AHCCCS Home > This Page

AHCCCS News & Updates AHCCCS News & Updates RSS Feed

Looking for a previous story? Information previously located on this page has been placed in either the State Legislative Budget Activities pages or the Federal Activities page.

Note: Information provided in PDF files, unless otherwise noted.

Health Insurance Exchange Updated Icon

Thurs Feb 2, 2012
The YH12-0023 Health Insurance Exchange Request for Proposal is now available. Use the link below for more information.

Health Insurance Exchange RFP

Hospital Meeting Updated Icon

Fri Jan 27, 2012
AHCCCS is hosting a meeting to discuss the potential for drawing down federal funds to match state gaming monies associated with Proposition 202. Prop. 202 currently funds unrecovered hospital costs for trauma facilities and Emergency Departments. AHCCCS will present three or four different options and will discuss the process for obtaining federal matching funds for this pool. AHCCCS personnel will also be available to answer any questions.

The meeting will be held at:

AHCCCS Administration
701 E. Jefferson, Gold Room
February 22, 2012 at 10:00AM - 12:00PM.

In-person attendance is appreciated, as only a limited number of phone lines are available. Please RSVP to  Alma Torres at Alma.Torres@azahcccs.gov and note whether you will attend by phone or in person.

DSH 2010 Pool 5 Deadline

Fri Jan 20, 2012
DSH 2010 Pool 5 funds will be reconciled and settled this year. Hospitals must have 2010 DSH final IGAs to AHCCCS by April 15, 2012, to be included in the final Pool 5 reconciliation and distributions and be eligible for DSH 2010 Pool 5 funding. See the link below for more information.

DSH Info

Acute Care RFP

Thur Feb 2, 2012
AHCCCS held a public meeting on January 18, 2012, to provide the public with information about the upcoming Request for Proposal for managed care contracts. More information about the meeting and related material is provided in the links below.

Public Meeting
RFP Information

QI-1 Program Update

Thur Dec 29, 2011
On Friday, December 23, 2011, the President signed into law the "Temporary Payroll Tax Cut Continuation Act of 2011" (TCCA). Under section 310 of that legislation, the Congress continued authority and additional funding for the QI program through February 29, 2012. Arizona is currently working with federal authorities at the Centers for Medicare and Medicaid Services (CMS) to ensure that the State has sufficient funding for AHCCCS members enrolled in the QI-1 program through February 29, 2012. Therefore, AHCCCS sent the following revised notice to all QI-1 members explaining that AHCCCS will continue to cover their Part B premiums through the end of February. AHCCCS will NOT move ahead with any discontinuances for now. However, Congress must still act to extend the QI-1 program for the remainder of the year. AHCCCS will continue to monitor, but federal officials believe that the Congress will act to extend authorization and full funding for the upcoming year. Continue to check the website for updates.

QI-1 Member Letter Update [PDF, 33KB]

Fri Dec 23, 2011
Because Congress has not yet authorized additional federal funding for the QI-1 population, AHCCCS sent the following to QI-1 members on 12/22/11.

QI-1 Letter - QI-1 Letter - 12/22/11 [PDF, 37KB]

Thur Dec 1, 2011
AHCCCS continues to monitor whether Congress will authorize additional federal funding for the QI-1 population. To date, no such funding has been allocated. Should Congress not act, AHCCCS will discontinue benefits for individuals enrolled in the QI-1 program effective December 31, 2011. QI-1 members will be notified about the termination the week of December 19, 2011. Continue to check this page for updates.

Fri Oct 21, 2011
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.

On October 21, 2011, AHCCCS issued the following correspondence to all members of Arizona’s congressional delegation regarding insufficient QI-1 Funding.

QI-1 Program Letter- 10/21/11

Provider Changes 1/1/12

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 final rule related to:

  1. Provider Registration and
  2. Suspension of Provider Payment based on a Credible Allegation of Fraud.

The link below has more information.

Provider changes 1/1/12

Prop 204 (Childless Adult Freeze) Litigation Update new icon

Tue Dec. 6, 2011
On December 6, 2011, the Arizona Court of Appeals issued a decision upholding the freeze on new enrollment for childless adults. Below are links to the press release and opinion issued by the court.

