State Plan for Medicaid

The Medicaid State Plan is a federally mandated contract between the State and the federal government, describing how Arizona’s Medicaid program is administered, and serving as the basis for Federal Financial Participation (FFP). In alignment with established federal regulations, the State Plan covers topics such as Medicaid eligibility standards, provider requirements, payment methods, health benefit packages, and other topics. Changes to the State Plan regularly occur through State Plan Amendments (SPAs), which undergo rigorous negotiations with the Centers for Medicare and Medicaid Services (CMS). Once a SPA is approved, it becomes a permanent part of Arizona’s Medicaid program and is filed in the State Plan.

The State Plan is composed of seven sections:

  1. Single State Agency and Organization
    Identifies the state agency responsible for administering the Medicaid program, and how the agency is organized.
  2. Coverage and Eligibility
    Describes who is eligible for Medicaid coverage and the conditions of eligibility.
  3. Services: General Provisions
    Describes Medicaid covered services and additional considerations (e.g., the amount, duration and scope of services).
  4. General Program Administration
    Describes a variety of topics related to administering the Medicaid program such as payment rates/methods, recordkeeping, quality control, cost sharing, and other topics.
  5. Personnel Administration
    Describes standards of personnel administration and topics such as training and subprofessional programs.
  6. Financial Administration
    Describes a variety of financial topics including fiscal policies, cost allocation, and state financial participation.
  7. General Provisions
    Describes miscellaneous provisions, such as the state plan amendment process, nondiscrimination, and special topics (e.g., Public Health Emergency (PHE) Provisions).

The purpose of this web page is to provide public access to Arizona’s Medicaid State Plan. Below, you will find the complete plan organized into sections and subsections which may be accessed by clicking on the respective links. In addition, you can find a link to the entire plan at the bottom of this web page.

Entire State Plan