•Arizona Section 1115 Demonstration Project Waiver
•Governor Brewer's Medicaid Reform Package
•Medicare Part B Premiums
•Planning Begins for Specialty RBHA with SMI Health Home
•ALTCS RFP Award Announcement
•Childless Adult Freeze to Begin July 8
•Outpatient Rebase
•AHCCCS Update Regarding Health Care Reform
•KidsCare Wait List
Looking for a previous story? Information previously located on this page has been placed in either the State Legislative Budget Activities pages or the Federal Activities page.
Note: Information provided in PDF files, unless otherwise noted.
--------------------------------------------------------------------------------
Arizona Section 1115 Demonstration Project Waiver
Thurs Oct 13, 2011
Arizona's current 1115 Waiver was previously extended until October 14, 2011. The Waiver will be further extended to provide CMS with additional time to finalize the approval process. All current authorities and terms of the existing 1115 Waiver will be in place until the new 1115 Waiver is approved by CMS. AHCCCS will continue to work with CMS to transition to the new 1115 Waiver Demonstration. More information is provided below.
Waiver Extension #2
Fri Oct 7, 2011
On October 7, 2011, CMS sent AHCCCS a letter summarizing the status of the Waiver negotiations and outlining the various proposals in the Governor's Medicaid Reform Plan. This letter should only serve as an update on CMS's review of the authorities requested and should not be interpreted as a formal approval or disapproval of the final Waiver agreement.
CMS Letter
Fri Sept 30, 2011
Arizona's current 1115 Waiver will be extended until October 14, 2011. All current authorities and terms of the exisiting 1115 Waiver will be in place until the new 1115 Waiver is approved by CMS. AHCCCS will continue to work with CMS to transition to the new 1115 Waiver Demonstration. More information is provided below.
Waiver Extension
Governor Brewer's Medicaid Reform Package
Fri Sep 30, 2011
The tracking document below has information about the implementation status of Arizona’s Medicaid Reform plan. Continue to check the website for updates to the document.
Tracking AZ's Medicaid Reform Plan, 9/30/2011 [57KB]
Wed Mar 16, 2011
On March 15, 2011, Governor Brewer presented her plan to preserve Arizona's Medicaid program with reforms that will drive down costs by an estimated $500 million in the State's General Fund for the partial first year. The plan was approved by the Legislature as part of the FY 2012 budget adoption and is subject to federal approval.
Medicaid Reform Plan [81KB]
1.AHCCCS October 1, 2011 Rate Reductions
Wed. October 19, 2011
AHCCCS is providing information on the status of the October 1, 2011, rate reductions. Click on the link for additional information and continue to check the AHCCCS website for updates.
AHCCCS Rate Update [10KB]
Tues. May 24, 2011
Laws 2011, Chapter 31, gives AHCCCS authority to reduce rates for all providers up to 5%. Effective October 1, 2011, AHCCCS will reduce all provider reimbursements by 5%, including all payment ratios utilized for provider reimbursement (e.g., all Cost-to-Charge Ratios (CCRs), By Report Percentages (BR), etc.). The only exceptions are for:
•Drugs administered in a physician's office
•Hospice rates - AHCCCS matches Medicare rates as required by Federal law.
•Payments for services provided by the Indian Health Service or Tribal 638 facilities claimed at 100% FMAP.
For more detail regarding the Provider Rate Reductions, please click on the links provided below:
Outlier Proposed Rule [68KB]
State Plan Amendments
Access to Care Studies, Memos and Additional Information
AHCCCS Comments on CMS Access to Care Proposed Rule
Notice of Public Information
Materials from Hospital Meeting 8/15 [166KB]
DDD Provider Meeting 9/9* [60KB]
Info for DDD Families [20KB]
Additional information, such as the Notice of Exempt Proposed Rulemaking and State Plan Amendment to CMS will be posted on the web as it becomes available.
*AHCCCS met with a small group representing providers of services to AHCCCS members enrolled in the Division of Developmental Disabilities (DDD) to learn more about their concerns regarding rate reductions. This presentation was shared with the group.
