October 1, 2020

AHCCCS Requests Public Comment on Proposed 2021-2026 Waiver Renewal

The Arizona Health Care Cost Containment System (AHCCCS) will submit a five-year renewal proposal of its 1115 Demonstration Waiver to the Centers for Medicare and Medicaid Services (CMS) in December 2020. Section 1115 of the Social Security Act gives the U.S. Secretary of Health and Human Services authority to approve Demonstration Projects that promote the objectives of the Medicaid program and the Children’s Health Insurance Program (CHIP). In Arizona, the CHIP program is known as KidsCare. This flexibility allows states to test innovative approaches to health care in an effort to improve quality, access, and efficiency.

AHCCCS is required to renew its 1115 Waiver with CMS every five years. In the waiver renewal request, AHCCCS outlines its proposed new and ongoing programmatic authorities. With CMS’ approval, the agency will continue to build on the successes of its existing care delivery model, extending authority for Arizona to implement programs including, but not limited to:

• Mandatory managed care.
• Home and community-based services for people in the long term care program (ALTCS).
• Administrative simplifications that reduce the inefficiencies in eligibility.
• Integrated health plans for AHCCCS members.
• Payments to providers participating in the Targeted Investments Program.
• AHCCCS Works Community Engagement Program.
• Waiver of Prior Quarter Coverage for specific populations.

In addition to renewing current waiver and expenditure authorities, AHCCCS is seeking to implement:

• 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, 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 federal financial participation 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.

Through November 2020, AHCCCS is accepting public comment on its proposed waiver renewal request. Submit comments via email to waiverpublicinput@azahcccs.gov.

The public is also invited to attend public forums to be held via webinar on:

• Oct. 14, 1:30-3:30 p.m.
• Oct. 16, 1:30-3:30 p.m.
• Oct. 19, 1:00-4:00 p.m.
• Nov. 13, 1:30-3:30 p.m.

Learn more on the 1115 Waiver Renewal Request web page.

Arizona’s existing Demonstration Waiver is currently approved through September 30, 2021, and the application is seeking a renewal period from October 1, 2021 through September 30, 2026.