Proposed State Rules

AHCCCS proposed rules are published in the Arizona Administrative Register (A.A.R.) for public review. To compare the following Proposed Rule language to Final Rule, please see corresponding topic when finalized at: http://www.azahcccs.gov/reporting/state/unpublishedrules.aspx

Note: Information provided in PDF files.

2014

FPEP Family Planning Extension Program Submit Comment on Proposed Rule


Friday September 11, 2014
The Administration proposes a rule-making to repeal rules related to the Family Planning Services Extension Program (FPEP) as authorized by A.R.S. § 36-2907.04 subject to the approval of a waiver from the federal government necessary to implement the program. This program provided coverage for family planning services to women who were eligible for AHCCCS during their pregnancy for a two year period following the end of their pregnancy. The federal waiver authorizing these extended benefits ended on December 31, 2013.

Hospital Presumptive Eligibility (HPE) Submit Comment on Proposed Rule


Wednesday August 6, 2014
The Administration is promulgating rules to comply with the Affordable Care Act of 2010, which added 42 USC 1396a(a)(47)(B), and 42 CFR 435.1110 which requires the State Medicaid agency to allow qualifying hospitals the option to determine presumptive eligibility for Medicaid for certain individuals. This process is referred to as Hospital Presumptive Eligibility (HPE). These proposed rules are to be effective January 1, 2015

Cost Sharing Part II 2014 Comment period ended - see Final Rule


Thursday July 31, 2014
Arizona Laws 2013, First Special Session, Chapter 10 (House Bill 2010) specified changes to the AHCCCS Program which require, among other items, rule-making to establish cost sharing provisions consistent with federal law and the Federal regulations which became effective January 1, 2014, in 42 CFR part 447.50, et seq. In this rulemaking, the Agency revised the current cost sharing rules to delineate the mandatory copayment requirements for the new adult group described in R9-22-1427 (E) with income above106% of the federal poverty guidelines (FPL) subject to CMS approval. In addition, this rulemaking clarifies that members in the new adult group with incomes at or below 106% FPL are exempt from any copayments. These proposed rules also clarify existing language, update cross-references, and include various non substantive changes.

Section 36 of this Law provides a rulemaking exemption: For a period of one year from the effective date of the Act, the AHCCCS Administration is exempt from the Administrative Procedure Act’s rulemaking requirements for rules regarding cost sharing.

BH/ADHS Changes Submit Comment on Proposed Rule


Thursday July 24, 2014
HB 2634 (Law 2011, Chapter 96) requires the Arizona Department of Health Services (ADHS) to reduce monetary or regulatory costs on persons or individuals receiving behavioral health services, streamline the regulation process, and facilitate licensure of integrated health programs that provide both behavioral and physical health services. The Administration cross references ADHS rules and must update its rules to correctly reference changes made by ADHS. In addition, changes recommended during a 5 year review of these rules have also been made along with any technical changes required to make the rulemaking clear.

Hospital Assessment Amendment Comment period ended - see Final Rule


Thursday May 15, 2014
A.R.S. § 36-2901.08, enacted by 2013 law, authorizes the Administration to establish, administer and collect an assessment on hospital revenues, discharges or bed days for funding a portion of the nonfederal share of the costs incurred beginning January 1, 2014, associated with eligible persons added to the program by A.R.S. §§ 36-2901.01 and 36-2901.07. The Administration is proposing a new rule to update the figures to be used as of State Fiscal Year 2015 for the process for establishing, administering and collecting the assessment on hospitals, this new assessment pays for a full year for the expansion population.

Laws 2013, 1st Special Session, Chapter 10 added an exemption to the Administrative Procedure Act for purposes of the administration and implementation of the hospital assessment: A.R.S. § 41-1005 (A)(32) exempts the Administration from Title 41, Chapter 6 of the Arizona Revised Statutes (the Arizona Administrative Procedure Act) for purposes of implementing and establishing the hospital assessment; however, that provision requires the Administration to provide public notice and an opportunity for public comment at least thirty days before doing so. Laws 2013, 1st Special Session, Chapter 10 provides: Sec. 44. Intent; hospital assessment It is the intent of the legislature that: 1. The requirement that the hospital assessment established pursuant to section 36-2901.08, Arizona Revised Statutes, as added by this act, be subject to approval by the federal government does not adopt federal law by reference.

