First Regular Session - 50th Legislature


Governor Brewer's Medicaid Reform Package

Thu  Jan 19, 2012
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, 6/27/2012  [PDF]   

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 [PDF]

  1. AHCCCS October 1, 2011 Rate Reductions 
    Tues April 3, 2012
    On April 2, 2012, the Arizona Hospital and Healthcare Association (AzHHA) withdrew the lawsuit it filed against AHCCCS and the federal government challenging the 5% rate reductions for hospitals which became effective October 1, 2011. AzHHA's decision to end its litigation follows the District Court’s order denying AzHHA's motion for Preliminary Injunction and granting, in part, AHCCCS' Motion to Dismiss some of AzHHA's claims. The 5% rate reductions will remain in place. More information is provided below.

    AzHHA Notice of Dismissal 4/2/11 [PDF]
    District Court Order re Injunction 3/23/11 [PDF]
    District Court Order re Motion to Dismiss 3/23/11 [PDF]

    Wed February, 8, 2012
    On November 29, 2011, a lawsuit was filed by the Arizona Hospital and Healthcare Association (AzHHA) against AHCCCS and the federal government challenging the 5% rate reductions effective October 1, 2011. The lawsuit is currently pending before the federal District Court. More information is provided below and will be updated as new developments occur.

    AzHAA Complaint
    AzHHA’s Complaint- 11/29/11 [PDF]

    AHCCCS Motion to Dismiss
    AHCCCS Motion to Dismiss- 12/19/11 [PDF]
    AzHHA Response to AHCCCS Motion to Dismiss- 1/3/12 [PDF]
    AHCCCS Reply to Motion to Dismiss- 1/10/12 [PDF]

    AzHAA Motion for Preliminary Injunction
    AzHHA Motion for Preliminary Injunction- 12/14/11 [PDF]
    CMS Response to Motion for Preliminary Injunction 1/10/12 [PDF]
    AHCCCS Response to Motion for Preliminary Injunction- 1/26/12 [PDF]
    AzHHA Reply to Motion for Preliminary Injunction- 2/6/12 [PDF]

    Declaration of AHCCCS Director (Exhibit to AHCCCS Response to Preliminary Injunction)
    Declaration of AHCCCS Director- 1/26/12 [PDF]

    Tues November 22, 2011
    CMS has approved the State Plan Amendments to reduce Reimbursement Rates by 5%. CMS has also approved the State Plan Amendment update the payment methodology for paying inpatient hospital claims with extraordinary operating costs. Click on the links below to view the CMS approval letters:

    SPA Approval 11-009A - Inpatient Hospital Rates [PDF]
    SPA Approval 11-009B - Outpatient Hospital Rates [PDF]
    SPA Approval 11-009C - Rate Reductions [PDF]
    SPA Approval 11-009D - Nursing Facility Rates [PDF]
    SPA Approval 11-011- Outlier [PDF]

    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 [PDF]

    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 [PDF]
    State Plan Amendments
    Access to Care Studies, Memos and Additional Information
    AHCCCS Comments on CMS Access to Care Proposed Rule [PDF]
    Notice of Public Information [PDF]
    Materials from Hospital Meeting 8/15 [PDF]
    DDD Provider Meeting 9/9* [PDF]
    Info for DDD Families [PDF]

    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. Proposal to Provide Funding Assistance to Hospitals
    April 6, 2012
    On Friday, April 6, 2012, AHCCCS received approval under Arizona's Section 1115 Waiver, to move forward with two new programs critical to Arizona’s safety net healthcare delivery system – the Safety Net Care Pool and the Indian Health Services/tribal 638 facilities supplemental payment program. See the links below for additional information.
    Governor's Announcement [PDF]
    Waiver Amendment Fact Sheet [PDF]
    SNCP Information
    KidsCare II Information
    I.H.S./638 Information
    Prop 202 Options

    Mon Nov 28, 2011
    Governor Brewer and area hospitals propose to use local dollars to fund uncompensated care and hospital improvements. The proposal is pending before CMS. Click on the link below for more information (See item #15):

    Funding Pools Proposal [PDF]

  3. 340B Pricing Update
    March 12, 2012
    Beginning April 11, 2012, AHCCCS is implementing changes to the reimbursement methodology for FQHC and FQHC Look-Alike pharmacies. For additional information, please click on the link below.

    Pharmacy Updates

  4. Payment Reform Pilot Program
    Wed November 16, 2011
    AHCCCS is pleased to announce the Payment Reform Pilot Program. Under the program, AHCCCS can reimburse for a specific service array that drives quality over quantity and furthers cost control improvements. More information can be found in the link below:

    Payment Reform Information [PDF]

  5. 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

  6. 2011 Benefit Changes

    Tues April 17, 2012
    CMS approved SPA #11-012, which establishes a 25-day annual inpatient limit effective October 1, 2011. The limit applies to adults age 21 and older. See the link below for the CMS approval package.

    SPA 11-0012 [PDF]

    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

  7. 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 [PDF] Specific information is provided in the link below.

    Community Forums

  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  [PDF]
    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 [PDF]
    Data Narrative and Detail [PDF]


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