Arizona’s Section 1115 Waiver Renewal Request (2022-2027)

The Arizona Health Care Cost Containment System (AHCCCS) is requesting a five-year renewal of Arizona’s Demonstration project under Section 1115 of the Social Security Act. Arizona’s existing Demonstration project is currently approved through September 30, 2021, and the application is seeking a renewal period from October 1, 2022 through September 30, 2027.

Since its inception, AHCCCS has operated its program under a Section 1115 Demonstration project, which must be renewed every five years. The State’s current Demonstration exempts Arizona from particular provisions of the Social Security Act and also includes expenditure authority permitting federal financial participation (FFP) for State expenditures that would not otherwise qualify for federal participation. Moreover, Demonstration projects, including Arizona’s, must establish budget neutrality where Medicaid costs to the federal government are not expected to exceed costs to the federal government in the absence of the Demonstration.

The Centers for Medicare and Medicaid Services’ (CMS) approval of Arizona’s Demonstration renewal application will continue the success of Arizona’s unique Medicaid program and statewide managed care model, extending authority for Arizona to implement programs including, but not limited to:

• Mandatory managed care
• Home and community-based services for individuals in the Arizona Long Term Care System (ALTCS)
• Administrative simplifications that reduce the inefficiencies in eligibility determination
• Integrated health plans for AHCCCS members
• Payments to providers participating in the Targeted Investments Program
• AHCCCS Works
• Waiver of Prior Quarter Coverage for specific populations

In addition to renewing current waiver and expenditure authorities, AHCCCS is seeking to implement the following:

• Authority to allow for verbal consent in lieu of written signature for up to 30 days for all care and treatment documentation for ALTCS members when included in the member's record and when identity can be reliably established.
• Authority to reimburse traditional healing services provided in, at, or as part of services offered by facilities and clinics operated by the Indian Health Service (IHS), a tribe or tribal organization, or an Urban Indian health program.
• Authority to reimburse Indian Health Services and Tribal 638 facilities to cover the cost of adult dental services that are eligible for 100 percent FFP, that are in excess of the $1,000 emergency dental limit for adult members in Arizona’s State Plan and $1,000 dental limit for individuals age 21 or older enrolled in the ALTCS program.