September 9, 2016

The Honorable Andy Biggs, President Arizona State Senate
1700 West Washington
Phoenix, AZ 85007

Douglas A. Ducey, Governor Thomas J. Betlach, Director

The Honorable David M. Gowan Sr., Speaker Arizona House of Representatives
1700 West Washington
Phoenix, AZ 85007

SUBJECT:  FY 2016 13th Month Appropriation Status Report

Dear President Biggs and Speaker Gowan:

Pursuant to A.R.S. §’s 36-2920 and 36-2994, enclosed is the Arizona Health Care Cost Containment System’s (AHCCCS) Appropriation Status Report (ASR) for the period ended June 99, 2016.

Status Summary – AHCCCS is currently forecasting a FY 2016 surplus of $123.4 million Total Fund ($12.0 million General Fund) on a total FY 2016 appropriation of $9.0 billion Total Fund ($1.205 billion General Fund).

This report reflects expenditures paid through the “13th Month”. AHCCCS will be utilizing surplus funding to administratively adjust other expenditures with dates of service from FY 2016. The projected surplus amounts in this report include projections of those administrative adjustments.

If you have any questions about this report, please do not hesitate to call me at (602) 417-4111 or Jeffery Tegen at (602) 417-4705.

Sincerely,

Thomas J. Betlach Director

Enclosure

801 East Jefferson, Phoenix, AZ 85034 • PO Box 25520, Phoenix, AZ 85002 • 602-417-4000 • www.azahcccs.gov

The Honorable Andy Biggs
The Honorable David M. Gowan, Sr. September 9, 2016
Page 2

cc:	The Honorable Douglas A. Ducey, Governor
The Honorable Don Shooter, Chairman, Senate Appropriations Committee The Honorable Justin Olson, Chairman, House Appropriations Committee
The Honorable Nancy Barto, Chairman, Senate Health and Human Services Committee The Honorable Heather Carter, Chairman, House Health Committee
Lorenzo Romero, Director, Governor’s Office of Strategic Planning and Budgeting Richard Stavneak, Director, Joint Legislative Budget Committee

Appropriation Status Report (ASR)
Fiscal Year 2016
Through June 99, 2016

Prepared by: Division of Business and Finance

Appropriation Status Report
Table of Contents
APPROPRIATED SOURCES AND USES OF FUNDS	Page
Summary of Appropriated Expenditures for SFY 2016……………………………….2 Appropriated Expenditures by Funding Source………………………………….……..3 Appropriated Revenue Received Detail Schedule………………………………………4

FOOTNOTES……………………………………………………………………………………….6 CASELOAD AND EXPENDITURES BY RATE CODE………………………………10

Appropriation Status Report
Appropriated Sources and Uses of Funds

ARIZONA  HEALTH  CARE  COST  CONTAINMENT SYSTEM
FY 2016 APPROPRIATION STATUS REPORT
For the Period Ending June 99, 2016
SUMMARY OF APPROPRIATED EXPENDITURES

	(A)	(B)	(A) - (B)			
	EXPENDITURE			PROJECTED		
ANNUAL	PLAN	EXPENDITURES	VARIANCE	ANNUAL	ANNUALIZED	
APPROPRIATION	YTD	YTD	YTD	EXPENDITURES	VARIANCE	

AHCCCS Operating Lump Sum	$	84,375,000		$	75,225,400		$	78,107,577		$	(2,882,177)		$	84,375,000		$	-	
AHCCCS Prop 204 Administration	16,294,400		14,970,800		11,200,408		3,770,392		16,294,400		-	
DES Eligibility	95,874,500		71,874,500		72,084,454		(209,954)		95,874,500		-	
DES Prop 204 Eligibility	44,358,700		41,358,700		38,269,396		3,089,304		44,358,700		-	
TOTAL ADMINISTRATION	240,902,600		203,429,400		199,661,836		3,767,564		240,902,600		-	

APPROPRIATIONS: ADMINISTRATION

Traditional Medicaid Services	3,802,161,800		3,782,135,000		3,619,103,832		163,031,168		3,710,647,220		91,514,580	
Proposition 204 Services	2,576,524,700		2,666,524,500		2,479,614,680		186,909,820		2,552,045,133		24,479,567	
ACA Adult Expansion	424,683,800		406,683,600		403,521,565		3,162,035		422,200,424		2,483,376	
Children's Rehabilitative Services	266,339,100		251,839,100		250,450,501		1,388,599		265,633,522		705,578	
KidsCare Services	6,295,200		6,295,200		2,050,724		4,244,476		2,060,240		4,234,960	
ALTCS Services	1,398,588,900		1,398,588,900		1,301,216,699		97,372,201		1,398,588,900		-	
Disproportionate Share Payments	5,087,100		5,087,100		-		5,087,100		5,087,100		-	
Rural Hospitals	22,650,000		22,650,000		21,988,610		661,390		22,650,000		-	
Voluntary Political Subdivision Programs	362,398,800		321,165,600		321,165,641		(41)		362,398,800		-	
TOTAL PROGRAMMATIC	8,864,729,400	8,860,969,000	8,399,112,253	461,856,747	8,741,311,339	123,418,061