2.
AHCCCS Integration
Mon Sept 26, 2011
As part of Arizona's Medicaid Reform Plan, AHCCCS is reviewing opportunities to further integrate care. The link below has more information.
AHCCCS Integration Page
3.2011 Benefit Changes
Fri. Jul 22, 2011
As part of Arizona's Medicaid Reform Plan, AHCCCS will be making changes to the benefit package, effective October 1, 2011, unless otherwise indicated. More information is provided below.
2011 Benefits
4.Reduction in Respite Hours
Wed. Jul 20, 2011
In an effort to preserve Arizona's Medicaid program to the greatest extent possible while achieving necessary program savings, effective October 1, 2011, the number of respite hours for adults and children receiving ALTCS Services and/or Behavioral Health Services will be reduced from 720 to 600 hours per contract year. See the link below for additional information.
Respite Information [13KB]
Respite Changes FAQs [15KB]
5.Childless Adult Phase Out Plan
Fri. Jul 1, 2011
Pursuant to the flexibilities outlined in Secretary Sebelius’ letter, Governor Brewer’s Medicaid Reform Package phases out the current Childless Adult program. A Phase Out Plan was first submitted to CMS on April 11, 2011 and was approved by CMS on July 1, 2011. AHCCCS eligibility systems will stop screening for the Childless Adult eligibility category beginning July 8, 2011.
Childless Adult Phase Out Plan
6.
Community Forums
Wed May 18, 2011
AHCCCS will hold a number of public meetings over the next few months to provide updates on various aspects of Arizona’s Medicaid Reform Plan. Specific information is provided in the link below.
Community Forums
7.Medical Expense Deduction (MED) Phase Out
Wed Mar 16, 2011
Pursuant to the flexibilities outlined in Secretary Sebelius’ letter, Governor Brewer’s Medicaid Reform Package includes the phase out of the MED program. A phase out plan was submitted to CMS on March 16, 2011 and the final version was approved by CMS on April 29, 2011. More information is provided below.
Medical Expense Deduction (MED) Phase Out
8.Revised Waiver Proposal
Thurs Mar 31, 2011
On March 31, 2011, AHCCCS submitted a revised Waiver Demonstration proposal to CMS incorporating provisions of the Governor's Medicaid Reform Plan. Waivers from various federal requirements are needed for flexibilities that will allow the State to manage its Medicaid program within budgetary constraints. The links below have more information including the proposal, how to submit comments about the proposal and public hearings about the proposal.
Waiver Information
Estimated Impact Data [17KB]
Public Meeting Notice
Tues Mar 15, 2011
In response to a number of requests, AHCCCS is providing details related to the medical utilization and costs of the expansion groups- including Waiver and Proposition 204 populations.
Summary
Data Narrative and Detail
9.Transplant Restoration Update
Wed April 6, 2011
Governor Brewer’s Medicaid Reform Plan restores the transplants AHCCCS previously covered for adult members age 21 and older, effective April 1, 2011. See the link below for additional information:
Transplant Restoration Update[81KB]
Medicare Part B Premiums
Mon Jul 18, 2011
Update on Medicare Part B Premiums
Based on preliminary discussions with CMS and flexibilities under the 1115 Waiver, AHCCCS is hopeful that it will continue to provide coverage for the cost of Part B premiums after October 1, 2011. Continue to check the website for updates as they become available.
Thur Jul 7, 2011
Effective October 1, 2011, AHCCCS will no longer cover Medicare Part B Premiums for approximately 10,000 ALTCS members.
As a result of an OIG audit and CMS decision, payment of the Medicare Part B premium for approximately 10,000 ALTCS members whose income exceeds 120% of the Federal Poverty Level (FPL) will be terminated by AHCCCS and will become the member’s responsibility effective October 1, 2011. See the link below for more information.
