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AHCCCS Receives Federal Approval of 5-Year Waiver Renewal

October 14, 2022

PHOENIX — The Centers for Medicare and Medicaid Services (CMS) approved Arizona’s request for a five-year extension of its 1115 Waiver, the agreement with the federal government that authorizes the Arizona Health Care Cost Containment System (AHCCCS) to reform and modernize the State’s Medicaid program.

This 1115 Waiver approval continues the long-standing authorities and programs that have made Arizona’s Medicaid program innovative, effective, and efficient, including integrated managed care for AHCCCS populations through AHCCCS Complete Care (ACC); the Arizona Long Term Care System (ALTCS); the Comprehensive Health Plan (CHP) for children in foster care; and Regional Behavioral Health Agreements (RBHAs) which provide integrated care for individuals with a Serious Mental Illness (SMI).

In addition to renewing these historic programs, this 1115 Waiver includes approval for transformative projects intended to advance member health outcomes.

Targeted Investments (TI) Program 2.0 Approved

AHCCCS partners with more than 120,000 registered providers across the state to provide health care services to Medicaid members. For the last five years, the Targeted Investments Program has helped providers integrate physical and behavioral health care at the point of service, increasing members’ access to a full array of services and demonstrating significant improvements in health outcomes. TI 2.0 will extend the program to additional providers and continue provider incentive funding to further integration efforts, including a range of initiatives aimed at addressing social drivers of health.

Housing and Health Opportunities (H2O) Approved

CMS approved the new Housing and Health Opportunities project to further address health-related social needs for vulnerable populations and ensure their access to health care.

For many years, Arizona has prioritized housing and used State General Fund dollars to support rental subsidies for nearly 3,000 individuals experiencing homelessness each year. AHCCCS and its contracted health plans have successfully leveraged this experience to expand the reach of housing opportunities, improve member health outcomes, and reduce overall health care costs.

Recognizing that stable housing is an important component of overall health, CMS approved the H2O program to strengthen outreach to vulnerable Medicaid members, including those experiencing homelessness, those living with an SMI, and young adults transitioning out of the foster care system. AHCCCS will be able to reimburse for up to six months of medically necessary transitional housing (for example, for individuals leaving health care or correctional settings, or emergency shelters who need supports to remain medically stable) and enhance those services that support a member’s success in housing, like tenant rights education, eviction prevention, and medically necessary home modifications.

Tribal Dental Benefit Added

In 2020, the Arizona State Legislature approved a dental benefit for American Indian/Alaska Native (AI/AN) members that removed a prior $1,000 limit on services. This waiver approval will allow AHCCCS to reimburse Indian Health Services and Tribal 638 facilities for dental services provided to AI/AN adults beyond the existing $1,000 limit.

Negotiations Continue on Traditional Healing and Reach-in Services

In its approval notice, CMS recognized the State’s interest in reimbursing for traditional healing services offered by tribal nations and will continue to work with Arizona on this request. Additionally, CMS noted its willingness to further explore reimbursement for pre-release services for individuals in federal, state, local, and tribal correctional facilities.

The Waiver approval is effective October 14, 2022 through Sept. 30, 2027. All documents, including the original and amended waiver applications and the approval letter from CMS, are posted on the AHCCCS 1115 Waiver web page.

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