COVID-19 Federal Emergency Authorities Request
On March 17 and March 24, 2020, the Arizona Health Care Cost Containment System (AHCCCS) submitted requests to the Administrator for the Centers for Medicare and Medicaid Services (CMS) to waive certain Medicaid and KidsCare requirements to enable the State to combat the continued spread of 2019 novel coronavirus (COVID-19). AHCCCS is seeking a broad range of emergency authorities to:
- Strengthen the provider workforce and remove barriers to care for AHCCCS members,
- Enhance Medicaid services and supports for vulnerable members for the duration of the emergency period, and
- Remove cost sharing and other administrative requirements to support continued access to services.
Arizona’s request to CMS is posted below:
- Letter To CMS Administrator on COVID-19 Flexibilities (submitted March 17, 2020)
- Summary of Additional COVID-19 Flexibility Requests (submitted March 24, 2020)
- Summary of Additional COVID-19 Flexibility Requests (submitted April 17, 2020)
Status of AHCCCS Emergency Authority Requests (updated April 6, 2023)
The federally declared public health emergency (PHE) ended on May 11, 2023. However, AHCCCS implemented a variety of flexibilities under section 1902(e)(14)(A) of the Social Security Act during the period of unwinding from the continuous enrollment condition. Those flexibilities are intended to protect beneficiaries and reduce state administrative burden associated with conducting redeterminations and renewals of Medicaid and CHIP eligibility.
CMS approved components of Arizona’s request under the 1135 Waiver, Appendix K and State Plan:
- 1135 Waivers
- 1135 Waiver Approval Letter for COVID-19 Flexibilities (received March 23, 2020)
- 1135 Waiver Approval Letter for COVID-19 Flexibilities (received May 6, 2020)
- 1135 Waiver Approval Letter for COVID-19 Flexibilities (received July 9, 2020)
- 1115 Waivers/Attachment K
- 1115 Waiver Appendix K Amendment and Approval Letter (received April 6, 2020)
- 1115 Waiver Appendix K Amendment and Approval Letter HCBS (received August 31, 2020)
- AHCCCS COVID-19 1115 Demonstration EPSDT Approval (received January 1, 2021)
- 1115 Waiver Appendix K Amendment and Approval Letter Extension (received April 16, 2021)
- 1115 Waiver Appendix K Amendment and Approval Letter ARPA Lumpsum Payment (received August 12, 2022)
- 1115 Waiver Appendix K Amendment and Approval Letter PPCG (received March 22, 2023)
- 1115 Waiver Appendix K Amendment and Approval Letter CHIP Continuous Coverage (received June 7, 2023)
- 1115 Waiver Appendix K Parents as Paid Caregivers Temporary Extension (received October 31, 2023)
- State Plan Amendments
- SPA AZ-20-0001 Suspension of Member Cost Sharing (received April 1, 2020)
- SPA-AZ-20-0004 Home Health and Bed Hold Days(received April 9, 2020)
- SPA AZ-20-0002 CHIP PHE Flexibilities (received April 24, 2020)
- SPA AZ-20-0005 GME Payments (received May 22, 2020)
- SPA AZ-2006 NF Directed Payment (received August 4, 2020)
- SPA AZ-20-0009 Optional Testing Group (received July 28, 2020)
- SPA AZ-20-0014 Bed-hold Days (received September 3, 2020)
- SPA AZ-20-0021 Pharmacy Technician and Intern Vaccine Administration (received March 2, 2021)
- SPA AZ-20-0031 COVID Vaccine Administration Rates (received March 16, 2021)
- SPA AZ-21-0001 HIS/638 COVID Vaccine Admin Rate (AIR) (received April 20, 2021)
- SPA AZ-21-0002 NF Directed Payment (received March 25, 2021)
- SPA AZ-21-0004 NEMT Rate COVID Vaccine Sites (received April 20, 2021)
- SPA AZ-21-0007 COVID Vaccine Administration Rate Update (received September 10, 2021)
- SPA AZ-22-0006 PHE Directed Payment (received July 29, 2022)
- SPA AZ-23-0006 Temporary Suspension Cost Sharing (received March 24, 2023)
- Opioid Treatment Flexibilities
- 1902(e)(14)(A) Waivers
- AHCCCS Request Letter (submitted April 12, 2022)
- AHCCCS Request Letter (submitted July 11, 2023)
- Ex-Parte Renewal for Individuals with no Income (received April 25, 2022)
- Renewal for Individuals with no AVS Data Returned in a Reasonable Timeframe (received April 20, 2022)
- Partnering with Managed Care Plans to Update Beneficiary Contact Information (received April 25, 2022)
- Partnering with USPS NCOA to Update Beneficiary Contract Information (received May 20, 2022)
- Extended Timeframe to take Final Administrative Action (received July 8, 2022)
- Renewal for Individuals At Or Below 100% FPL and No Data Returned (received July 24, 2023)
- Permit Managed Care Plans to Provide Assistance to Enrollees (received July 20 2023)
- Suspension of the Requirement that Beneficiaries Cooperate (Received August 23, 2023)
- Suspension of the Requirement that Individuals Apply for Certain Other Benefits (received September 11, 2023)
The allowances from CMS grant broad authority to Arizona to tailor changes to best serve its citizens. AHCCCS will make decisions about how and when these changes will be implemented.
AHCCCS will pursue the extension of some of the flexibilities granted (updated 7/21/2020) during the public health emergency.
AHCCCS has hosted the following community meetings to provide the public with information about Arizona's request for COVID-19 Federal Emergency Authorities:
- Special Tribal Consultation Meeting, March 19, April 6, April 20, May 7, May 21, June 4, June 18, July 7, July 31, 2020
- Behavioral Health Providers (March 24, April 7, April 21, May 6, May 20, June 12, July 2, July 23, 2020)
- Telehealth Delivery (March 20 and April 9, 2020)
- State Medicaid Advisory Committee (SMAC) Meeting, April 8, May 12, June 3, July 8, 2020
- Peer & Family Run Organization (April 9, 2020)