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.
July 1, 2014
AHCCCS will be applying for the State Innovative Model Grant, Round Two. The initiative provides support
and funding for state multi-payer efforts around payment reform and health care system transformation to
improve health, transform the delivery system, and lower costs. The Initiative provides funding for states
to either design or test health care innovation models. More information can be found on the link below. SIM Grant Info
Tue Dec 20, 2011
Effective January 1, 2012, the AHCCCS Office of
the Inspector General will implement program integrity changes as required by the
Affordable Care Act and published in the CMS
[PDF] related to:
The link below has more information.
Provider changes 1/1/12
January 2, 2013
As a result of recent Congressional action, increased federal funding for the QI-1 program was made available and AHCCCS will open the
program effective immediately. All applications that were previously denied because the program was scheduled to expire December 31, 2012,
will now be processed. Also, QI-1s who were previously notified their QI-1 benefits were ending, will be reinstated effective January 1,
December 13, 2012
Pursuant to Section 1933 of the Social Security Act, the AHCCCS Administration will institute an enrollment freeze for
persons who would otherwise be eligible for benefits as "qualifying individuals" or "QI-1s." Although QI-1s are a mandatory
eligibility group, subsection (b)(3) of section 1933 of the Act requires the State to limit the number of QI-1s made eligible
for the calendar year so that the amount of assistance provided to such individuals is estimated to equal but not exceed the
State's federal allocation for the QI-1 population. Due to insufficient federal funding, AHCCCS will be denying new and
pending applications for QI-1s as of December 14, 2012. Also, current QI-1 members will be notified the week of December
17th, that AHCCCS will discontinue their benefits effective December 31, 2012 due to insufficient federal funding. AHCCCS will
continue to monitor whether Congress will authorize additional federal funding for the QI-1 population for the remainder of
2012 and in the future.
QI-1 Letter 12/14/12
QI-1 Member Letter Update [PDF]
QI-1 Program History
Fri Jul 15, 2011
In March 2011, AHCCCS and ADHS/DBHS applied for, and were awarded, a planning grant to
explore the feasibility of a specialty Regional Behavioral Health Authority (RBHA) model
with expanded responsibility for Title XIX eligible adults determined to have a Serious
Mental Illness (SMI). The "Specialty RBHA with SMI Health Homes" model would be funded
and fully responsible for coordinated and integrated behavioral healthcare and physical
healthcare for Title XIX eligible adults with SMI through the use of SMI health homes.
The ADHS/DBHS website
provides additional information on the Specialty RBHA concept, along with background
information on integration of care, and how consumers and stakeholders can participate.
AHCCCS will also post updates as information becomes available.
Fri Oct 21, 2011
CMS approved Arizona's request for flexibilities under the 1115 Waiver to provide
coverage for the cost of Part B premiums after October 1, 2011. Pursuant to authority
in the Waiver, AHCCCS will continue to pay the Medicare Part B premiums for certain
AHCCCS members. A link to the approval letter is provided below.
CMS Approval Letter
Thur Jul 7, 2011
As a result of an OIG audit and CMS decision, payment of the Medicare Part B premium for
approximately 10,000 ALTCS members whose income exceeds 120% of the Federal Poverty
Level (FPL) will be terminated by AHCCCS and will become the member’s responsibility
effective October 1, 2011. See the links below for more information.
Updated information on the status and impact of Health Care Reform, is available on the link below. Information on
this page provides useful background based on various proposals and documents Arizona’s tracking of these issues.
Please visit the AZ Future page for the most recent data and updates.
AZ Future Page
Thu Jan 26, 2012
AHCCCS has updated its analysis on Medicaid expansion scheduled to be effective
January 1, 2014, pursuant to the Affordable Care Act (ACA). Note, these estimates are based
on information available at this time and should not be considered definitive as there remains
a number of uncertainties. Federal guidance regarding a number of issues is forthcoming
and is expected to have an impact on these estimates. Continue to check the website for
updates to this information.
ACA Prelim Estimates [PDF]
Fri Feb 4, 2011
Information regarding AHCCCS implementation of some of the Medicaid provisions of the
Act (ACA) [PDF] is provided below. This document will be updated regularly as information
Thu Mar 25, 2010
On March 23, 2010, President Obama signed federal health care reform into
law (HR 3590
On March 25, the Senate passed the House amendments to HR 3590 via the Reconciliation
bill (HR 4872
was sent back to the House for a second vote on a procedure change. The House passed the
Reconciliation bill a second time that same evening and now the bill awaits President Obama's
signature, which is expected sometime next week. AHCCCS has completed its initial review of
the impact to Arizona and has updated the fiscal estimates from the December 7, 2009, analysis.
