AHCCCS pays hospitals for inpatient and outpatient services to AHCCCS members. Additionally, AHCCCS pays
supplemental payments to hospitals for different purposes and activities. A summary of all hospital payments
(claims as well as supplemental payments) is available
here.
Critical Access Hospital Payments
Critical Access Hospitals (CAHs) are rural community hospitals that meet defined criteria outlined in
the Conditions of Participation, 432CFR-485 and subsequent legislative refinements to the program through
the BBA, BIPA, and Medicare Modernization Act. The Arizona State Legislature has directed AHCCCS to allocate
additional funds appropriated in the annual state budget.
More information on Critical Access payments can be found here.
Rural Hospital Inpatient Fund Payments
The Rural Hospital Inpatient Fund was established by the Legislature in 2005 in response to a 2002 hospital
inpatient study that showed rural hospital inpatient cost structures are higher than urban hospital cost structures
for inpatient services. This fund was designed to supplement rural hospital inpatient payments.
More information on Rural Hospital Inpatient Fund payments can be found here.
Proposition 202 Trauma & Emergency Services Fund Payments
In November 2002, Arizona voters approved Proposition 202, the Indian Gaming and Self-Reliance Act. Among other things,
the initiative established the Arizona Benefits Fund, consisting of tribal gaming revenues paid to the State on a
quarterly basis. The Benefits Fund is administered by the Department of Gaming. To help offset the readiness and costs
of Level 1 Trauma Centers and the increasing volume in Emergency Departments, a portion of these funds are transferred
to AHCCCS for distribution.
More information on Proposition 202 payments can be found here.
Deadlines:
-
Hospitals must have Prop 202 worksheets to AHCCCS by
October 31 of each year in order to receive Prop 202
funds for that State fiscal year.
Graduate Medical Education Payments
Graduate Medical Education (GME) funds are distributed to hospitals that provide training and education for medical
school graduates. This training includes internships, residencies and fellowships. GME funds are either designated
to cover direct medical education expenses or indirect medical education expenses.
More information on Graduate Medical Education payments can be found here.
Disproportionate Share Hospital Payments
Disproportionate Share Hospital (DSH) payments provide financial assistance to hospitals that serve a large number
of low-income patients such as people on Medicaid and the uninsured. Medicaid DSH payments are the largest source
of federal funding for uncompensated care.
More information on Disproportionate Share Hospital payments can be found
here.
Deadlines:
-
Hospitals must have 2010 DSH final IGAs to AHCCCS by
April 15, 2012 in order to have those included
in the final Pool 5 reconciliation and distributions.
-
Hospitals must have 2011 DSH final IGAs to AHCCCS by
April 15, 2013 in order to have those included
in the final Pool 5 reconciliation and distributions.
-
Hospitals must have 2012 DSH applications to AHCCCS by
April 15, 2012 in order to be included in any
and all DSH allocations for 2012.
Electronic Health Record Incentive Payments
Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible health
care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt
certified EHR technology and use it to achieve specified objectives.
More information on EHR Incentive payments can be found here.
Deadlines:
-
Hospitals must have complete Federal Fiscal year 2011 EHR
attestations in the AHCCCS ePIP system by November 30, 2011.
-
Hospitals must have complete Federal Fiscal year 2012 EHR
attestations in the AHCCCS ePIP system by November 30, 2012.