Court of Appeals Press Release
Court of Appeals Decision
Other Relevant Documents

MVD Photos on AHCCCS On-Line Eligibility Verification

Tue Dec 6, 2011
Beginning December 15, 2011, AHCCCS will be adding photos to the on-line verification tool used by providers to verify member eligibility. More information can be found in the link below:

MVD Photos on AHCCCS On-Line Eligibility Verification [12KB]

Governor Brewer's Medicaid Reform Package

Thu  Jan 19, 2012
The tracking document below has information about the implementation status of Arizona’s Medicaid Reform plan. Continue to check the website for updates to the document.

Tracking AZ's Medicaid Reform Plan, 1/18/2012  [127KB]   Updated Icon

Wed Mar 16, 2011
On March 15, 2011, Governor Brewer presented her plan to preserve Arizona's Medicaid program with reforms that will drive down costs by an estimated $500 million in the State's General Fund for the partial first year. The plan was approved by the Legislature as part of the FY 2012 budget adoption and is subject to federal approval. 

Medicaid Reform Plan [81KB]

  1. Proposal to Provide Funding Assistance to Hospitals New Icon
    Mon Nov 28, 2011
    Governor Brewer and area hospitals propose to use local dollars to fund uncompensated care and hospital improvements. The proposal is pending before CMS. Click on the link below for more information (See item #15):

    Funding Pools Proposal [1.09MB]

  2. AHCCCS October 1, 2011 Rate Reductions Updated Icon
    Tues November 22, 2011
    CMS has approved the State Plan Amendments to reduce Reimbursement Rates by 5%. CMS has also approved the State Plan Amendment update the payment methodology for paying inpatient hospital claims with extraordinary operating costs. Click on the links below to view the CMS approval letters: 

    SPA Approval 11-009A - Inpatient Hospital Rates
    SPA Approval 11-009B - Outpatient Hospital Rates
    SPA Approval 11-009C - Rate Reductions
    SPA Approval 11-009D - Nursing Facility Rates
    SPA Approval 11-011- Outlier

    Note: CMS continues to consider the State Plan Amendment to limit covered inpatient days for adult members.

    Wed October 19, 2011
    AHCCCS is providing information on the status of the October 1, 2011, rate reductions. Click on the link for additional information and continue to check the AHCCCS website for updates

    AHCCCS Rate Update [10KB]

    Tues. May 24, 2011
    Laws 2011, Chapter 31, gives AHCCCS authority to reduce rates for all providers up to 5%. Effective October 1, 2011, AHCCCS will reduce all provider reimbursements by 5%, including all payment ratios utilized for provider reimbursement (e.g., all Cost-to-Charge Ratios (CCRs), By Report Percentages (BR), etc.). The only exceptions are for:
    • Drugs administered in a physician's office
    • Hospice rates - AHCCCS matches Medicare rates as required by Federal law.
    • Payments for services provided by the Indian Health Service or Tribal 638 facilities claimed at 100% FMAP.

    For more detail regarding the Provider Rate Reductions, please click on the links provided below:

    Outlier Proposed Rule [68KB]
    State Plan Amendments
    Access to Care Studies, Memos and Additional Information
    AHCCCS Comments on CMS Access to Care Proposed Rule
    Notice of Public Information
    Materials from Hospital Meeting 8/15 [166KB]
    DDD Provider Meeting 9/9* [60KB]
    Info for DDD Families [20KB]

    Additional information, such as the Notice of Exempt Proposed Rulemaking and State Plan Amendment to CMS will be posted on the web as it becomes available.

    *AHCCCS met with a small group representing providers of services to AHCCCS members enrolled in the Division of Developmental Disabilities (DDD) to learn more about their concerns regarding rate reductions. This presentation was shared with the group.

  3. Payment Reform Pilot Program
    Wed November 16, 2011
    AHCCCS is pleased to announce the Payment Reform Pilot Program. Under the program, AHCCCS can reimburse for a specific service array that drives quality over quantity and furthers cost control improvements. More information can be found in the link below:

    Payment Reform Information [22KB]

  4. AHCCCS Integration
    Mon Sept 26, 2011
    As part of Arizona's Medicaid Reform Plan, AHCCCS is reviewing opportunities to further integrate care. The link below has more information.