Copies of the AHCCCS preliminary analysis and the bills are provided below:
Fri Mar 18, 2011
The Centers for Medicare & Medicaid Services (CMS) is inviting proposals from State
Medicaid agencies to compete for grant awards for the Medicaid Incentives for Prevention
of Chronic Diseases Program. CMS is conducting a nationwide program to test and evaluate
the effectiveness of a program to provide financial and non-financial incentives to Medicaid
beneficiaries of all ages who participate in prevention programs and demonstrate changes in
health risk and outcomes, including the adoption of healthy behaviors. The initiatives or
programs are to be "comprehensive, evidence-based, widely available, and easily accessible."
The programs must use relevant evidence-based research and resources, including: the Guide to
Community Preventive Services; the Guide to Clinical Preventive Services; and the National
Registry of Evidence-based Programs.
AHCCCS is reviewing this grant opportunity as part of an overall effort to reform the
Medicaid program for Arizona. Any interested organization wishing to partner with AHCCCS or
submit a concept for consideration may do so at
Because state Notices of Intent are due to CMS by April 4, 2011, AHCCCS is requesting that
external stakeholders submit their concepts to AHCCCS no later than
6:00p.m., MONDAY, MARCH 28, 2011. Please limit submissions to two pages and include: (1) a
brief description of the concept; (2) citations to evidence-based research supporting
the concept; and (3) a representation of the anticipated workload for AHCCCS in implementing
AHCCCS will review all concepts submitted and make a final determination as to whether the
agency will pursue the grant. If the agency pursues the grant and adopts any of the concepts
submitted, those entities will be notified in advance. AHCCCS will post the Notice of Intent
and any final grant application, if pursued, to its website.
For more information about this grant opportunity, please visit:
On March 29, 2001, CMS approved Arizona's planning request for the funding opportunity
provided under Section 2703 of the Affordable Care Act- "Health Homes for Enrollees with
Chronic Conditions." As detailed in the request, Arizona is interested in determining the
feasibility of developing integrated health homes for persons with Serious Mental Illness.
Fri Feb 4, 2011
AHCCCS applies for a contract to develop an innovative model for improving the integration
of care for dual-eligible members. See contract submission here:
Integrated Care for Dual Eligibles [PDF]
Governor Brewer has shared her concerns about Arizona's challenges with Health Care
Reform to Congressional leaders. Links and descriptions of those letters are provided
below, beginning with the most recent.
Tues Dec 28, 2010
AHCCCS continues to work with CMS on issues related to the KidsCare program, including the
impact of the Enrollment freeze.
For additional information about the Enrollment cap visit:
Mon Jun 28, 2010
AHCCCS has received guidance from CMS regarding the impact of the
Affordable Care Act (ACA)
the KidsCare program.
Thu Mar 18, 2010
Effective June 15, 2010, the KidsCare program will end. KidsCare is
Arizona's Children's Health Insurance Program and covers children whose
families have income between 100% and 200% of the Federal Poverty Level
(FPL). The State does not have enough funds to keep paying its portion of
this program. This program was funded jointly by the State and federal
government under Title XXI of the Social Security Act. There are about
38,000 children currently enrolled in the program.
Loss of KidsCare or AHCCCS Health Insurance is now a qualifying event
for an employer's group health plan. See the
Federal Activities page for more information.
AHCCCS has submitted the following notice to CMS:
AHCCCS Notice to CMS Regarding KidsCare Termination - 3/18/10 [PDF]
Fri Jul 2, 2010
The Pre-existing Condition Insurance Plan (PCIP) was established by the U.S. Department of
Health and Human Services (HHS). The PCIP offers health coverage through 2014 to qualified
individuals who can not get health coverage because of a pre-existing health condition. After 2014,
insurers will be required to provide access to more affordable private insurance via the new
Exchanges as described in the
Affordable Care Act [PDF]. Applicants in Arizona will be linked directly to the federal application
page since the HHS is running the PCIP for Arizona. More information about the PCIP and how to
apply is available at: www.HealthCare.gov.
PCIP Pamphlet [PDF]
Wed May 5, 2010
The Affordable Care
Act (ACA) [PDF] establishes temporary high risk pools beginning June 21, 2010. The ACA
allows states to either operate their own risk pool or opt out and allow their state's
citizens to access a federally operated risk pool. In a recent letter to HHS Secretary
Sebelius, Arizona elected to opt out. More information about the federal government's plans
to implement and operate the temporary high risk pools in Arizona will be provided as soon
as it is received.
Governor Brewer's Letter to HHS - 4/30/10 [PDF]
Mon Apr 19, 2010
AHCCCS has summarized the various Medicaid provisions of health care reform from
Care Act [PDF]. Please note, other sections not included in the matrix may be added at a later
date. Information will be updated as it is available.
Health Care Reform Matrix [PDF]
Mon Feb 22, 2010
President Obama unveiled key provisions of his proposal for health care
reform. AHCCCS is in the process of reviewing the provisions, although the
documents currently available do not provide significant detail to allow for a
thorough impact analysis. More information will be posted as it becomes available.
