AHCCCS is in the process of evaluating how Community Health Workers (CHWs) and Community Health Representatives (CHRs) can be reimbursed by the Medicaid program.
In 2018 the Arizona Legislature passed, and the Governor signed, House Bill 2324, which required the Arizona Department of Health Services (ADHS) to establish qualifications, a scope of practice, and core competencies for Certified Community Health Workers (CHWs). ADHS was also charged with establishing a voluntary certification program that outlined the education and training program requirements as well as standards for CHW/CHR trainers. ADHS is in the process of developing and finalizing rules governing this certification program.
AHCCCS has been following the development of this ADHS rule closely. Many CHWs and CHRs are currently providing vital community services across Arizona, but their services to the Medicaid population are not reimbursable. With the implementation of a certification program, CHWs and CHRs who obtain certification may potentially be eligible for Medicaid reimbursement.
AHCCCS will update this page to provide information on its findings and status as the rulemaking process is finalized and AHCCCS reviews the CHW and CHR scope of practice in a Medicaid environment.
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