    AHCCCS Integration Page

  5. 2011 Benefit Changes
    Fri. Jul 22, 2011
    As part of Arizona's Medicaid Reform Plan, AHCCCS will be making changes to the benefit package, effective October 1, 2011, unless otherwise indicated. More information is provided below.

    2011 Benefits

  6. Community Forums
    Wed May 18, 2011
    AHCCCS will hold a number of public meetings over the next few months to provide updates on various aspects of Arizona’s Medicaid Reform Plan. Specific information is provided in the link below.

    Community Forums

  7. Revised Waiver Proposal
    Thurs Mar 31, 2011
    On March 31, 2011, AHCCCS submitted a revised Waiver Demonstration proposal to CMS incorporating provisions of the Governor's Medicaid Reform Plan. Waivers from various federal requirements are needed for flexibilities that will allow the State to manage its Medicaid program within budgetary constraints. The links below have more information including the proposal, how to submit comments about the proposal and public hearings about the proposal.

    Waiver Information
    Estimated Impact Data [17KB]
    Public Meeting Notice

    Tues Mar 15, 2011
    In response to a number of requests, AHCCCS is providing details related to the medical utilization and costs of the expansion groups- including Waiver and Proposition 204 populations.

    Summary
    Data Narrative and Detail

Arizona Section 1115 Demonstration Project Waiver Approved

Fri Oct 21, 2011
On October 21, 2011, CMS approved Arizona’s Section 1115 Research and Demonstration Waiver for a period to begin October 22, 2011 through September 30, 2016. More information, including the provisions of the Waiver and accompanying Special Terms and Conditions are provided below:

Waiver Approval Fact Sheet [14KB]
CMS Approval Letter [2.5MB]
Waiver Approval Package [7.4MB]

Medicare Part B Premiums  

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.

Thur Jul 7, 2011
Effective October 1, 2011, AHCCCS will no longer cover Medicare Part B Premiums for approximately 10,000 ALTCS members.

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 link below for more information.

Medicare Part B Premiums


ALTCS RFP Award Announcement

Tues June 14, 2011 
On June 14, 2011, Mercy Care plan was awarded a contract for Pima county. Please see the link below for updated information:

Updated ALTCS Award Announcement [34KB]


Thurs May 13, 2011
On May 5, 2011, AHCCCS awarded managed care program contracts to provide long term care services to Arizonans enrolled in the Arizona Long Term Care System (ALTCS). On May 12, 2011, AHCCCS awarded an additional capped contract. The contracts begin October 1, 2011, and are in place for up to a five year period. Please see the link below for updated information.

ALTCS Award Announcement [44KB]


Mon Jan 31, 2011
The AHCCCS Long Term Care Request for Proposal and Bidder's Library is now available. Use the link below for more information.

YH12-0001 RFP and Bidder's Library


AHCCCS Update Regarding Health Care Reform

  1. AHCCCS Activities

    Thu Jan 26, 2012 New icon
    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 [40KB]


    Fri Dec 16, 2010
    Information regarding AHCCCS implementation of some of the Medicaid provisions of the Patient Protection and Affordable Care Act (ACA) is provided below. This document will be updated regularly as information becomes available.

    AHCCCS Activities- 5/13/11 [45KB]

    For additional information about the ACA, please visit the Federal Activities page.


KidsCare Wait List

Thu Jan 19, 2012
There were 132,570 applicants on the KidsCare waiting list as of January 15, 2012. Please note, this number does not mean all individuals on the waiting list are actually eligible for KidsCare. AHCCCS has recently updated the list to remove duplicate applications, children who have turned 19 and would no longer qualify for Kidscare, and individuals currently eligible under other AHCCCS programs . Typically, 30% of all applicants are denied for the KidsCare program. However, this percentage will become less precise as more time goes by, since the applications on the waiting list will be older and circumstances for those applicants change. Thus, there is no good way to predict how many of the applicants on the waiting list might be eligible for KidsCare. Regardless, AHCCCS will continue to update the waiting list number at the end of each month.

Fri Dec 29, 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:

KidsCare Enrollment Cap

Information about denial and discontinuance activity in the KidsCare program can be found at:

KidsCare Activity