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The AHCCCS program is governed by Arizona statutes and
rules, federal statutes and rules, and two written
agreements with the federal government called the State Plan
and the Waiver.
Arizona Revised Statutes ("A.R.S.") that
apply to the AHCCCS program can be found at Title 36,
Chapter 29. Click on this link to go to an on-line version
of the Arizona Revised Statutes.
The Arizona Administrative Code ("A.A.C.")
is the collection of formal rules that Arizona State
agencies publish about the programs that they run. The state
rules about AHCCCS are found in Title 9 of the Arizona
Administrative Code, Chapters 22, 28, 29, 30, 31, and 34.
Click on this link to go to an on-line version of the
Arizona Administrative Code.
For rules that have been
finalized but not yet published in the A.A.C., please refer
to the Final Rules page.
For rule changes that are in process please refer to the Regulatory Agenda and the
Proposed Rules. Please view public Comments/AHCCCS Responses within the Proposed Rules
page by topic.
The United States Code ("U.S.C.") that
apply to the Medicaid program can be found at Title 42,
Subchapter XIX (Medical Assistance) and
Subchapter XXI (State Children's Health Insurance Program or
"KidsCare" as called in Arizona). Click on one of the
links to go to an on-line version of these parts of the
United States Code. The Code of Federal Regulations ("C.F.R.")
is the collection of formal regulations that federal
agencies publish regarding the programs they run. The
federal regulations about the
Medical Assistance (Medicaid) program are found at
42 Part 430 through 456. The federal regulations about the
SCHIP (KidsCare) program are found at Title 42 Part 457.
Click on one of the links to go to an on-line version of
these parts of the United States Code.
Arizona has a Waiver granted by the federal
government. As a result, it does not have to follow certain
federal statutes and regulations. However, AHCCCS must run
its program under Special Terms and Conditions required by
the federal government. A
list of those federal statutes and regulations and the
Special Terms and Conditions can be found by clicking on
Arizona State Plan for the
Federal Medicaid program can
be viewed on this site. The federal government has approved a
amendments to the State Plan, and they can be viewed on
this site. The
Arizona State Plan for the State Children's Health Insurance
Program (KidsCare) can be viewed on this site.
AHCCCS Medical Policy
Manual (AMPM) documents the medical and program
policies and requirements implemented by the AHCCCS
Administration for Contractors and fee-for-service providers
of these covered services. The manual provides information
regarding covered health care services for Arizona residents
who are eligible for AHCCCS services. Members who are
eligible for emergency services only receive those services
through the Federal Emergency Services Program. This manual
also provides information regarding behavioral health
Notice of Action Policy
and Guide is provided to the AHCCCS Health Plans to help
them write Notice of Action letters to members. Notice
of Action letters are written when a Health Plan does not
approve a service or stops a service that a member has been
getting. The guide explains when a letter should be
written and what should be in it.