Seventh Special Session - 49th Legislature

• AHCCCS April 1, 2011 Provider Rate Reductions
• KidsCare Wait List
• KidsCare Program
• Prop 204 Expansion Population Scale Back
• Adult Benefit Reduction
• Provider Rates

On March 16, 2010, the Legislature completed its 7th Special Session to address the budget shortfall for FY 2010. Below is information regarding the impact to the AHCCCS program. AHCCCS will continue to update this section as further information becomes available.

1. AHCCCS April 1, 2011 Provider Rate Reductions

   Mon Nov 22, 2010
   On April 1, 2011, AHCCCS will be reducing provider rates by the following percentages:

   • Inpatient and Outpatient Hospital Fee Schedule – 5%
   • Physician Fee Schedule – 5% (includes DME, radiology and lab, but excludes drugs administered in a physician’s office)
   • Dental Fee Schedule – 5%
   • Emergency and Non-Emergency Transportation – 5%
   • ALTCS EPD HCBS Services – 2.5% (a 2.5% reduction was imposed on October 1, 2010)

More information is provided on the Provider Rate Reduction Fact Sheet.

2. KidsCare Wait List

   Wed July 25, 2012
   There were 93,331 applicants on the KidsCare waiting list as of July 15, 2012. Please note, AHCCCS continues to verify eligibility for Medicaid and revise the KidsCare wait list accordingly.

   Wed Feb 15, 2012
   There were 136,843 applicants on the KidsCare waiting list as of February 15, 2012. 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

3. KidsCare Program

   Refer to the Federal Activities section for more information about the impact of health care reform on the KidsCare program.

   Mon Jun 28, 2010

   • CMS acknowledgement of AHCCCS withdrawal of KidsCare termination request - 6/24/10 [979KB]
   • CMS Clarification re Enrollment Freeze - 5/17/10 [964KB]
   • AHCCCS Withdrawal of KidsCare Termination Request - 5/12/10 [26KB]
   • AHCCCS Letter to CMS Regarding KidsCare Enrollment Cap - 4/1/10 [31KB]
   • CMS Response to KidsCare Termination Letter of 3/18/10 (see below) - 4/1/10 [1.23MB]
   • AHCCCS Notice to CMS Regarding KidsCare Termination - 3/18/10 [28KB]

Thu Mar 18, 2010
Effective June 15, 2010, the KidsCare program will end. KidsCare is Arizona's Children's Health Insurance Program and covers children whose families have income between 100% and 200% of the Federal Poverty Level (FPL). The State does not have enough funds to keep paying its portion of this program. This program was funded jointly by the State and federal government under Title XXI of the Social Security Act. There are about 38,000 children currently enrolled in the program.

Loss of KidsCare or AHCCCS Health Insurance is now a qualifying event for an employer's group health plan. See the Federal Activities page for more information.

AHCCCS has submitted the following notice to CMS:

AHCCCS Notice to CMS Regarding KidsCare Termination - 3/18/10 [28KB]

4. Prop 204 Expansion Population Scale Back

   Thu May 13, 2010
   AHCCCS submitted the following letter to withdraw the Waiver and State Plan amendment requests below.

   • Waiver Withdrawal Letter to CMS - 5/12/10 [25KB]
   • SPA 10-004 Withdrawal - 5/12/10 [25KB]

   Thu Mar 18, 2010
   The Proposition 204 population will be fully funded through December 2010. Effective January 1, 2011, AHCCCS will not have sufficient funding to continue coverage for the Proposition 204 population at current levels. The FY 2010 enacted budget authorizes AHCCCS to define eligibility in accordance with available funding levels.

   Please note, in the event Congress continues federal funding to states as authorized by the American Recovery and Reinvestment Act, AHCCCS will have sufficient monies to fund the population through June 30, 2011. Additional information will be posted as it is available.

   • Waiver Notice to CMS - 3/18/10 [32KB]
   • SPA 10-004 Submittal to CMS - 3/18/10 [64KB]
   
   
5. Adult Benefit Reduction

   Fri Apr 9, 2010
   The enacted budget directs AHCCCS to implement several changes to the adult benefit package. As a result, AHCCCS will review and make necessary changes to its State Plan and applicable policies. Additional information will be made available as further details emerge. Below is a link to the Benefit Changes page where you can find more information.

   • AHCCCS Benefit Changes
   
   
6. Provider Rates

   Thu Mar 18, 2010
   The FY 2010 enacted budget authorizes AHCCCS to reduce provider rates (in addition to previous reductions already implemented) up to 5% to meet its budget requirements. In addition, the budget authorizes AHCCCS to reduce provider rates an additional 10% in the event the sales tax increase proposal is not passed by voters on May 18, 2010. Additional information will be available as it is received.