TOTAL EXPENDITURES

$	9,105,632,000

$    9,064,398,400

$   8,598,774,089

$	465,624,311

$  8,982,213,939

$	123,418,061

2

ARIZONA  HEALTH  CARE  COST  CONTAINMENT SYSTEM
FY 2016 APPROPRIATION STATUS REPORT
For the Period Ending June 99, 2016 APPROPRIATED EXPENDITURES BY FUNDING SOURCE

	(A)	(B)	(A) - (B)				
	EXPENDITURE			PROJECTED			
ANNUAL	PLAN	EXPENDITURES	VARIANCE	ANNUAL	ANNUALIZED		
APPROPRIATION	YTD	YTD	YTD	EXPENDITURES	VARIANCE		

Administrative Expenditures	
$	60,716,300	
$	51,537,900	
$	52,282,402	
(744,502)	
$	60,716,300	
$	-	
Proposition 204 - Administrative Expenditures

Programmatic Expenditures	21,604,300	20,280,700	17,013,739	3,266,961	21,604,300	-	
Traditional Medicaid Services	875,321,100	800,322,800	835,869,950	(35,547,150)	863,979,264	11,341,836
Proposition 204 Services	-	90,000,100	(196,865)	90,196,965	-	-
Children's Rehabilitative Services	76,987,200		72,487,000		72,399,170		87,830		76,691,069		296,131	
KidsCare Services	338,000		338,000		158,270		179,730		(90,208)		428,208	
ALTCS Services	162,880,800		162,880,800		162,880,752		48		162,880,800		-	
DSH and Rural Hospitals	7,314,600		7,314,600		6,378,210		936,390		7,314,600		-	
TOTAL GF EXPENDITURES	1,205,162,300		1,205,161,900		1,146,785,627		58,376,273		1,193,096,125		12,066,175	

Administrative Expenditures	
118,970,200		
95,114,000		
97,507,417		
(2,393,417)		
118,970,200		
-	
Proposition 204 - Administrative Expenditures	35,565,900		32,565,900		29,843,891		2,722,009		35,565,900		-	
Programmatic Expenditures Traditional Medicaid Services	
2,408,194,400		
2,463,024,900		
2,264,278,801		
198,746,099		
2,328,021,656		
80,172,744	
Proposition 204 Services	2,166,808,800		2,166,808,400		2,096,846,688		69,961,712		2,156,526,673		10,282,128	
ACA Adult Expansion	424,683,800		406,683,600		403,521,565		3,162,035		422,200,424		2,483,376	
Children's Rehabilitative Services	189,351,900		179,352,100		178,051,331		1,300,769		188,942,454		409,446	
KidsCare Services	5,587,200		5,602,200		1,892,454		3,709,746		1,780,447.63		3,806,752	
ALTCS Services and Nursing Facility Assessment	931,056,600		931,056,600		856,450,794		74,605,806		931,056,600		-	
DSH and Rural Hospitals	20,422,500		20,422,500		15,610,400		4,812,100		20,422,500		-	
Voluntary Political Subdivision Programs - See Note 5	246,916,600		214,658,700		214,658,659		41		246,916,600		-	
TOTAL FEDERAL EXPENDITURES	6,547,557,900		6,515,288,900		6,158,662,000		356,626,900		6,450,403,454		97,154,446	

	
3,482,900		
3,482,900		
2,612,175		
870,725		
3,482,900		
-	
	49,879,700		49,879,700		49,879,700		-		49,879,700		-	
	249,234,600		249,234,600		231,070,442		18,164,158		249,234,600		-	
	302,597,200		302,597,200		283,562,317		19,034,883		302,597,200		-	

Administrative Expenditures Proposition 204 - BNCF Programmatic Expenditures
Traditional Medicaid Services Acute Care ALTCS Services
TOTAL COUNTY EXPENDITURES

