You are invited to participate in a survey regarding your experience using the AHCCCS website. This survey will take approximately two minutes. Your responses will help us ensure that you have a high quality experience.
Hospital providers have expressed interest in identifying AHCCCS payments for hospital services for populations funded by
the recently-implemented assessment. Populations covered by the assessment include the Proposition 204 (Childless Adults)
Restoration population from 0-100% of the Federal Poverty Level (FPL), as well as the Newly Eligible Adult Expansion population
from 100-133% FPL. These members are displayed by a yellow bar in the Hospital Assessment Funding by Medicaid Eligibility Category Chart. (NOTE: For ease of display and understanding,
for the purposes of this chart, the Newly Eligible Adult Expansion Population from 100-133% FPL is shown as associated with the existing
eligibility groups, e.g., persons with disabilities who are under age 65 who do not qualify for Medicare, parents and childless
adults. In the AHCCCS enrollment reporting for this category, those groups will all be displayed together as part of the Newly
Eligible Adult Expansion.) Additionally, the hospital assessment will fund a portion of coverage for parents from 22-100% FPL,
displayed by the red bar in the chart.
The Rate Code Table lists specific codes that define the majority of the
population covered by the assessment (those populations displayed in the yellow bars), referred to as rate codes. Hospitals have access
to these rate codes by utilizing the AHCCCS Online Provider Website: Member Eligibility and Enrollment Verifications, or via Electronic
Data Interchange (EDI): 270/271 Batch Eligibility Request and Response. Rate code information can be used to track revenue from AHCCCS
and its Contractors. It will not be possible to identify revenue associated with members represented by the red bar.
Providers may also be interested in AHCCCS Acute Care Program enrollment activity since the implementation of the assessment. A
month-by-month statewide tracking of estimated populations compared to actual populations is available in the
Population Tracking Sheet.
As a reminder, a statewide hospital assessment will be in place beginning in
January 2014 to cover the state costs (not covered by other funds) associated with
restoring coverage required by Proposition 204 (General Election 2000), in which voters
increased AHCCCS eligibility for all persons up to 100% of the federal poverty level.
Laws 2013, 1st Special Session, Chapter 10 (adding new section 36-2901.08, Arizona Revised
Statutes) also increased eligibility for Medicaid up to 133% of the federal poverty level.
The cost for this new population is, initially, funded entirely with federal funds; future
state costs will be funded by the assessment. For the first six months of State Fiscal Year
2014, the assessment is expected to generate $75.4 million.
AHCCCS is currently awaiting CMS approval of the assessment proposal, and expects to have
this approval in time to begin in January 2014 as planned.
AHCCCS will be sending email notifications to all Arizona hospitals subject to the
assessment on or before January 15, 2014, that the assessment invoice is available on a
secure website. No invoices will be produced on paper or mailed to a physical address.
As such, it is imperative that AHCCCS have a dedicated group email address for every
facility. We will not send emails to individual people as staffing changes occur often
and we must ensure that invoices are not lost or missed due to individual staff schedules
or termination. This email address should be accessed by multiple staff to ensure proper
delivery. Please submit the group email
address to HospitalAssessmentProject@azahcccs.gov by Tuesday, January 7, 2014.
On April 4, 2013, AHCCCS hosted a meeting with hospital providers to discuss the Governor’s proposal to expand Medicaid
coverage through hospital assessment funding. In this meeting, AHCCCS presented some of the principles and next steps in
moving forward with this plan.
AHCCCS will form workgroups of hospital representatives to work through the methodology and issues related to the
assessment. If you are interested in participating, please contact AHCCCS at
AHCCCS Hospital Assessment Workgroup
Hospital Assessment Workgroup Presentation May 8, 2013
Below please find the AHCCCS Draft Proposed Hospital Assessment Rule and the associated model. These
documents will be discussed at the Hospital Workgroup meeting on August 22 and are available for your written
comments until September 4, 2013. Please send your written comments to
FFSRates@azahcccs.gov. AHCCCS expects to post a proposed rule in
November, with a 30 day formal public comment period, for expected implementation of the final rule on
January 1, 2014.
At the request of Workgroup members, below please find an updated proposed model which includes the
SFY 15 impacts by hospitals. The SFY 15 impacts are for illustration purposes only and will change as
AHCCCS updates its budget projections for SFY 15, and based on possible changes to peer group assessment
rates as revenues and expenses are monitored on an ongoing basis. Other than the addition of SFY 15 data,
this model is identical to the August 22, 2013 version except for the reclassification of one urban hospital
which was incorrectly included in the rural hospital peer group.
Proposed Model Including SFY 15 impacts
On September 20, 2013, AHCCCS submitted the statewide hospital assessment proposal to CMS. Below are links with the
narrative request and assessment model. After carefully reviewing comments, AHCCCS made the following changes
from the model distributed to hospitals on August 22, 2013:
AHCCCS will post to this website CMS action on this request, and the proposed state rule will be
posted for public comment on or about November 15, 2013.
As has been discussed in each workgroup meeting, AHCCCS considers the development of the hospital assessment
to be an iterative process. This proposed rate is for the first six months of calendar year 2014 only, and
further workgroup meetings and modeling will be completed for the State Fiscal Year 2015
(July 1, 2014-June 30, 2015) rate period.
CMS Approval Letter 1/14/14
CMS Request 9/20/13
Initial Proposed Assessment Model (see Updates below)
Subsequent to the submission of this assessment model to CMS, a minor change was made to the
model to account for a separately licensed hospital that falls into one of the exemption
categories that is located within a larger hospital which is subject to the assessment. A very
small number of discharges associated with the separately licensed facility were reduced from the
hospital’s total number of discharges. Because the number of discharges was so small, this change
does not impact the overall 2014 rate, and it does not result in changes to the assessment amounts
for any other hospital.
As noted above, the proposed assessment rate is limited to the first six months of calendar year 2014.
AHCCCS anticipates that a new analysis will be completed in order to determine the assessment rate for
the period of July 1, 2014 through June 30, 2015 (State Fiscal Year 2015). Modeled results for the
State Fiscal Year 2015 period are provided for informational purposes only and the actual SFY 2015
rates will be updated based on further analysis, Workgroup discussions and updated data.
Projected Coverage Payments
As discussed in Workgroup meetings, the projected coverage payments displayed in the model represent
payments associated only with those populations funded by the hospital assessment. See the
Assessment Population Chart at the top of this page for a summary of populations funded by the
assessment. The projected coverage payments do not represent the full impact to hospitals of the
various changes in coverage expected beginning January 1, 2014, including the expansion of coverage
for children and the woodwork effect on traditional Medicaid populations. Hospitals should not use
the projected coverage payments to estimate the total increase in hospital revenue associated with
the coverage changes beginning January 1, 2014.
Revised CMS Request
Revised 2014 Assessment Model (including 2015 data)
The Administration is proposing a new rule to describe the process for establishing, administering and collecting the assessment on hospitals.
A.R.S. § 41-1005 (A)(32) exempts the Administration from Title 41, Chapter 6 of the Arizona Revised Statutes (the Arizona Administrative Procedure Act)
for purposes of implementing and establishing the hospital assessment; however, that provision requires the Administration to provide public notice
and an opportunity for public comment at least thirty days before doing so.
Hospital Assessment Notice of Proposed Rulemaking
Effective January 15, 2014, AHCCCS filed the Final Rule for the Hospital Assessment
with the Arizona Secretary of State.
Hospital Assessment Final Rule