President's Proposal [PDF]
Governor's Letter to President Obama - 3/10/10 [PDF]
Thu Dec 24, 2009
The Senate passes The Patient Protection and Affordable Care Act (H.R. 3590), the
Senate vehicle for health care reform legislation.
Senate Proposal [PDF]
Sat Nov 7, 2009
The House of Representatives passes The Affordable Health Care for America Act (H.R. 3962).
House Proposal [3.2MB]
Fri Jan 29, 2010
On January 27, 2010, AHCCCS made a presentation about Federal Health Care Reform to the Arizona
House and Senate Health Committees. A copy of the presentation is provided below:
AHCCCS Federal Health Care Reform Update [PDF]
AHCCCS recently sent a letter to the Governor outlining the Agency's assessment
on the impact that Congressional health reform proposals will have on the Arizona
state budget and Medicaid program.
Letter to the Governor
Outlining the Impact of Federal Health Care Reform Proposals [PDF]
The presentation below provides the Agency's analysis regarding the potential impact
of the federal health care reform proposals to Arizona. Please note, following December
18, 2009, when the presentation was created, the U.S. Senate made changes to its
proposal that are not reflected in the presentation. AHCCCS will continue to monitor
the impact to Arizona as information becomes available. Updated information about
changes to the proposals can be found on the website of the
Kaiser Family Foundation.
Care Reform Analysis and Update [PDF]
Information about the impact of Federal Health Care Reform to Arizona has appeared
in recent media outlets.
On December 30, 2009, the Governor issued the following statement regarding the
financial impact of the Federal Health Care Reform plan.
Statement Regarding HCR [PDF]
Tue Mar 1, 2011
The new Federal Poverty Level limits effective April 1, 2011 are now available:
2011 Federal Poverty Guidelines
Tue Mar 16, 2010
On January 22, 2010, the Federal register published a notice to
advise that the 2009 poverty guidelines will remain in effect
until updated 2010 poverty guidelines are published. To date,
the 2010 poverty guidelines have not been published. AHCCCS will
post information as soon as it becomes available. A copy of the
Federal Register notice is provided below:
Federal Register Notice - 1/22/10 [PDF]
UPDATE: The Federal
register did not publish new poverty guidelines in 2010. There
were no increases in 2010 to the FPL.
Tue Aug 17, 2010
On August 10, 2010, President Obama signed
HR 1586, which includes an extension of $16 billion in increased Medicaid funding to states
through June 30, 2011. It is anticipated that Arizona's general fund will benefit by $246 million
in Medicaid funding but leaves about $150 million short for FY 2011. The complete loss of stimulus
dollars for FY2012, which begins July 1, 2011, will leave a $1 billion shortfall for FY 2012. More
information will be posted as it becomes available.
HR 1586 [PDF]
On February 4, 2009, the Children's Health Insurance Program Reauthorization Act of
2009 (CHIPRA or Public Law 111-3) was signed into law. CHIPRA reauthorizes and finances the
Children's Health Insurance Program (CHIP) through FY 2013 and made other changes to the CHIP
and Medicaid programs. More information is provided below:
Section 104 of the Children's Health Insurance Program Reauthorization Act (CHIPRA) provides
for a performance bonus payment to states that meet five of eight enrollment and retention
provisions for children. CMS informed AHCCCS that it was deficient in two of the provisions
to qualify for performance bonus payments. Below is additional information regarding Arizona's
appeal of the CMS decision that the state does not meet five of the eight requirements to
qualify for performance bonus payment.
It is estimated the State would have received approximately $31.7 million over 3 years to
help sustain its KidsCare program.
The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 made
several changes designed to help people get or keep health insurance coverage. One of
the changes allows employees and their families to enroll in their employer's group health
plan without having to wait for an open enrollment period when the employee or dependent
loses their AHCCCS or KidsCare benefits. The employee or dependent must:
Contact your employer immediately if you think you may be eligible to enroll in their group
health plan coverage and your AHCCCS or KidsCare coverage is ending. More information is
available from CMS:
Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009, Section 311
For additional information about CHIPRA, visit the CMS website:
On February 17, 2009, President Obama signed into law
the American Recovery and Reinvestment Act (ARRA)(P.L. 111-5).
Title 5 of the ARRA provides approximately $87 billion in grant
money to help States, the District of Columbia, and Territories meet the health care
needs during the economic crisis.
Information on how the ARRA would impact Arizona's Medicaid program is provided below:
For additional information about ARRA and Medicaid, visit the CMS website:
Tue Oct 5, 2010
On January 1, 2011, the administrative oversight for the Children's Rehabilitative Services (CRS)
program will be consolidated in AHCCCS. There will be no change in how members
and families interact with their health plan, providers, network or service
Member Notice [PDF]
Adobe Acrobat Reader is required to view PDF files. This is a free program available
from the Adobe web site. Follow the download directions on the Adobe
web site to get your copy of Adobe Acrobat Reader.