Arkansas - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-08-15

In Arkansas, a Personal Emergency Response System (PERS) is defined as installed or wearable electronic monitoring equipment that provides 24-hour response capabilities for Medicaid waiver participants who live alone or are at risk of falls. This service allows individuals to summon emergency assistance instantly, supporting their independence and integration within the community under programs like the ARChoices in Homecare waiver and the Community and Employment Support (CES) waiver.

The single biggest structural barrier to entry for new PERS providers in Arkansas is the mandatory managed care credentialing required for the behavioral health and intellectual/developmental disability populations. To serve CES Waiver participants, a provider cannot simply enroll in fee-for-service Medicaid; they must secure a network contract and pass credentialing with at least one of the state's Provider-Led Arkansas Shared Savings Entities (PASSEs), which act as the gatekeepers for this demographic.

1. Service Definition and Scope

Arkansas Medicaid defines PERS as an electronic device connected to a 24-hour call center that enables a participant to secure help in an emergency. The service encompasses the provision of the equipment, installation, participant instruction, and ongoing monthly monitoring.

The service is strictly limited to individuals who live alone, are alone for significant parts of the day, or have no regular caregiver for extended periods, and who possess the cognitive and physical ability to operate the device effectively.

• Covered Waivers: ARChoices in Homecare and the Community and Employment Support (CES) Waiver.
• Core Components: Device installation, participant instruction, and 24/7 call center monitoring.
• Testing Requirement: Mandatory monthly testing of the PERS unit, which must be documented by the provider.
• Service Limitations: Not covered if the participant does not live alone or lacks the cognitive ability to understand how to use the device.

2. Regulatory and Oversight Agencies

Oversight of PERS in Arkansas is divided among several divisions within the Arkansas Department of Human Services (DHS) and private managed care organizations. The Division of Medical Services (DMS) handles the overarching Medicaid state plan and provider enrollment.

The Division of Aging, Adult, and Behavioral Health Services (DAABHS) oversees the ARChoices waiver, while the PASSE organizations manage the CES waiver network and authorize specific services for their members.

• Arkansas Department of Human Services (DHS): The umbrella state agency responsible for all Medicaid and HCBS programs.
• Division of Medical Services (DMS): Administers the Medicaid program, manages the MMIS Provider Portal, and processes initial provider enrollment.
• Division of Aging, Adult, and Behavioral Health Services (DAABHS): Oversees policy and clinical eligibility for the ARChoices in Homecare waiver.
• PASSE Organizations: Managed care entities (e.g., CareSource PASSE, Summit Community Care) that credential providers and authorize PERS for CES waiver participants.

3. Gatekeeping Prerequisites: Who Can Even Apply

Arkansas does not subject PERS agencies to Certificate of Need (CON) or Facility Need Review processes. Any legally established business can apply to become a Medicaid provider if they meet the equipment and call center standards.

However, the primary structural gatekeeper is the PASSE system. While ARChoices operates on a fee-for-service model through DMS, serving the CES waiver population requires a provider to successfully navigate the closed-network credentialing process of the individual PASSEs.

• PASSE Credentialing: Mandatory network affiliation and contracting with at least one PASSE to serve CES waiver clients.
• Business Registration: Must be registered and in good standing with the Arkansas Secretary of State.
• NPI Requirement: Must obtain a National Provider Identifier (NPI) via NPPES prior to initiating the Medicaid application.
• No CON Required: Arkansas does not require a Certificate of Need or prior state need-review approval to open a PERS agency.

4. Licensure and Certification Requirements

Arkansas does not issue a distinct state license for Personal Emergency Response System providers through the Department of Health. Because it is primarily an equipment and monitoring service rather than direct hands-on care, providers are approved directly through Medicaid enrollment.

Instead of a state facility license, approval hinges on meeting the technical standards outlined in the ARChoices and CES Medicaid Provider Manuals, specifically regarding equipment safety and call center reliability.

• State Licensure: No specific state health facility license is required for PERS providers in Arkansas.
• Equipment Standards: Devices must meet Underwriters Laboratories (UL) safety standards for home healthcare signaling equipment.
• Call Center Certification: Monitoring centers must maintain UL listing or equivalent emergency response center certification to ensure 24/7 reliability.
• Out-of-State Providers: Permitted to enroll if they meet Arkansas Medicaid standards and maintain valid business licensure in their home state.

5. Medicaid Provider Enrollment

Enrollment is conducted electronically through the Arkansas Medicaid MMIS Provider Portal, operated by Gainwell Technologies. Providers must submit a complete application package that exactly matches their IRS and NPI records.

Initial provider enrollment applications require the payment of a federal application fee, and all demographic data must align perfectly to avoid automatic system rejections.

