ARP Provider Payment Information 2024 (Updated 04/05/2024)
In its American Rescue Plan (ARP) Act Home and Community Based Services (HCBS) spending plan, AHCCCS received federal approval to allocate almost $1.3 billion over three years in one-time provider payments to recruit and retain a knowledgeable and well-trained workforce. This amount is subject to change pending additional modifications made to the HCBS Spending Plan. These time-limited payments will be made in State Fiscal Years (SFY) 2022, 2023, and 2024. AHCCCS intends to conclude the time-limited ARP payments with a 2024 final payment in the spring of 2024.
The SFY 2024 provider payments total more than $387 million and will be paid by the AHCCCS managed care organizations (MCOs) and the fee-for-service (FFS) administration to providers serving members enrolled in all AHCCCS programs who are active providers in good standing. Of note, the Department of Economic Security/Division of Developmental Disabilities (DES/DDD) will make direct payments to its contracted providers using a methodology similar to that used by AHCCCS. Providers should also note that the SFY 2024 payments may be different from the SFY 2023 payments.
These payments outlined below are meant to be a FINAL one-time directed payment for HCBS and Rehabilitation providers. AHCCCS will not continue this funding in the future.
The AHCCCS managed care provider payments, called “directed payments,” will be computed by applying a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from a specified time period for select ARP qualifying codes. For SFY 2024, key components of calculations are included below:
- The flat percentage is 15%,
- The specified time period is dates of service from October 1, 2022 through March 31, 2023. The six months of data will be doubled to approximate a full year of payments, and
- There are nearly 70 qualifying procedure codes summarized by category.
Approximately 1,900 AHCCCS managed care providers are expected to qualify for the final SFY 2024 payments. Based on this significant number of impacted providers, and the application of nearly 70 procedure codes, only approved and adjudicated encounters in the AHCCCS database will be utilized in the computations. AHCCCS will not consider any other data when computing payments, including validation or verification of provider computations. Provider payments may be made by multiple MCOs and involve multiple transactions in the same proportion that claims payments from the specified period were received.
Approximately 3,000 provider agencies will receive the final directed payments from DES/DDD utilizing a similar methodology, though the percentage rate applied to prior Medicaid payments will vary by service category.
Working within federal and state guidelines, AHCCCS has developed the methodology for making time- limited payments to fee-for-service (FFS) providers. FFS provider payments will utilize the same ARP qualifying services as those identified for the AHCCCS managed care Directed Payments for eligible providers. Both non-Indian Health Service /638 tribal (IHS/638) providers, and IHS/638 providers, could be eligible for payment.
ARP Directed Payment Provider Guidance 2024
Guidance regarding ARP provider payments as authorized by Laws 2022, Second Regular Session, Chapter 2 and the Centers for Medicare and Medicaid Services (CMS) through 438.6(c) is available at the links provided below. To the extent that CMS requires changes to the payment methodology and/or process, this guidance may be updated.
The SFY 2024 payments outlined below are meant to be a FINAL one-time directed payment for HCBS and Rehabilitation providers. AHCCCS will not continue this funding in the future.
The Provider Directed Payment Guidance available at the link below is for all lines of business, except ALTCS-DD. The DES/DDD issued its own guidance and requirements for ALTCS-DD providers, which can be found on the DDD ARP web page.
As outlined in this AHCCCS guidance, there are requirements regarding how the funds are to be utilized. Eligible providers must attest that they will follow these guidelines. The eligible providers included in the Individual Eligible Providers with NPI (Non-DDD and DDD Subcontracted Health Plan) list (link below) are providers contracted through the MCOs. Please note that providers AHCCCS determines are ineligible for payments will be excluded, either before or after attestation.
AHCCCS has developed a similar process for providers reimbursed through the FFS program. Providers who serve both MCO and FFS members will be required to complete two attestations. One related to MCO payments and a second related to FFS payments. For Fee-for-Service providers, AHCCCS intends to distribute the FINAL ARP SFY 2024 funds no later than May 31, 2024. Providers will be required to complete a SFY 2024 attestation prior to distribution of any FINAL SFY 2024 payments. The FFS attestation will be posted to the AHCCCS website in Quarter 2 of 2024. Guidance for FFS providers will be provided at a later date.
FFS Program Updates (04/05/2024)
The FFS attestation link will be available from April 1, 2024 through April 12, 2024. See link below.
Guidance for FFS providers is below in the FFS ARP HCBS Provider FAQs 2024 document.
