then worked as a researcher and administrator for the policy analysis and research section of theArkansas Bureau of Legislative Research,which serves as non-partisan staff for the Arkansas General Assembly. She has worked at theArkansas Department of Health and now atArkansas DHS.She’s excited to be part of ensuring all Arkansans have access to quality healthcare. medications will be $4.70, and specialty drugs will be $9.40. There will be no costs to clients for some services such as preventive care and emergency services. Certain groups of people will not have a copay for any service, regardless of their in- come or situation: • People of American Indian or Alaska Native descent. • Individuals ages 19-20 years. • PASSE enrollees. • Individuals in hospice. • Pregnant women. • Individuals under 20% Federal Poverty Level (FPL). • Medically frail individuals. If clients do not fall into any of those groups, they will have copays going forward. Clients will receive a letter that tells them if they will have copays. COPAY LIMITS Arkansas Medicaid has put a system in place to help limit these costs. There will be a quarterly “cap,” or a limit to what clients