Essential Health Care Benefits (EHB) or (AHB) Comment period ended - see Final Rule


Friday March 7, 2014
The Administration must conduct a rule-making to implement the elements of Arizona Laws 2013, First Special Session, Chapter 10 (House Bill 2010), that relate to changes to covered services regarding well exams, and other cost-effective services. In addition to “clean up” of rules related to scope of services, such as updating cross-references and non-substantive changes to improve clarity. The provisions are necessary to comply with federal or state requirements.

DRG - Diagnostic Related Groups Comment period ended - see Final Rule


Friday March 7, 2014
Arizona Laws 2013, Chapter 202, section 3, amended A.R.S. 36-2903.01.G.12 to require the AHCCCS administration to "adopt a diagnosis-related group based hospital reimbursement methodology consistent with title XIX of the social security act for inpatient dates of service on and after October 1, 2014." The statutory and regulatory provisions of Medicaid (Title XIX of the Social Security Act) provide state’s significant flexibility with respect to hospital reimbursement methodologies; however, the Medicaid Act, at 42 U.S.C. 1396a(a)(30)(A), requires that the State must adopt payment methodologies "as may be necessary to safeguard against unnecessary utilization of such care and services and to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area."

In addition, the choices reflected in this proposed rule were based other design considerations such as achieving budget neutrality (recognizing that funding is not unlimited the methodology was designed to be budget neutral compared to past aggregate reimbursement for these services) and adaptability (whether the methodology facilitates adapting to changes in utilization and future service models).

Nursing Facility Assessment Amendment 2 | Comment period ended - see Final Rule


Friday February 28, 2014
A.R.S. § 36-2999.52 authorizes the Administration to administer a provider assessment on health care items and services provided by nursing facilities and to make supplemental payments to nursing facilities for covered Medicaid expenditures. The Administration is proposing an amendment to rule to revise the process for calculating the nursing facility assessment using Uniform Accounting Report data submitted to the Arizona Department of Health Services and amending the dollar amounts used to calculate the assessment. In addition, the proposed rules update terminology and clarify language in both the assessment and supplemental payment sections so that the methodology is more concise and understandable.

Hospital Assessment | Comment period ended - see Final Rule


Friday December 13, 2013
A.R.S. § 36-2901.01, adopted by Initiative Measure Proposition 204 in the 2000 general election, includes individuals with income up to 100% of the federal poverty level as part of the definition of persons eligible for health care coverage through AHCCCS. Due to the lack of available funding, effective July 8, 2011, the Administration closed the program to new enrollment for persons described by A.R.S. § 36-2901.01 who were not also described in the Arizona State Plan for Medicaid. Arizona Laws 2013, 1st Special Session, Chapter 10, Section 5, added A.R.S. § 36-2901.07, which expanded the definition of eligible persons to include individuals with income between 100% and 133% of the federal poverty level

A.R.S. § 36-2901.08, also enacted in the same section of the 2013 law, authorizes the Administration to establish, administer and collect an assessment on hospital revenues, discharges or bed days for funding a portion of the nonfederal share of the costs incurred beginning January 1, 2014, associated with eligible persons added to the program by A.R.S. §§ 36-2901.01 and 36-2901.07. The Administration is proposing a new rule to describe the process for establishing, administering and collecting the assessment on hospitals. A.R.S. § 41-1005 (A)(32) exempts the Administration from Title 41, Chapter 6 of the Arizona Revised Statutes (the Arizona Administrative Procedure Act) for purposes of implementing and establishing the hospital assessment; however, that provision requires the Administration to provide public notice and an opportunity for public comment at least thirty days before doing so.

AHCCCS Public Hearing Locations

  • AHCCCS Administration
    701 East Jefferson, Gold Room
    Phoenix, AZ 85034
  • Arizona Long Term Care System
    1010 North Finance Center Drive, Suite 201
    Tucson, AZ 85701
  • Arizona Long Term Care System
    2717 N. 4th St. STE 130
    Flagstaff, AZ 86004

Contact

Comments on proposed AHCCCS rules may be submitted in the following ways:

  • Mail:
    Office of Administrative Legal Services (OALS)
    701 East Jefferson Street, Mail Drop 6200
    Phoenix, Arizona 85034
  • Phone: (602) 417-4232
  • FAX: (602) 253-9115
  • E-mail: AHCCCSRules@azahcccs.gov

 

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