MedicaidPrior AuthHigh impact
Prior Authorization Changes for Inpatient Stay
Arkansas Medicaid·AR·Prior Authorization
Effective date
Sep 1, 2026
We identified it
Aug 27, 2026
Summary
Arkansas Medicaid has extended the inpatient prior authorization threshold from 5 days to 7 days, effective September 1, 2026. Hospitals now do not require prior authorization for inpatient stays of 7 days or less; authorization is only required beginning on day 8 and beyond. Critical Access Hospitals and Rehabilitation Hospitals maintain their existing separate thresholds (4 days and 10 days, respectively).
Action Required
By August 31, 2026: Billing team must update all billing system rules and prior authorization workflows to reflect the new 7-day threshold for standard hospitals. (1) Modify billing software to NOT require prior authorization for inpatient admissions on days 1-7. (2) Configure system to automatically trigger prior authorization requests beginning on day 8 for any inpatient stay exceeding 7 days. (3) Update internal documentation and billing protocols to reflect the change from the previous 5-day threshold. (4) Ensure Critical Access Hospital admissions continue to require prior auth after 4 days (96 hours) and Rehabilitation Hospital admissions after 10 days—these thresholds have NOT changed. (5) For transferred patients, ensure prior authorization certification continues under the receiving hospital provider per existing transfer policy. (6) Train billing staff on the new thresholds and verify understanding before the September 1 effective date. Failure to implement these changes will result in incorrect claim denials for days 5-7 inpatient stays that should not require prior authorization.