ARP Provider Payment Resources 2024
- Provider Directed Payment Guidance 2024 (Revised 3/11/2024)
- FFS Attestation Form 2024 (Revised 4/5/2024)
- FFS ARP HCBS Provider FAQs 2024 (Revised 4/5/2024)
- CYE 24 ARP HCBS Frequently Asked Questions FAQs (Revised 3/29/2024)
- CYE 24 Individual Eligible Providers with NPI (Non-DDD and DDD Subcontracted Health Plans) (Revised 3/11/2024)
- CYE 24 Eligible Provider Types (Non-DDD)- (Attachment A)
- CYE 24 Eligible Categories of Services- (Attachment B)
Provider questions about ARP Directed Payments can be emailed to: AHCCCSARPADIRECTEDPAYMENTS@mslc.com
ARP Provider Payment Information 2023 (Updated 12/21/2023)
In its American Rescue Plan (ARP) Act Home and Community Based Services (HCBS) spending plan, AHCCCS received federal approval to allocate almost $1.3 billion over three years in one-time provider payments to recruit and retain a knowledgeable and well-trained workforce. This amount is subject to change pending additional modifications made to the HCBS Spending Plan. These time-limited payments will be made in State Fiscal Years (SFY) 2022, 2023, and 2024. AHCCCS anticipates making the SFY 2023 payments in the spring of 2023.
The SFY 2023 provider payments total more than $500 million and will be paid by the AHCCCS managed care organizations (MCOs) and the fee-for-service (FFS) administration to providers serving members enrolled in all AHCCCS programs who are active providers in good standing. Of note, the Department of Economic Security/Division of Developmental Disabilities (DES/DDD) will make direct payments to its contracted providers using a methodology similar to that used by AHCCCS. Providers should also note that SFY 2024 payments may be different from the SFY 2023 payments.
The AHCCCS managed care provider payments, called “directed payments,” will be computed by applying a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from a specified time period for select ARP qualifying codes. For SFY 2023 key components of calculations are included below:
- The flat percentage is 11%,
- The specified time period is dates of service from March 1, 2022 through August 31, 2022. The six months of data will be doubled to approximate a full year of payments, and
- There are nearly 70 qualifying procedure codes summarized by category.
Approximately 1,500 AHCCCS managed care providers are expected to qualify for SFY 2023 payments. Based on this significant number of impacted providers, and the application of nearly 70 procedure codes, only approved and adjudicated encounters in the AHCCCS database will be utilized in the computations. AHCCCS will not consider any other data when computing payments, including validation or verification of provider computations. Provider payments may be made by multiple MCOs and involve multiple transactions in the same proportion that claims payments from the specified period were received
Approximately 3,570 provider agencies will receive one-time, directed payments from DES/DDD utilizing a similar methodology, though the percentage rate applied to prior Medicaid payments will vary by service category.
Working within federal and state guidelines, AHCCCS has developed the methodology for making time- limited payments to fee-for-service (FFS) providers. FFS provider payments will utilize the same ARP qualifying services as those identified for the AHCCCS managed care Directed Payments for eligible providers. Both non-Indian Health Service /638 tribal (IHS/638) providers, and IHS/638 providers, could be eligible for payment.
All information contained in this notice is subject to change if any amendments to the ARP HCBS spending plan impact available funding. In addition, the total payment amount across all three years, the SFY 2023 payment values, and the SFY 2023 payment percentages, are subject to change.
ARP Directed Payment Provider Guidance 2023
Guidance regarding ARP provider payments as authorized by Laws 2022, Second Regular Session, Chapter 2 and the Centers for Medicare and Medicaid Services (CMS) through 438.6(c) is available at the links provided below. To the extent that CMS requires changes to the payment methodology and/or process, this guidance may be updated.
These SFY 2023 payments are one-time payments for HCBS and Rehabilitation providers. AHCCCS does not intend to continue this level of funding permanently.
The Provider Directed Payment Guidance available at the link below is for all lines of business, except ALTCS-DD. The DES/DDD issued its own guidance and requirements for ALTCS-DD providers, which can be found on the DDD ARP web page.
As outlined in this AHCCCS guidance, there are requirements regarding how the funds are to be utilized. Eligible providers must attest that they will follow these guidelines. The eligible providers included in the Individual Eligible Providers with NPI (Non-DDD and DDD Subcontracted Health Plan) list (link below) are providers contracted through the MCOs.
AHCCCS has developed a similar process for providers reimbursed through the FFS program. Providers who serve both MCO and FFS members will be required to complete two attestations. One related to MCO payments and a second related to FFS payments. The FFS ARP Provider Attestation 2023 will be posted in April 2023.
