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MEDICAL SERVICES POLICY MANUAL,SECTION A

A 100 General Program Information

A-100 General Program Information

MS Manual 01/01/23 The Health Care Program (Medicaid) is a Federal-State Program designed to meet the financial expenseof medical services for eligible individuals in Arkansas. The Department of Human Services (DHS), Division of County Operations (DCO) and Medical Services have the responsibility for administration of the Health Care Program. The purpose of Medical Services is to provide medical assistance to low income individuals and families and to insure proper utilization of such services. DCO will accept all applications, verification documents, and make eligibility determinations. Benefits for the Arkansas Medicaid and ARKids Programs include: • Emergency Services; • HomeHealth and Hospice; • Hospitalization; • Long Term Care; • Physician Services; • Prescription Drugs; and • Transportation-(Refer to Appendix B for a description of Transportation Services). Generally, there is no limit on benefits to individuals under twenty-one (21) years of age who are enrolled in the Child Health Services Program (EPSDT). There may be benefit limits to individuals over twenty-one (21) years of age. The Adult Expansion Groupcoverage for most individuals will be provided through a private insurance plan, this is, a Qualified Health Plan (QHP). QHP coverage will include: • Outpatient Services; • Emergency Services; • Hospitalization; • Maternity and Newborn Care; • Mental Health and Substance Abuse;