MedicaidAdministrativeMedium impact
Additional Medicaid Utilization Management Program (MUMP) Days Submitted on a Reconsideration Request
Arkansas Medicaid·AR·Provider Notice
Effective date
Aug 14, 2026
We identified it
Aug 15, 2026
Summary
Arkansas Medicaid clarifies the process for requesting review of additional hospital days beyond an initial adverse utilization management determination. Providers must submit a separate written request identifying additional dates of service along with the reconsideration request and complete medical records, or those dates will not be reviewed. If additional dates are denied, providers must appeal rather than request further reconsideration.
Action Required
Effective immediately: Billing and prior authorization teams must update reconsideration request procedures for all Arkansas Medicaid hospital claims. When submitting a reconsideration request that includes additional days of service not covered in the initial determination, submit a separate written request identifying those specific dates along with complete medical records covering those dates. Failure to submit a separate written request will result in AFMC refusing to review the additional days. If additional dates are denied after reconsideration, direct providers to file an appeal per Section 212.504 rather than attempt further reconsideration. Update internal workflows and provider communication templates to reflect this requirement. Train billing staff on the distinction between reconsideration scope (limited to original dates unless separate request submitted) and extension requests (which may be used if initial determination is fully overturned but no separate request was submitted).