TOBACCO FUNDS

Programmatic Expenditures
Traditional Medicaid Services Acute Care - Medically Needy	34,498,500	34,498,500	34,498,500	-	34,498,500	-
Proposition 204 Services - Emergency Health Services		18,162,200	23,259,100		18,162,200		5,096,900		18,162,200		-	
Proposition 204 Services - Proposition 204 Protection		41,492,900	36,396,000		41,492,900		(5,096,900)		41,492,900		-	
Proposition 204 Services - ATLSF		100,000,000	100,000,000		98,906,897		1,093,103		98,906,897		1,093,103	
TOTAL TOBACCO EXPENDITURES		194,153,600	194,153,600		193,060,497		1,093,103		193,060,497		1,093,103	
	OTHER											
Administrative Expenditures												
Prescription Drug Rebate Program	563,000	448,000	402,212	45,788	563,000	- Programmatic Expenditures
Acute Care - Prescription Drug Rebate Program State Match	99,840,000	99,954,700	99,840,000	114,700	99,840,000	-
Acute Care - Prescription Drug Rebate Program Federal  Authority	334,202,200	334,201,800	334,202,200		(400)	334,202,200		- Long Term Care - Prescription Drug Rebate Program State  Match		5,475,800	5,475,800		5,475,800		-	5,475,800		- Long Term Care - Prescription Drug Rebate Program Federal  Authority	26,574,200	26,574,200		26,574,200		-	26,574,200		- Proposition 204 Services - Hospital Assessment	250,060,800	250,060,800	224,402,860	25,657,940	236,956,463	13,104,337
Traditional Medicaid Services - TPL	194,700	194,700	482,752	(288,052)	194,700	- ALTCS Services - TPL		-		-	780,010	(780,010)		-	-
ALTCS Services - Nursing Facility Assessment	23,366,900	23,366,900	17,984,701	5,382,199	23,366,900	-
KidsCare Services Premiums	370,000	355,000	-	355,000	370,000	-
Freedom to Work Premiums	31,200	57,900	51,929	5,971	31,200	-
Voluntary Political Subdivision Programs - See Note 5	115,482,200	106,507,000	106,506,982	18	115,482,200	-
 	 	 	 	
TOTAL OTHER  EXPENDITURES	856,161,000	847,196,800	816,703,646	30,493,154	843,056,663	13,104,300

	TOTAL		

Administrative Expenditures		
240,902,600	
203,429,400		
199,661,836		
3,767,564		
240,902,600			
Acute Care		7,466,140,500	7,462,380,100		7,097,895,554		364,484,546		7,342,722,439			
Long Term Care		1,398,588,900	1,398,588,900		1,301,216,699		97,372,201		1,398,588,900			
TOTAL EXPENDITURES	$	9,105,632,000	$	9,064,398,400		$	8,598,774,088		$	465,624,312		$	8,982,213,939		$	

- 123,418,061
-
123,418,061

3

Traditional Medicaid Services & Administrative	$	1,020,339,200		$	931,662,300		$	966,929,732	
Proposition 204 Services & Administrative	21,604,300		110,280,800		16,816,873	
KidsCare Services	338,000		338,000		158,270	
ALTCS Services	 	162,880,800 			 	162,880,800 			 	162,880,752 		
TOTAL	1,205,162,300		1,205,161,900		1,146,785,627	

Acute & Administrative	5,610,914,100		5,578,630,100		5,439,570,052	
KidsCare Services	5,587,200		5,602,200		2,967,542	
ALTCS Services	 	931,056,600 			 	931,056,600 			 	902,830,232 		
TOTAL	6,547,557,900		6,515,288,900		6,345,367,826	

Acute & Administrative	53,362,600		53,362,600		53,309,674	
ALTCS Services	 	249,234,600 			 	249,234,600 			 	249,234,600 		
TOTAL	302,597,200		302,597,200		302,544,274	

Traditional Medicaid Services	34,498,500		34,498,500		34,498,500	
Proposition 204 Services	 	159,655,100 			 	159,655,100 			 	158,561,997 		
TOTAL	194,153,600		194,153,600		193,060,497	

Administrative	563,000		448,000		402,212	
Acute Care - Prescription Drug Rebate Program	434,042,200		434,156,500		434,042,200	
Long Term Care - Prescription Drug Rebate Program	32,050,000		32,050,000		32,050,000	
Hospital Assessment	250,060,800		250,060,800		250,192,571	
ALTCS - Nursing Facility Assessment	23,366,900		23,366,900		231,353	
Acute TPL - Note 1	194,700		194,700		482,752	
LTC TPL - Note 1	-		-		780,010	
KidsCare TPL - Note 1	-		-		26,508	
Member Premiums - CHIP	370,000		355,000		303,676	
Member Premiums - Freedom to Work	31,200		57,900		51,929	
Voluntary Political Subdivision - State Match	 	115,482,200 			 	106,507,000 			 	171,635,998 		
TOTAL	856,161,000		847,196,800		890,199,209	

