The following changes were made as part of the FY 2010 budget
revision bill passed during the 2009 Third Special Session in July, 2009:
AHCCCS Policy Regarding HB 2008
The documents below provide information about the AHCCCS policy regarding discovered violations of immigration law, as required under
Review of the Acute Care Adult Benefit Package
Due to Arizona's significant fiscal challenges and a substantial growth in the Medicaid population, AHCCCS has reviewed the current acute care adult benefit package. Listed below is more information about the review and process, including the briefing for stakeholders.
Legislative authority was was required to implement several of
the changes outlined below. Such authority was not included in the most recent budget legislation. As a result of FY 2010 reductions, AHCCCS is reviewing and making changes to medically necessary criteria and policy. For updates on recent policy changes
AHCCCS Medical Policy Manual (AMPM). AHCCCS continues to review the acute care adult benefit package to address how cost savings can be achieved in light of the continued budget shortfall and growth in the Medicaid population. Additional information will be made available as further details emerge.
Graduate Medical Education Payments (GME)
House Bill 2643 reduces Direct GME authorized funding by a total of $2.8 million in total funds for the period of July 1, 2009 through June 30, 2010, then what had been authorized in FY 2009. Indirect Medical Education payments are expected to be increased by about $6 million in total funds for the same period. Given the overall number of residents and funding levels distributed in FY 2009, the AHCCCS administration expects little to no impact in direct GME funding for FY 2010.
Changes to the AHCCCS Dental Program
As part of the budget changes to address the financial shortfall in the 2010 state fiscal year, AHCCCS will:
- Extend 5% fee reductions to the AHCCCS Fee-for-Service (FFS) dental fee schedule for all procedures; and
- Implement various medical management changes to the dental program as described in more detail in the attached notice below;
- The Arizona Legislature passed House Bill 2013, which eliminates AHCCCS coverage of dentures for adults beginning September 30, 2009.
FFS Rate Update Effective October 1, 2009
Fee For Service rates for dates of service October 1, 2009 through September 30, 2010, will be reduced by 5% for the majority of providers, unless those rates were already reduced by 5% during 2009. Providers who already experienced the 5% rate reduction will have their rates frozen.
The exceptions to this rate reduction are hospitals and nursing facilities. Nursing facility and hospital inpatient and outpatient rates will be frozen at the October 1, 2008 levels.
FFS Rate Update Public Notice [PDF]
Elimination of AHCCCS Health Insurance for Parents
As of October 1, 2009, the AHCCCS Health Insurance for Parents program will end. This program typically covers parents of KidsCare children who 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. Arizona has notified CMS of this change as required by the Special Terms and Conditions of Arizona's 1115 Waiver. AHCCCS will be sending letters to members in September to inform them of the program ending and provide information about other resources.
Notice of Elimination of AHCCCS
Health Insurance for Parents Program [PDF]
Loss of KidsCare or AHCCCS Health Insurance is now a qualifying event for your employer's group health plan. See
Federal Activities page for more
Medicaid Population Increases
Over the past two months alone, the AHCCCS program has grown by about 49,000 members and in the last 12 months 120,700 new members have enrolled in the program. As a result of this significant growth rate, AHCCCS has recently updated its budget projections for SFY 2010. The revised General Fund estimates (prior to the release of the May enrollment information) are approximately $250 million greater than the General Fund amounts included in the JLBC SFY 2010 Baseline Budget. Attached please find
updated information regarding the forecast for the FY2010 AHCCCS budget
Preliminary 2010 Capitation Rate Estimates
On March 9, 2009, as required by Laws 2006, Chapter
344, AHCCCS submitted its
preliminary actuarial estimates of the capitation rate
changes for FY 2010 [PDF] along with the reasons for the
estimated changes to the Joint Legislative Budget
2010 Budget Reduction Options: 5-20% Reduction Scenarios
At the request of the Governor's Office, AHCCCS provided proposed
fiscal year 2010 budget
reduction options [PDF] including the programmatic impacts of implementing budget reductions of 5, 10, 15 and 20 percent.
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