State Plan

The State Plan is a comprehensive written contract between AHCCCS and the Centers for Medicare and Medicaid Services (CMS) that describes the nature and scope of its Medicaid program. Arizona has a State Plan for Medicaid and a State Plan for the Children's Health Insurance Program (KidsCare).

The following information is provided:


Purpose of the State Plan

The State Plan assures that Arizona will administer the Medicaid and Children's Health Insurance Program (KidsCare) programs according to federal requirements under the provisions of the Social Security Act and provides a basis for Federal Financial Participation (FFP). The Centers for Medicare and Medicaid (CMS) has the responsibility for approval of amendments to the State Plan at the federal level.

 

AHCCCS Responsibility

AHCCCS is Arizona's state agency with the responsibility for the State Plan. AHCCCS submits amendments to reflect changes in federal law, regulation, policy, or court decisions. The methods used for determining eligibility for AHCCCS programs or coverage groups may be modified by Arizona's waiver or by its State Plan for Medicaid or its State Plan for the Children's Health Insurance Program (KidsCare).

 

State Plan for Medicaid

Arizona's Medicaid plan is composed of seven sections:

  • Single State Agency Organization
  • Coverage and Eligibility
  • Services: General Provisions
  • General Program Administration
  • Personnel Administration
  • Financial Administration
  • General Provisions

 

State Plan for Children's Health Insurance Program (KidsCare)

Arizona's CHIP (KidsCare) plan is composed of 12 sections:

  • General Description and Purpose of the State Child Health Plans and State Child Health Plan Requirements
  • General Background and Description of State Approach to Child Health Coverage and Coordination
  • Methods of Delivery and Utilization Controls
  • Eligibility Standards and Methodology
  • Outreach
  • Coverage Requirements for Children's Health Insurance
  • Quality and Appropriateness of Care
  • Cost Sharing and Payment
  • Strategic Objectives and Performance Goals and Plan Administration
  • Annual Reports and Evaluations
  • Program Integrity
  • Applicant and Enrollee Protections