AHCCCS Financial Reporting Guidelines
The Arizona Health Care Cost Containment System (AHCCCS) provides Financial Reporting Guides for the following Contractors: AHCCCS Complete Care (ACC), ACC-Regional Behavioral Health Agreement (ACC-RBHA), Arizona Long Term Care System (ALTCS), Comprehensive Health Plan (CHP), Division of Developmental Disabilities (DDD), and Medicare Advantage Prescription Drug (MAPD).
The purpose of the Financial Reporting Guides is to set forth the monthly, quarterly, annual and ad hoc financial related reporting requirements for all of the AHCCCS programs.
The following templates are utilized by more than one Contractor Type:
- Form FQHC RHC E-9 Template(Updated: 12/15/2024)
- Related Party Transactions
- Contract Year Annual Supplement (Updated: 12/23/2024)
- MCO Semi-Annual PBM Audit Template (Updated: 07/20/2023)
- Medical Loss Ratio Guidance (Updated: 12/20/2024)
- Appendix H - Annual MLR Attestation Statement
- Appendix I - Community Reinvestment Activities Report Template (Updated: 06/30/2023)
- Appendix J – Sample Statement of Actuarial Opinion (Updated: 12/20/2024)
- Appendix K – Sample Supplemental Report Template (Updated: 12/20/2024)
AHCCCS Complete Care Contractors (ACC)
Financial Reporting Guide for ACC and ACC-RBHA Contractors (Updated: 12/20/2024)
- ACC Financial Reporting Template CYE 25 (Updated: 12/20/2024)
ACC-Regional Behavioral Health Agreement (RBHA) Contractors
Financial Reporting Guide for ACC and ACC-RBHA Contractors (Updated: 12/20/2024)
- ACC/RBHA Financial Reporting Template CYE 25 (Updated: 12/20/2024)
Arizona Long Term Care System (ALTCS) Health Care Contractors
Financial Reporting Guide for ALTCS Program Contractors (Updated: 12/20/2024)
- ALTCS Financial Reporting Template CYE25 (Updated: 12/20/2024)