• Enrollment Portal: Arkansas Medicaid MMIS Provider Portal managed by Gainwell Technologies.
• Application Fee: $750 for Calendar Year 2026 for institutional providers, unless waived by proof of prior Medicare payment.
• Required Forms: Certified W-9 matching IRS records and an EFT Authorization with a voided bank check.
• Matching Rule: Provider name, NPI, and tax ID must match exactly across the W-9, NPPES, and the electronic enrollment application.

6. Staffing, Training and Background Checks

While PERS does not involve direct nursing or personal care, staff who enter participant homes to install devices or who respond to emergency signals must meet basic Medicaid screening and training requirements.

Providers are responsible for ensuring that all personnel are legally permitted to participate in federal healthcare programs and are competent in operating the specific PERS equipment provided.

• Background Checks: Installers entering participant homes must pass Arkansas State Police criminal background checks.
• Exclusion Screening: All staff and owners must be screened monthly against the OIG LEIE and SAM.gov databases.
• Installer Training: Staff must be trained on device installation, troubleshooting, and delivering participant instruction.
• Call Center Staff: Must be trained in emergency triage, communication protocols, and dispatching local Arkansas emergency responders.

7. Documentation, Policies and Records

Arkansas Medicaid requires strict documentation of service delivery, particularly the monthly testing of PERS units. Records must be available for audit by DMS, DAABHS, or the Medicaid Fraud Control Unit (MFCU).

Failure to maintain precise logs of equipment testing and participant consent is a primary driver of Medicaid clawbacks during post-payment reviews.

• Installation Records: Signed documentation by the participant or authorized representative verifying receipt of the PERS unit and instruction on its use.
• Testing Logs: Documented results of mandatory monthly unit tests, which must be retained by the PERS provider even if a Targeted Case Manager assists with the test.
• Maintenance Records: Logs of battery replacements, repairs, and equipment swaps.
• Record Retention: Providers must retain all Medicaid service, training, and billing records for a minimum of five years.

8. Billing, Rates and Claims

PERS is billed using specific HCPCS codes for the initial installation and the ongoing monthly monitoring. Claims for ARChoices are submitted via the MMIS portal, while CES claims are routed to the respective PASSE.

All services must be prior-authorized and reflected in the participant's Person-Centered Plan (PCP) before any equipment is installed or billed.

• HCPCS Codes: Typically billed using S5160 for initial installation and S5161 for ongoing monthly monitoring.
• Prior Authorization: Required for all PERS services, authorized by the DHS RN for ARChoices or the PASSE care coordinator for CES.
• Fee-for-Service Billing: Claims for ARChoices are submitted via Provider Electronic Solutions (PES) software or the MMIS Provider Portal.
• PASSE Billing: Claims for CES waiver participants must be submitted directly to the specific PASSE's designated clearinghouse.

9. Approval Sequence and Timeline

The approval process begins with establishing the business entity and obtaining an NPI, followed by the formal Medicaid enrollment application. The entire sequence can take 3 to 6 months depending on PASSE contracting.

Providers cannot bill for services until both the DMS Medicaid enrollment is approved and, if applicable, the PASSE network contracts are fully executed.

• Step 1: Obtain an NPI and register the business with the Arkansas Secretary of State (1 to 2 weeks).
• Step 2: Submit the Arkansas Medicaid enrollment application via the MMIS portal (30 to 60 days for DMS review).
• Step 3: Pay the $750 application fee and pass federal database verification.
• Step 4: Apply for network credentialing and contracting with Arkansas PASSEs to serve the CES population (60 to 90 days).

10. Common Denials and Survey Findings

Initial Medicaid applications are most frequently denied due to clerical mismatches between federal databases and state forms. Post-enrollment, providers face financial penalties primarily for documentation failures.

Auditors frequently target PERS providers who bill for monthly monitoring without proof that the mandatory monthly equipment test was successfully completed.

• Application Denial: Name or address mismatches between the W-9, NPI registry, and the MMIS Medicaid application.
• Audit Finding: Missing documentation of the mandatory monthly PERS unit test.
• Audit Finding: Failure to obtain the participant's signature verifying receipt of the device and training at the time of installation.
• Audit Finding: Billing for monthly monitoring when the device was disconnected, returned, or the participant was institutionalized.

11. Key Contacts and Resources

Providers should utilize the Arkansas DHS website and the MMIS portal for the most current provider manuals, official notices, and fee schedules. The PASSEs maintain their own distinct provider relations departments.

Technical issues with the enrollment portal should be directed to the Medicaid Provider Enrollment Unit operated by Gainwell Technologies.

• Arkansas DHS Division of Medical Services (DMS): Oversees Medicaid policy, provider manuals, and official notices.
• Medicaid Provider Enrollment Unit: Contact at 1-800-457-4454 for application status and MMIS technical issues.
• Gainwell Technologies: The contractor that operates the Arkansas Medicaid MMIS Provider Portal.
• Arkansas PASSEs: CareSource PASSE, Empower Healthcare Solutions, Summit Community Care, and Arkansas Total Care for CES waiver contracting.

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