ARP HCBS Directed Payments SFY 2024 (Revised 12/21/2023)
AHCCCS plans to distribute final funding for ARP to recruit and retain the workforce. In SFY 2022 ARP payments, AHCCCS distributed approximately $500 Million as calculated using a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from October 2020 - March 2021 for select ARP qualifying codes. AHCCCS distributed approximately $344.8 Million in SFY 2023 calculated using a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from March 2022 - August 2022 for select ARP qualifying codes. AHCCCS is finalizing the methodology that will be utilized in SFY 2024 but intends for the funds to be used for expenditures that occur from January 1, 2024 to February 28, 2025. Although the total amount to distribute will be slightly higher between SFY 2024 and SFY 2023, the amounts at a provider level will differ from the 2023 amounts. These SFY 2024 payments are the final one-time payments for HCBS and Rehabilitation providers. AHCCCS will not continue this level of funding.
AHCCCS intends to distribute ARP SFY 2024 funds through MCOs to providers no later than May 31, 2024. Providers will be required to complete a SFY 2024 attestation prior to distribution of SFY 2024 payments. AHCCCS intends to post this attestation to the AHCCCS website in February 2024. AHCCCS will provide additional guidelines regarding SFY 2024 ARP payments late January 2024.
AHCCCS intends to distribute ARP SFY 2024 funds to Fee-for-Service (FFS) providers no later than May 31, 2024. Providers will be required to complete a SFY 2024 attestation prior to distribution of SFY 2024 payments. FFS providers will be required to submit a separate attestation from the MCO attestation. FFS attestation will be posted to the AHCCCS website in March or April 2024.
ARP Provider Payment Resources 2023 (Revised 07/20/2023)
- Provider Directed Payment Guidance 2023 (Revised 07/20/2023)
- AHCCCS MCO ARP Provider Attestation 2023
- FFS Attestation Form 2023 (Added 04/21/2023)
- ARP HCBS Frequently Asked Questions FAQs 2023 (Revised 04/21/2023)
- FFS ARP HCBS Provider FAQs 2023 (Added 04/21/2023
- Individual Eligible Providers with NPI (Non-DDD and DDD Subcontracted Health Plans) 2023
- Eligible Provider Types (Non-DDD) 2023- (Attachment A)
- Eligible Categories of Services 2023- (Attachment B) (Revised 07/20/2023)
Provider Payment Information (updated 01/10/2023)
In its American Rescue Plan (ARP) Act Home and Community Based Services (HCBS) spending plan, AHCCCS received federal approval to allocate almost $900 million over three years in one-time provider payments to recruit and retain a knowledgeable and well-trained workforce. These time-limited payments will be made in State Fiscal Years (SFY) 2022, 2023, and 2024. AHCCCS anticipates making the SFY 2022 payments in the spring of 2022.
The SFY 2022 provider payments total more than $500 million and will be paid by the AHCCCS managed care organizations (MCOs) and the fee-for-service (FFS) administration to providers serving members enrolled in all AHCCCS programs. Of note, the Department of Economic Security/Division of Developmental Disabilities (DES/DDD) will make direct payments to its contracted providers using a methodology similar to that used by AHCCCS. Providers should also note that AHCCCS is allocating greater funds to this SFY 2022 payment than in subsequent years due to the immediate needs of the workforce.
The AHCCCS managed care provider payments, called “directed payments,” will be computed by applying a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from a specified time period for select ARP qualifying codes. For SFY 2022:
- The flat percentage is 17.8%,
- The specified time period is dates of service from October 1, 2020 through March 31, 2021. The six months of data will be doubled to approximate a full year of payments. This time period was selected to comply with CMS requirements regarding directed payments, which does not permit AHCCCS to select a period earlier than October 1, 2020, and
- Nearly 70 ARP qualifying procedure codes summarized by category.
Approximately 1,800 AHCCCS managed care providers are expected to qualify for SFY 2022 payments. Based on this significant number of impacted providers, and the application of nearly 70 procedure codes, only approved and adjudicated encounters in the AHCCCS database will be utilized in the computations. AHCCCS will not consider any other data when computing payments, including validation or verification of provider computations. Provider payments may be made by multiple MCOs and involve multiple transactions in the same proportion that claims payments from the specified period were received.
Approximately 3,570 provider agencies will receive one-time, directed payments from DES/DDD utilizing a similar methodology, though the percentage rate applied to prior Medicaid payments will vary by service category. The DES/DDD directed payment strategy was informed by stakeholder input received in response to the provider rates which became effective October 1, 2021.
