Proposed State Rules

AHCCCS proposed rules are published in the Arizona Administrative Register (A.A.R.) for public review. To compare the following Proposed Rule language to Final Rule, please see corresponding topic when finalized at:

Note: Information provided in PDF files.


Hospital Assessment Amendment 2015

Friday March 13, 2015
A.R.S. § 36-2901.08 authorizes the Administration to establish, administer and collect an assessment on hospital revenues, discharges or bed days for funding a portion of the nonfederal share of the costs incurred beginning January 1, 2014, associated with eligible persons added to the program by A.R.S. §§ 36-2901.01 and 36-2901.07. It is the agency’s objective to assess only so much as is necessary to meet the estimated costs associated with the projected populations referenced in the statute. As such, it is necessary for the Administration to adjust the assessment from time to time as the Administration obtains new information to update estimations of the number of eligible persons and projections of the costs anticipated to provide coverage for those persons. The Administration is proposing a new rule to update the figures to be used as of April 1, 2015 for collecting the assessment on hospitals.

Incontinence Brief Coverage

Thursday March 12, 2015
This rulemaking is required as a result of the May 2014 Ninth Circuit Court of Appeals Decision in Alvarez et al v Betlach. Litigation challenging AHCCCS coverage of incontinence briefs for members in the ALTCS Program was filed in federal court in 2009 by the Arizona Center for Disability Law. The lawsuit sought to compel AHCCCS to provide incontinence briefs and supplies to members in the Arizona Long Term Care Program who were age 21 years and older and who were incontinent as a result of their disabilities in order to prevent skin breakdown. The current rule applicable to this population limits coverage of incontinence briefs for members age 21 and older to circumstances when medically necessary to treat a medical condition, such as an infection, but not for preventive purposes. The Ninth Circuit Court of Appeals determined that AHCCCS is required to provide coverage of incontinence briefs prescribed for members in the Arizona Long Term Care Program who are 21 years of age and older when medically necessary to prevent skin breakdown and infection.

BH Inpatient Payment Responsibility Comment Period Closed

Friday November 11, 2014
The Administration is proposing a rulemaking to clarify an issue that has been identified through the administrative hearing process regarding contractor responsibility for covering inpatient hospital services when both medical and behavioral health services are provided during the same hospital stay. The proposed rule will clarify the reimbursement methodology. The Administration is proposing to clarify through rule, its existing policy that the RBHA is responsible for all inpatient hospital services if the principle diagnosis on the hospital claim is a behavioral health diagnosis. Those claims will be paid in accordance with a per diem fee schedule developed by ADHS and approved by AHCCCS. Hospital claims that do not have a behavioral health diagnosis as the principle diagnosis will be paid by the acute care contractor using the DRG payment methodology. This proposed amendment will benefit hospitals by clarifying to whom claims should be submitted and the amount of reimbursement that the hospital can expect. The Administration intends to initiate and implement this clarification as soon as possible to reduce billing disputes between hospitals and health plans and to reduce unnecessary administrative hearings arising from those disputes.

AHCCCS Public Hearing Locations

  • AHCCCS Administration
    701 East Jefferson, Gold Room
    Phoenix, AZ 85034
  • Arizona Long Term Care System
    1010 North Finance Center Drive, Suite 201
    Tucson, AZ 85701
  • Arizona Long Term Care System
    2717 N. 4th St. STE 130
    Flagstaff, AZ 86004


Comments on proposed AHCCCS rules may be submitted in the following ways:

  • Mail:
    Office of Administrative Legal Services (OALS)
    701 East Jefferson Street, Mail Drop 6200
    Phoenix, Arizona 85034
  • Phone: (602) 417-4232
  • FAX: (602) 253-9115
  • E-mail:


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