AHCCCS Seeks Public Comment on HCBS Needs Tool (HNT) and Extraordinary Care Review (ECR) Rulemaking
The Arizona Health Care Cost Containment System (AHCCCS) is seeking stakeholder feedback on proposed exempt rulemaking related to the Home and Community Based Services (HCBS) Needs Tool (HNT) and the Extraordinary Care Review (ECR) process for members enrolled in the Arizona Long Term Care System (ALTCS).
The public comment period runs from September 12, 2026, through October 12, 2026.
ALTCS is Arizona's Medicaid long-term care program for individuals who are elderly or who have physical or developmental disabilities and are at risk of institutionalization. The program provides services and support that help eligible members remain in their homes and communities whenever possible.
The HNT is a standardized assessment used to evaluate a member's need for direct care and habilitation services. The tool helps determine whether an individual may benefit from receiving home and community-based services that support activities of daily living, such as bathing, dressing, eating, and mobility, as well as instrumental activities of daily living, including meal preparation, household tasks, and community participation.
In accordance with Arizona law, AHCCCS implemented a strengthened assessment process to better determine the need for extraordinary care for minor children. As part of this process, ALTCS members under age 18 who are assessed using the HNT may be eligible for an ECR when the member or the member's healthcare decision-maker disagrees with the number of service hours determined through the assessment based on age-related limitations within the tool.
The proposed exempt rulemaking:
- Supports implementation of the strengthened HCBS assessment process.
- Promotes furtherance of Arizona statutory requirements.
- Describes MCO obligations both prior to, and upon implementation, of the ECR process.
- Specifies required training for ECR clinicians, including annual training requirements for the person-centered service planning process Improves care delivery and service planning for ALTCS members.
- Supports the long-term sustainability of the ALTCS program.
Comments received during the 30-day review period will help inform the final exempt rulemaking process and support AHCCCS' ongoing efforts to deliver consistent, person-centered care for ALTCS members.
For information on how to submit comments and access rulemaking materials, please visit the AHCCCS proposed rules webpage.