Medicare Part B Premiums
Planning Begins for Specialty RBHA with SMI Health Home
Fri Jul 15, 2011
In March 2011, AHCCCS and ADHS/DBHS applied for, and were awarded, a planning grant to explore the feasibility of a specialty Regional Behavioral Health Authority (RBHA) model with expanded responsibility for Title XIX eligible adults determined to have a Serious Mental Illness (SMI). The "Specialty RBHA with SMI Health Homes" model would be funded and fully responsible for coordinated and integrated behavioral healthcare and physical healthcare for Title XIX eligible adults with SMI through the use of SMI health homes.
The ADHS/DBHS website provides additional information on the Specialty RBHA concept, along with background information on integration of care, and how consumers and stakeholders can participate. AHCCCS will also post updates as information becomes available.
ALTCS RFP Award Announcement
Tues June 14, 2011
On June 14, 2011, Mercy Care plan was awarded a contract for Pima county. Please see the link below for updated information:
Updated ALTCS Award Announcement [34KB]
Thurs May 13, 2011
On May 5, 2011, AHCCCS awarded managed care program contracts to provide long term care services to Arizonans enrolled in the Arizona Long Term Care System (ALTCS). On May 12, 2011, AHCCCS awarded an additional capped contract. The contracts begin October 1, 2011, and are in place for up to a five year period. Please see the link below for updated information.
ALTCS Award Announcement [44KB]
Mon Jan 31, 2011
The AHCCCS Long Term Care Request for Proposal and Bidder's Library is now available. Use the link below for more information.
YH12-0001 RFP and Bidder's Library
Outpatient Rebase
Mon June 06, 2011
Every five years, the fee schedule and the state-wide cost-to-charge ratio are “rebased” using more current Medicare cost data. A number of other refinements are needed to ensure proper cost containment and provide more equitable compensation among hospitals. More information can be found here:
Proposed Rule [41KB]
AHCCCS Update Regarding Health Care Reform
1.AHCCCS Activities
Fri Dec 16, 2010
Information regarding AHCCCS implementation of some of the Medicaid provisions of the Patient Protection and Affordable Care Act (ACA) is provided below. This document will be updated regularly as information becomes available.
AHCCCS Activities- 5/13/11 [45KB]
For additional information about the ACA, please visit the Federal Activities page.
2.Incentives for Prevention of Chronic Disease
Fri May 13, 2011
On May 11, 2011, AHCCCS submitted its proposal for the Medicaid Incentives Prevention of Chronic Diseases grant opportunity.
Proposal
Thurs Mar 31, 2011
AHCCCS is reviewing and accepting comments for the Medicaid Incentives for Prevention of Chronic Diseases Program grant opportunity as part of an overall effort to reform the Medicaid program for Arizona.
3.Health Homes for Enrollees with Chronic Conditions
Wed March 23, 2011
On March 29, 2001, CMS approved Arizona's planning request for the funding opportunity provided under Section 2703 of the Affordable Care Act- "Health Homes for Enrollees with Chronic Conditions."
AZ Planning Request
KidsCare Wait List
Mon Sept 19, 2011
There were 120,483 applicants on the KidsCare waiting list as of September 15, 2011. Please note, this number does not mean all individuals on the waiting list are actually eligible for KidsCare. AHCCCS has recently updated the list to remove duplicate applications, children who have turned 19 and would no longer qualify for Kidscare, and individuals currently eligible under other AHCCCS programs . Typically, 30% of all applicants are denied for the KidsCare program. However, this percentage will become less precise as more time goes by, since the applications on the waiting list will be older and circumstances for those applicants change. Thus, there is no good way to predict how many of the applicants on the waiting list might be eligible for KidsCare. Regardless, AHCCCS will continue to update the waiting list number at the end of each month.
Fri Dec 29, 2010
AHCCCS continues to work with CMS on issues related to the KidsCare program, including the impact of the Enrollment freeze. For additional information about the Enrollment cap, visit:
KidsCare Enrollment Cap
Information about denial and discontinuance activity in the KidsCare program can be found at:
KidsCare Activity
http://www.azahcccs.gov/Default.aspx
