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...News
The agency proudly announced the launch of its new and improved online provider directory, which was designed to make it easier than ever for members to find AHCCCS-enrolled providers who meet their unique healthcare needs.
Kristen Challacombe, Deputy Director of Business Operations at AHCCCS,
We’re excited to offer this...Arizona News
The Arizona Health Care Cost Containment System (AHCCCS) new address is shared with the Arizona Department of Health Services and is located at 150 N. 18th Avenue in Phoenix.
The former office at 801 E. Jefferson Street closed Wednesday, June 25, 2025. In February 2021, AHCCCS consolidated its two offices at 701 and 801 E. Jefferson...
The Arizona State Legislature is running out of time to pass a budget before a government shutdown is triggered on July 1. But, while Senate Republicans negotiated a budget with Democratic Governor Katie Hobbs, the Arizona House introduced its own. The House budget made cuts to healthcare, a $225 million Medicaid cut and increasing the...
Beginning October 1, 2025, Banner Health and Mercy Care will join Centene and UnitedHealthcare to provide covered services for about 26,000 Arizonans enrolled in its Arizona Long Term Care System (ALTCS) Elderly and/or Physically Disabled (EPD) program. Statewide contracts were awarded to Centene and UHC but Banner Health and Mercy Care...Arizona News
Arizona's Democratic Governor Katie Hobbs accepted the resignations of AHCCCS Director Carmen Heredia and ADHS Director Jennifer Cunico the day before they were set to appear before the Senate Committee on Director Nominations (DINO), led by Republican Jake Hoffman, who had foreshadowed his torpedoing of both women's...Arizona Comings & Goings
Anthony Flot has been promoted from chief technology officer to chief information officer.
Maureen Sharp is now a senior executive consultant for analytics at AHCCCS, she was formerly the agency’s chief analytics officer....
To date, there is no set plan to cut Medicaid yet industry stakeholders and political analysts continue to speculate on the potential targets and magnitude of potential funding changes for the program that now insures 79 million Americans or 24% of the U.S. population.
The Trump administration launched its radical overhaul of the...
The waiver application aligns with Arizona legislation passed in 2015 that requires AHCCCS to request (annually) the federal agency's approval to institute a work requirement for all “able-bodied adults” receiving Medicaid services, place a lifetime limit of five years of Medicaid benefits on “able-bodied adults” and develop and...Arizona News
Now that Congress has funded the government through September, Republicans are beginning to seriously negotiate President Donald Trump's massive legislative package. The bill will be required to include $880 billion in cuts to programs under the purview of the House Committee on Energy and Commerce, which is virtually guaranteed to...
