AHCCCS Rate Changes
FFS Rate Update Effective October 1, 2010
FFS Rate Update Public Notice [PDF, 16KB]
FFS Rate Update Effective October 1, 2009
On September 4, 2009, Governor Brewer signed into law HB 2013 of the 49th Legislature, Third Special Session. As noted in the Public Notice
below, this action results in inpatient and outpatient hospital rates frozen at their October 1, 2008 levels, and ADHS-regulated emergency ground transportation rates reduced by 5% to 76% of ADHS rates.
FFS Rate Update Public Notice [PDF, 10KB]
5% FFS Reduction Effective February 1, 2009
The State of Arizona is currently facing a projected budget deficit of $1.2 billion in State Fiscal
Year 2009 and an estimated shortfall of at least twice that in State Fiscal Year 2010. As part of
the Governor's Budget Management Plan, the Arizona Health Care Cost Containment System
(AHCCCS) proposes to revise specified Fee-For-Service (FFS) payment rates for services
provided to members enrolled in the AHCCCS FFS program, the Medicaid School Based
Claiming (MSBC) program and the Comprehensive Medical and Dental Program (CMDP) for
dates of service on and after February 1, 2009. AHCCCS has established the "FFS Program
Capped Fee Schedule" and rates contained therein will be reduced by 5%.
5% FFS Rate Reduction Announcement [PDF, 10KB]
- Inpatient Hospital Tiered per Diem Rates and Outpatient Hospital Fee Schedule
Pursuant to Laws 2008, Chapter 288, hospital
inpatient and outpatient rates will remain frozen at the
October 1, 2007 values from October 1, 2008 through
September 30, 2009.
- Nursing Facilities
FFS nursing facility rates will be adjusted by component
- direct,
indirect, and capital.
- The direct component will be inflated using the Global Insight
estimate of the Employment Cost Index (ECI) for total compensation
for nursing and residential care facilities.
- The indirect component will be inflated by the Global Insight
estimate of the Consumer Price Index (CPI) for medical services,
with an additional adjustment based on prior year cost report data.
- The capital component will be inflated by the Global Insight
estimate of skilled nursing facility total market basket capital
costs net of interest.
The estimated impact of the increases in nursing facility FFS rates
on AHCCCS' FFS expenditures for federal fiscal year 2009 is an increase
of 4.0%.
- Home and Community-Based Services
FFS home and community based service rates will be inflated by the
Global Insight forecast of the Consumer Price Index for medical services
rounded to the nearest $0.05. The estimated impact on AHCCCS' FFS
HCBS expenditures for federal fiscal year 2009 is an increase of 4.6%.
- Physician Fee Schedule
The physician fee schedule rates will be updated as follows:
- laboratory and pathology rates, and DMEPOS rates, will be
updated based on Medicare's corresponding fee schedules;
- rates for drugs and injectibles will be updated based on
Medicare's corresponding fee schedule, except that chemotherapy
drugs will continue to be based on 85% of Average Wholesale Price;
- all other rates will be updated based on Medicare's
Resource-Based Relative Value Schedule, using conversion factors
that will produce AHCCCS claims budget neutral.
The estimated impact on AHCCCS Fee-For-Service expenditures for the
period October 1, 2008 - September 30, 2009 is 0%.
- Transportation
- Emergency Ground Transportation: Base rates for emergency
ground transportation providers not regulated by the Arizona
Department of Health Services (ADHS) will be inflated by a composite
of the Global Insight forecast of the Consumer Price Index (CPI) for
medical care services and the Global Insight forecast of the CPI for
medical services by other medical professionals. Mileage rates
will be inflated by a composite of the Global Insight forecast of
the CPI for medical services by other medical professionals and a
fuel index based on the increases in gasoline prices in Arizona.
The estimated impact of the inflated base and mileage rates on
non-ADHS-regulated FFS emergency ground transportation services for
federal fiscal year 2009 is an increase of 3.57%.
- Non-Emergency Ground Transportation: Base rates for
non-emergency ground transportation providers not regulated by ADHS will
be inflated by the Global Insight forecast of the CPI.
Mileage rates for non-emergency ground transportation will be inflated
by a composite of the Global Insight forecast of the ECI for
transportation workers and a fuel index based on the increases in
gasoline prices in Arizona. Mileage rates for Arizona Long Term
Care Services (ALTCS) providers of home and community based services to
Native Americans will be adjusted to the IRS business mileage allowance
rate. The estimated impact of the inflated base and mileage rates
on non-ADHS-regulated FFS non-emergency ground transportation services
for federal fiscal year 2009 is an increase of 4.63%.
- Emergency Air Transportation Rates: Base rates for emergency
air transportation providers not regulated by ADHS will be inflated by a
composite of the Global Insight forecast of the CPI for transportation
services and the Global Insight forecast of the CPI for medical services
by other medical professionals. Mileage rates will be inflated by
a composite of the Global Insight forecast of the CPI for
transportation, the Global Insight forecast of the ECI for
transportation workers and the Federal Aviation Administration forecast
of jet fuel prices. The estimated impact of the inflated base and
mileage rates on non-ADHS-regulated FFS emergency air transportation
services for federal fiscal year 2009 is an increase of 3.91%.