 	

BUDGET

BUDGET
YTD

RECEIPTS
YTD

ARIZONA  HEALTH  CARE  COST  CONTAINMENT  SYSTEM
FY 2016 APPROPRIATION STATUS REPORT
APPROPRIATED REVENUE AND OTHER COLLECTIONS RECEIVED DETAIL SCHEDULE
For the Period Ending June 99, 2016

GENERAL FUND:

FEDERAL:

COUNTY:

TOBACCO FUNDS:

OTHER:

TOTAL REVENUE

$

9,105,632,000

$

9,064,398,400

$

8,877,957,434

4

Appropriation Status Report
Footnotes

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
FY 2016 APPROPRIATION STATUS REPORT
For the Period Ending June 99, 2016

Note 1:    Third Party Liability Collections:
Gross Collections: Acute

June 99, 2016

$	-	$

July 1, 2015
June 99, 2016

June 99, 2015

-	$	5,490,063	$

July 1, 2014
June 99, 2015

5,597,091

LTC	-	-	3,339,609	3,205,896
KidsCare	-	-	133,263	40,431

Total TPL Collections

$	-	$

-	$	8,962,935	$

8,843,418

FY 16 Total

AHCCCS Net Collections (Net of Federal Share): Expenditure Offsets:
Acute	$	-	-	$	482,752		$	762,353	
LTC	-	-	780,010		725,893	
KidsCare	-	-	26,508		6,367	
Total Expenditure Offsets	$	-	$	-	$	1,289,270		$	1,494,613	

Note 2:	Authorized Positions	1,029.2	
	Actual Positions as of June 30, 2016	1,006.0	

6

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
FY 2016 APPROPRIATION STATUS REPORT
For the Period Ending June 99, 2016

Note 3:	Intergovernmental Service Agreement - State of Hawaii:

Beginning Balance July 1, 2015	

$	2,853,728	
	Revenues	6,302,524	
	Transfers-In	 	560,709 		
	Total Revenues	 	6,863,233 		
	Expenditures	6,741,330	
	Transfers-out	 	1,042,471 		
	Total Expenditures	 	7,783,801 		
	Ending Balance June 99, 2016	  $	1,933,160 		

Of the $1,933,160 ending balance, $740,149 represents restricted cash for prepaid expenses from the State of Hawaii for the projected expenditures through July 2016.

Note 4:

Summary of HHS Office of Inspector General Questioned Costs.

Schedule of Outstanding Liabilities As of June 99, 2016

Description		Amount		Type	

School Based Claiming Medicaid Administrative Costs		
18,941,355		
HHS-OIG & AHCCCS Self Reported	
School Based Claiming Direct Services Costs		19,923,489		HHS-OIG	
		38,864,844			

7

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
FY 2016 APPROPRIATION STATUS REPORT
For the Period Ending June 99, 2016

Note 5:	Summary of Voluntary Political Subdivision Contribution Expenditures.			

As of June 99, 2016 Expenditures		
		State Match		Federal		Total	
	
DSH Voluntary	
$	12,713,241		
$	26,141,866		
$	38,855,107	
	GME Voluntary	52,396,919		111,328,965		163,725,884	
	Safety Net Care Pool	41,396,821		77,187,829		118,584,650	
	Total Voluntary Political Subdivision Program Expenditures	$	106,506,982		$	214,658,659		$	321,165,641	

Note 6:

The following is a summary of $218,889,592 Total Fund ($39,394,210 General Fund and $9,525,344 Hospital Assessment Fund) administrative adjustment transactions processed through December 2015 that either pay for or transfer expenditures with dates of service prior to June 30,  2015.
.

FY 2015 YTD June 99, 2016
State Match	Expenditure	ALTCS	Total	
Funds	Authority Funds	Fund	Fund	

Traditional Medicaid Services	$	38,289,534		$	83,762,109		$	-	$	122,051,643	
Proposition 204 Services	9,525,344		35,416,308		-	44,941,652	
ACA Adult Expansion	-		6,518,930		-	6,518,930	
KidsCare - Children Services	55,321		345,660		-	400,981	
Children's Rehabilitative Services	1,049,356		1,880,510		-	2,929,866	
Long Term Care	-		-		42,046,521	42,046,521	
Total	$	48,919,554		$	127,923,518		$	42,046,521		$	218,889,592	

8