Lawmakers fast-track review of Optum assessments after hundreds of Arkansas Medicaid beneficiaries lose services

Mark White, deputy director for the Division of Aging, Adult and Behavioral Health Services at the Arkansas Department of Human Services, told the Senate Children and Youth Committee that Arkansas began using the Arkansas Independent Assessment (ARIA) this year under a contract with Optum Healthcare Solutions. White said ARIA returns a tiered level of care used to determine eligibility for the Living Choices Medicaid 1915(c) waiver and related home‑and‑community‑based services.

White said the state saw a sharp increase in beneficiaries found ineligible after Optum began administering ARIA: about 44% of assisted‑living reassessments and roughly 31% of AR Choices reassessments were initially found ineligible. DHS identified 776 assessments for a quality re‑review (551 AR Choices and 225 Living Choices); as of White’s report the agency had re‑reviewed 287 of those and was conducting a systematic nurse‑led quality review intended to catch obvious errors and reinstate eligibility where appropriate.

"We began working on it, trying to address it, identify the cause, and also make sure that we made improvements that we needed to make," White said,…