Ark. Code Ann. § 20-77-1707: Prior authorizations - Retrospective reviews

If the Department of Human Services requires a provider to justify the medical necessity of a service through prior authorization, the department shall not later take the position that the services were not medically necessary, unless the retrospective review establishes that:

(1) The previous authorization was based upon misrepresentation by act or omission;

(2) The services billed were not provided; or

(3) An unexpected change occurred that rendered the prior-authorized care not medically necessary.