Arizona’s Section 1115 Waiver Renewal Request (2021-2026)
With over 2 million Arizonans enrolled in AHCCCS, Medicaid has a huge responsibility for impacting population health in the state. Despite past innovation, AHCCCS says it has an opportunity and obligation to do more.
The goals of modernizing Arizona Medicaid are to:
- Engage Arizonans to take charge of their health
- Make Medicaid a temporary option
- Promote a quality product at the most affordable price
AHCCCS posted a draft of the Section 1115 Waiver, which allows Arizona to run its unique and successful managed care model and exempts Arizona from certain provisions of the Social Security Act. It also includes expenditure authority for costs not otherwise matched by the federal government. Waiver programs are required to be budget neutral for the federal government − such programs don’t require more federal dollars than without a waiver.
The Centers for Medicare and Medicaid Services’ (CMS) approval of Arizona’s Demonstration renewal application will extend 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.
On November 13, from 1:30-3:30 pm, AHCCCS will hold a waiver public forum meeting over Zoom.
Download the presentation slides for the public forum from AHCCCS