- DES/DDD payment adjustments summarized by category (Revised 07/20/23)
Working within federal and state guidelines, AHCCCS has developed the methodology for making time- limited payments to fee-for-service (FFS) providers. FFS provider payments will utilize the same ARP qualifying services as those identified for the AHCCCS managed care Directed Payments for eligible providers. Both non-Indian Health Service /638 tribal (IHS/638) providers, and IHS/638 providers, could be eligible for payment.
All information contained in this notice is subject to change if any amendments to the ARP HCBS spending plan impact available funding. In addition, the total payment amount across all three years, the SFY 2022 payment values, and the SFY 2022 payment percentages, are subject to change.
ARP Directed Payment Provider Guidance
Guidance regarding ARP provider payments as authorized by Laws 2022, Second Regular Session, Chapter 2 and the Centers for Medicare and Medicaid Services (CMS) through 438.6(c) is available at the links provided below. To the extent that CMS requires changes to the payment methodology and/or process, this guidance may be updated.
These SFY 2022 payments are one-time payments for HCBS and Rehabilitation providers. AHCCCS does not intend to continue this level of funding permanently.
The Provider Directed Payment Guidance available at the link below is for all lines of business, except ALTCS-DD. The DES/DDD issued its own guidance and requirements for ALTCS-DD providers, which can be found on the DDD ARP web page.
As outlined in this AHCCCS guidance, there are requirements regarding how the funds are to be utilized. Eligible providers must attest that they will follow these guidelines. The eligible providers included in the Individual Eligible Providers with NPI (Non-DDD) list (link below) are providers contracted through the MCOs.
AHCCCS has developed a similar process for providers reimbursed through the FFS program. FFS providers who provided attestation through the MCO will be required to submit a separate FFS attestation prior to distribution of FFS payment.
ARP HCBS Directed Payments SFY 2022 Update - Providers have until February 28, 2023 to expend SFY 2022 ARPA HCBS Directed Payment funds
AHCCCS has previously communicated that the State Fiscal Year (SFY) 2022 ARP HCBS directed payments made by Managed Care Organizations (MCOs) in April/May 2022 must be spent by December 31, 2022 for expenses that occurred between January and December of 2022. AHCCCS has extended the deadline to spend ARP SFY 2022 HCBS directed payments to February 28, 2023 for expenses that occurred between January 2022 and February 2023. See links below for previous guidance on how these funds must be used. All prior guidance is applicable, except for the time period to spend the funds, which is now extended until February 28, 2023.
ARP HCBS Directed Payments SFY 2024 Update (12/21/2023)
AHCCCS plans to distribute final funding for ARP to recruit and retain the workforce. In SFY 2022 ARP payments, AHCCCS distributed approximately $500 Million as calculated using a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from October 2020 - March 2021 for select ARP qualifying codes. AHCCCS distributed approximately $344.8 Million in SFY 2023 calculated using a flat percentage rate to eligible providers’ prior Title XIX Medicaid payments from March 2022 - August 2022 for select ARP qualifying codes. AHCCCS is finalizing the methodology that will be utilized in SFY 2024 but intends for the funds to be used for expenditures that occur from January 1, 2024 to February 28, 2025. Although the total amount to distribute will be slightly higher between SFY 2024 and SFY 2023, the amounts at a provider level will differ from the 2023 amounts. These SFY 2024 payments are the final one-time payments for HCBS and Rehabilitation providers. AHCCCS will not continue this level of funding.
AHCCCS intends to distribute ARP SFY 2024 funds through MCOs to providers no later than May 31, 2024. Providers will be required to complete a SFY 2024 attestation prior to distribution of SFY 2024 payments. AHCCCS intends to post this attestation to the AHCCCS website in February 2024. AHCCCS will provide additional guidelines regarding SFY 2024 ARP payments late January 2024.
AHCCCS intends to distribute ARP SFY 2024 funds to Fee-for-Service (FFS) providers no later than May 31, 2024. Providers will be required to complete a SFY 2024 attestation prior to distribution of SFY 2024 payments. FFS providers will be required to submit a separate attestation from the MCO attestation. FFS attestation will be posted to the AHCCCS website in March or April 2024.
ARP Provider Payment Resources
- Provider Directed Payment Guidance
- Provider Change of Ownership Guidance
- Change of Ownership ARP Attestation Form
- AHCCCS ARP Provider Attestation
- FFS ARP Attestation Form
- Frequently Asked Questions (FAQs) (Revised 09/22/2022)
- FFS Frequently Asked Questions (FAQs) (Revised 09/22/2022)
- Individual Eligible Providers with NPI (Non-DDD)
- Eligible Provider Types (Non-DDD)
- Eligible Categories of Services
