Bill > HB4145

This bill makes changes to Arizona's health care system, primarily focusing on eligibility verification and presumptive eligibility for the Arizona Health Care Cost Containment System (AHCCCS) for the fiscal year 2026-2027. * The Arizona Health Care Cost Containment System (AHCCCS) Administration is mandated to implement stricter data matching and eligibility redetermination processes. This includes agreements with the Department of Revenue to identify lottery or gambling winnings and with the Department of Health Services for death records. Able-bodied adults will have their eligibility redetermined quarterly using data from the Department of Revenue and the Department of Economic Security. Self-attestation of eligibility factors will generally not be accepted without independent verification. * AHCCCS will seek approval from the Centers for Medicare and Medicaid Services to limit presumptive eligibility to children and pregnant women, and to eliminate mandatory hospital presumptive eligibility. Qualified hospitals will have new notification and application assistance requirements when making presumptive eligibility determinations, with escalating penalties for repeated violations, including mandatory training and potential loss of qualification to make such determinations. * County contributions for the Arizona Long-Term Care System (ALTCS) for fiscal year 2026-2027 are specified, totaling over $500 million across all counties, with Maricopa and Pima counties contributing the largest amounts. * Disproportionate share payments for fiscal year 2026-2027 are allocated, with $28,474,900 for the Arizona State Hospital and $884,800 for private qualifying disproportionate share hospitals, subject to specific criteria. * County contributions for acute care hospitalization and medical care for fiscal year 2026-2027 are outlined, totaling approximately $47 million across all counties. * For the health insurance benefit plan year 2027, state employee health insurance premiums will increase by 10%, with a further 5% increase intended for plan years 2028 and 2029. * AHCCCS is required to report on the costs and utilization of mental health medications for contract year 2024-2025 by January 31, 2027. * County contributions for administrative costs related to certain AHCCCS programs and for competency restoration services are excluded from county expenditure limitations. * AHCCCS is permitted to continue its risk contingency rate setting and administrative funding levels for managed care organizations for the contract year beginning October 1, 2026, and ending September 30, 2027.

Budget and Finance

https://apps.azleg.gov/BillStatus/BillOverview/85715