105 What Laws Apply to AHCCCS Medical Assistance?

The AAC is commonly referred to as the Rules. The AAC is developed by the responsible state agency and approved by the Governor’s Regulatory Review Council (GRRC). The AAC provides more detail than the ARS. The AHCCCS-related rules are located in Title 9:

·        Chapter 22 Medicaid;

o       Article 15 - SSI MAO

o       Article 19 - Freedom to Work

o       Article 20 - BCCTP

·        Chapter 28 ALTCS;

·        Chapter 29 QMB, SLMB and QI-1;

·        Chapter 31 KidsCare; and

·        Chapter 34 Grievance System.

See http://www.azsos.gov/rules/arizona-administrative-code to view the AAC.

The AAR is the official publication of the State of Arizona. The AAR contains rules approved by the GRRC but not yet published in the AAC.

See http://www.azsos.gov/rules/arizona-administrative-register to view the AAR.

The ARS are made by the Arizona legislature. The following AHCCCS-related statutes are located in Title 36, Chapter 29:

·        Article 1 Medicaid and Healthcare Group;

·        Article 2 ALTCS;

·        Article 3 QMB; and

·        Article 4 Children’s State Health Insurance Program (KidsCare);

See https://www.azleg.gov/arstitle to view the ARS.

Guidance and directives issued as:

·        State Medicaid Director letters (SMDL) to all Directors of State Medicaid agencies.

·        State Health Official (SHO) letters to state health officials.

·        CMS Rulings are final decisions of the Administrator that clarify complex or unclear provisions of the law or regulations relating to Medicaid or SCHIP.

See http://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html to search and view SMDL and SHO guidance by type and topic.

See http://cms.hhs.gov/rulings/ to view CMS Rulings.

A collection of general and permanent rules (regulations) that have been previously published in the Federal Register. The CFR provides more detail about conditions of eligibility than the USC. Medicaid and CHIP programs are covered in:

·        42 CFR - Public Health;

·        20 CFR - Supplemental Security Income; and

·        45 CFR - Public Welfare.

See http://www.ecfr.gov/cgi-bin/ECFR?page=browse to view the CFR.

The Federal Register is the official daily publication of the U.S. government. It contains:

·        New regulations;

·        Changes to regulations; and

·        Legal notices issued by Federal agencies and the President.

See https://www.federalregister.gov/ to view the Federal Register.

A printing of the full text of a new law or an amendment to an existing law after it has been enacted by Congress and signed by the President.

Public laws are later codified (collected and arranged) in the US Code (USC) along with all other Federal Laws.

See http://www.gpo.gov/fdsys/browse/collection.action?collectionCode=PLAW to view Public Laws.

A collection of federal laws that cover all areas of Social Security. The laws authorizing and governing the Medicaid and CHIP programs are contained in three titles of the Act:

·        Title XVI of the Act - Supplemental Security Income (SSI). The SSI program is for aged, blind and persons with disabilities that have low income. AHCCCS also uses this Title to develop policy for SSI-MAO and ALTCS.

·        Title XIX - Medicaid. This Title identifies the mandatory and optional coverage groups and the basic conditions of eligibility for each.

·        Title XXI - Children’s Health Insurance Program. Provides funds and the basic conditions of eligibility for CHIP. Arizona’s Title XXI program is called KidsCare.

See http://www.ssa.gov/OP_Home/ssact/ssact-toc.htm to view the Social Security Act.

Policy Manual for programs administered by the Social Security Administration. Some legal rules dictate that the agency use similar or less restrictive rules than the policies used by the Social Security Administration.

See https://secure.ssa.gov/apps10/ to view Social Security’s Policy Manual.

Policy guidance for the Medicaid requirements contained in the CFR developed by the Centers for Medicare and Medicaid Services (CMS).  

See https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021927.html to view the State Medicaid Manual.

A written contract between AHCCCS and the Centers for Medicare and Medicaid Services (CMS). The State Plan describes the nature and scope of the Medicaid or KidsCare program.

See https://azahcccs.gov/Resources/StatePlans/ to view Arizona’s Medicaid and CHIP State Plans.

A collection of the federal laws made by Congress sorted by subject matter.  

See https://uscode.house.gov/ to view the USC.