Reconsiderations and Appeals - Arkansas
Reconsiderations and Appeals
For Provider Reconsiderations:
A provider may request an administrative reconsideration within 30 calendar days. Requests for reconsideration should be faxed to (501)683-4124 Attn: Medicaid Pharmacy Program. For more information, please consult §160.000 of the program manual. Only one reconsideration request is permitted.
For Provider and Beneficiary Appeals:
If you disagree with our decision, you may ask for an appeal hearing from the Office of Appeals and Hearings. To ask for a hearing you must send your request in writing within 30 calendar days to the Office of Appeals and Hearings, P.O. Box 1437, Slot N401, Little Rock, AR 72203-1437. You must enclose a copy of the denial letter and a copy of the envelope containing the denial letter or enclose a copy of the denial letter showing the facsimile transmission confirmation with your request. If you do not include those copies, your appeal will be delayed. All deadlines run from the next business day after the date of the postmark on the envelope containing this letter or the next business day after the date on the facsimile transmission confirmation. All appeals shall conform to the Arkansas Administrative Procedure Act, Ark. Code Ann. §§ 25-15-201 – 25-15-218. Providers may appear in person, through a corporate representative or, with prior notice to the department, through legal counsel. Beneficiaries may represent themselves or they may be represented by a friend, by any other spokesperson except a corporation, or by legal counsel. A Medicaid beneficiary may attend any hearing related to his or her care, but the department may not make his or her participation a requirement for provider appeals. The department may compel the beneficiary’s presence via subpoena, but failure of the beneficiary to appear shall not preclude the provider’s appeal. If an administrative appeal is filed by both a provider and beneficiary concerning the same subject matter, the department may consolidate the appeals. Any person who considers himself or herself injured in his or her person, business, or property by the decision rendered in the administrative appeal is entitled to judicial review of the decision under the Arkansas Administrative Procedure Act, Ark. Code Ann. §§ 25-15-201 – 25-15-218. For more information, please consult §160.000 of the program manual.
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