Despite the sweeping investigation that revealed a massive fraud scandal billing Arizona's Medicaid program, new investigations into behavioral health fraud and fake sober living homes targeting Indigenous communities continue to turn up illegal activity.
At the scandal's height in 2023, the number of ongoing investigations into...
A new RAND analysis of the Medicaid provisions in the One Big Beautiful Bill Act suggests Arizona could face some of the largest fiscal and enrollment impacts in the country over the next decade.
The research report published last week finds that expansion states with heavy use of state-directed payments and provider...
Virginia “Ginny” Rountree announced Feb. 2 that she would resign as director of AHCCCS, citing personal health concerns. Rountree had a short tenure, she was appointed October 6 and her final day was Feb. 13.
Roberta Harrison, a longtime Arizona Department of Economic Security official, now serves as interim AHCCCS...
The Republican-led Arizona legislature has sent a number of politically-loaded healthcare-related bills to Governor Katie Hobbs's desk so far this session, and may deliver more in the coming weeks.
Arizona Governor Katie Hobbs vetoed nine bills on Friday, one of which would have required hospitals that accept Medicaid to request...
Virginia “Ginny” Rountree announced yesterday that she will resign as director of the Arizona Health Care Cost Containment System (AHCCCS), citing personal health concerns. Her final day with the agency will be Friday, Feb. 13.
After deep consideration and conversations with my family, I have made the difficult decision to step down...
An Arizona Medicaid contract dispute involving one of the state’s largest autism therapy providers and one of the largest Medicaid health plans is escalating into litigation, raising questions about network adequacy, reimbursement pressure, and continuity of care for children receiving applied behavior analysis services.
According...
The 2026 Arizona legislative session will begin shortly, and Republican Senator Wendy Rogers has again introduced a bill that would require Arizona hospitals to ask patients about their immigration status during intake.
This is the second year that Rogers has introduced the bill, arguing that the state needs to know how much is spent...Arizona News
Arizona now allows eligible justice-involved youth to access certain Medicaid and Children’s Health Insurance Program services up to 30 days before release from incarceration, marking a shift toward limited prerelease coverage aimed at improving reentry transitions.
The change, implemented Oct. 1 by the Arizona Health Care Cost...CMS Rules
On December 8, the Centers for Medicare and Medicaid Services (CMS) posted preliminary guidance for the Medicaid work requirements mandated by the One Big Beautiful Bill Act (OBBBA), which passed into law on July 4 this year.
The law requires the creation of new rules by June 2026 and CMS notes in the guidance overview that further...Arizona News
AHCCCS is moving into the next phase of its multi-year Medicaid Enterprise System (MES) modernization effort, an overhaul that began in 2019 to improve provider operations and strengthen program integrity across the agency’s technology platforms.
The agency said the upgrades are designed to make it easier, faster, and more secure...Arizona News
Last month, Governor Katie Hobbs intervened to pause the implementation of new Medicaid rules to assess the hours of service for Arizona children with developmental disabilities. Last week, the Arizona Health Care Cost Containment System (AHCCCS) posted new, amended rules through an emergency rulemaking process.
The rule arises out of...White Papers, E books, Reports and more
Artificial intelligence (AI) is rapidly spreading through state Medicaid programs—mostly through the managed care organizations (MCOs) that administer them. A new Urban Institute report finds these tools are increasingly used for risk stratification, prior authorization, and care coordination, yet few states or health plans explain how...National News
States must enforce Medicaid work requirements by January 1, 2027, but the Centers for Medicare and Medicaid Services (CMS) have yet to issue guidance for compliance for states eager to start planning its implementation.
The One Big Beautiful Bill Act (OBBBA) cuts nearly $1 trillion in Medicaid spending over a decade in part by adding...
AHCCCS and consultant Pacific Health Policy Group (PHPG) are seeking stakeholder input to reshape the agency’s RFP process before releasing the 2026 ALTCS-EPD solicitation and the multibillion-dollar ACC rebid that will succeed current contracts ending Sept. 30, 2028.
Arizona's Medicaid agency, The Arizona Health Care Cost Containment...
Arizona Governor Katie Hobbs has ordered the Arizona Health Care Cost Containment System (AHCCCS) to create an extraordinary care exception process for children with intellectual and developmental disabilities whose families need more direct care or habilitation hours than allowed under the state’s new standardized assessment...Arizona News
In October, a whopping $8 billion reduction in Disproportionate Share Hospital (DSH) payments took effect. More cuts are queued up for January 2026 and January 2027, bringing the total hit to $24 billion. Meanwhile, the government shut down on Oct. 1, and the House isn’t even in session—so don’t expect relief soon.
State...Arizona News
After a decade of advocacy, Arizona's Medicaid program is taking steps towards providing coverage for traditional healing practices for its 167,000 indigenous members.
The Arizona Health Care Cost Containment System (AHCCCS) has received federal approval to cover such practices, along with California, New Mexico and Oregon. According...Arizona News
On September 5, 2025, AHCCCS submitted its actuarial analysis and draft 2025–2026 capitation rates for managed care organizations (MCOs) to the Joint Legislative Budget Committee (JLBC). On October 1st the AHCCCS rates became effective with an overall per-member-per-month (PMPM) capitation rate growth of 5.18% across all Arizona...Arizona News
The Arizona Health Care Cost Containment System (AHCCCS) last week terminated its December 2023 ALTCS-EPD contract awards, resetting a procurement process that has been contested for nearly two years.
AHCCCS said it will issue a new request for proposals for the ALTCS-EPD program, with submissions expected in fall 2026.
Mercy Care,...Arizona News
This week an Arizona man has been sentenced to 3.5 years in prison for illegally attempting to profit from the state’s Medicaid program by brokering access to behavioral health services in exchange for kickbacks.
Corey Dion Beckhum was convicted June 26 of one count of Conspiracy to Commit Consideration for Patient Referral and one...
