ARIZONA
HOUSE OF REPRESENTATIVES
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HB 2659: health; budget reconciliation; 2018-2019. |
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PRIME SPONSOR: Representative Mesnard (with permission of committee on Rules), LD 17 BILL STATUS: Caucus & COW |
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Relating to Health and the FY
2019 state budget.
Provisions
Arizona Department of Health Services (ADHS)
1. Requires ADHS to deposit the first $300,000 of all radiation related fees for licensure and certification collected each FY into the GF.
a. Directs ADHS to deposit 90% of remaining monies into the Health Services Licensing Fund and 10% into the GF. (Sec. 1)
2. Repeals the Radiation Regulatory Fee Fund and the State Radiologic Technologist Fund.
a. Directs all unencumbered and unexpended monies from both funds to be deposited into the Health Services Licensing Fund. (Sec. 2, 4)
3. Asserts that ADHS must deposit all radiation related fees as outlined in statute. (Sec. 3)
4. Permits the Director of ADHS to raise fees in FY 2019 for services provided by the Bureau of Radiation Control.
a. States that it is the intent of the Legislature that increased fees do not exceed $561,000.
b. Directs fees to be deposited into the Health Services Licensing Fund.
c. Provides a rulemaking exemption until July 1, 2019. (Sec. 19)
5. Allows ADHS to use the FY 2019 appropriation from the Disease Control Research Fund for AIDS reporting and surveillance. (Sec. 20)
6. Permits ADHS to use the FY 2019 appropriation from the Health Research Fund for Alzheimer's disease research. (Sec. 22)
Arizona Health Care Cost Containment System (AHCCCS)
7. Stipulates that the reimbursement level for behavioral health services provided at an inpatient facility after July 1, 2018 is capped at the fee-for-service schedule adopted by AHCCCS, multiplied by 90%, unless the recognized inpatient facility and a contractor or RBHA enter into a contract. (Sec. 6)
a. Contains a retroactive date of July 1, 2018. (Sec. 25)
8. Repeals statute relating to the Hospital Loan Program. (Sec. 7)
9. Requires AHCCCS to transfer to the counties the portion necessary to comply with the Patient Protection and Affordable Care Act regarding the counties' proportional share of the state's contributions by December 31, 2019. (Sec. 12)
10. Permits AHCCCS to continue the risk contingency rate setting for all managed care organizations at funding levels imposed in 2010 for the contract year beginning October 1, 2018 and ending September 30, 2019. (Sec. 15)
11. Allows AHCCCS to participate in any Special Disability Workload 1115 Demonstration Waiver offered by CMS and specifies that any credits must be used in the FY when those credits are made available to fund the state share of any medical assistance expenditures that qualify for federal financial participation.
a. Requires AHCCCS to report the receipt of any credits to JLBC by December 31, 2018 and June 30, 2019. (Sec. 16)
12. Requires AHCCCS to submit a report to the Director of JLBC by January 2, 2019 on the availability of inpatient psychiatric treatment for adults, children and adolescents who receive services from RBHAs, which must include:
a. The number of available inpatient beds and the occupancy rates for those beds;
b. Expenditures on inpatient psychiatric treatment;
c. The total number of individuals who are sent out of state for inpatient psychiatric care; and
d. The prevalence of psychiatric boarding or the holding of psychiatric patients in emergency rooms for at least 24 hours before transferring the patient to a psychiatric facility. (Sec. 18)
13. States that it is the intent of the legislature that AHCCCS implement a program within the available appropriation relating to Proposition 204. (Sec. 24)
ADHS and AHCCCS
14. Requires the Directors of ADHS and AHCCCS to submit a joint report on hospital charge master transparency to the Governor, Legislature and Secretary of State by January 2, 2018. (Sec. 17)
15. Requires the joint report to include:
a. A summary of the current charge master reporting process;
b. A summary of hospital billed charges compared to costs;
c. Examples of how charge masters or hospital prices are reported and used in other states; and
d. Recommendations to improve use of hospital charge master information, including reporting and oversight changes. (Sec. 17)
16. Requires AHCCCS and ADHS to jointly report to JLBC how federal grant monies to combat the opioid epidemic will supplement monies appropriated to AHCCCS during the opioid special session. (Sec. 23)
Counties
17. Sets the annual county ALTCS contributions for FY 2019 at $268,554,800.
a. Specifies individual county contributions and requires contributions to be deposited into the ALTCS Fund. (Sec. 9)
18. States that if the overall cost for ALTCS exceeds the amount specified in the FY 2019 General Appropriations Act, the State Treasurer must collect the difference between outlined county contributions and the counties' share of the state's actual contribution. (Sec. 9)
19. Requires the counties' share of the state's contributions to comply with federal maintenance of effort requirements. (Sec. 9)
20. Requires the Director of AHCCCS to notify the State Treasurer of the counties' share of the state's contribution and report the amount to JLBC. (Sec. 9)
21. Specifies that the State Treasurer must withhold an amount necessary to fulfill a county's requirement as outlined.
a. Prohibits the state treasurer from withholding distributions from HURF. (Sec. 9)
22. Continues to require a city, town or county to reimburse ADHS for 100% of the costs of inpatient competency restoration treatment.
a. Excludes the county contributions from the county expenditure limitation.
b. Requires monies to be deposited into the ASH Fund. (Sec. 10)
23. Requires each city, town or county to make reimbursements to ADHS within 30 days of a request. (Sec. 10)
24. Stipulates that if a city, town or county fails to reimburse ADHS, the superintendent of ASH must notify the state treasurer and that county's reimbursement amount will be withheld from any TPT that is to be distributed to the county. (Sec. 10)
25. Permits a county to use any source of revenue designated by the county in order meet any statutory funding requirements for ALTCS and ASH Fund payments. (Sec. 10)
26. Sets the annual county acute-care contributions at $46,512,900 for FY 2019 and states it is the intent of the Legislature that Maricopa's County contribution be reduced in each subsequent year according to the changes in the GDP price deflator.
a. Outlines each county's contribution amount.
b. Requires the state treasurer to recover the cost of any funding that was not provided by a county from other funds owed to that county, excluding HURF.
c. Specifies payment processes and requirements. (Sec. 13)
27. Continues to exclude Proposition 204 administration costs from the county expenditure limitations. (Sec. 14)
Hospitals Disproportionate Share (DSH) Payments
28. Sets the annual DSH Payment amount for the District in FY 2019 in the amount of $113,818,500.
a. Requires the District to provide a certified public expense form for the amount of qualifying DSH expenditures made to AHCCCS by May 1, 2019 for all state plan years as required by the AHCCCS Section 1115 waiver.
b. States that if the certification is equal to or less than $113,818,500, and AHCCCS determines the revised amount is correct, they must:
i. Notify the Governor and Legislature; and
ii. Distribute $4,202,300 to the District and deposit the federal financial participation balance in the GF.
c. Stipulates that if the certification is for an amount less than $113,818,500 and AHCCCS determines the revised amount is not correct, they must:
i. Notify the Governor and Legislature; and
ii. Deposit the total amount of the federal financial participation in the GF.
d. States that if the certification is for an amount greater than $108,874,800, AHCCCS must distribute $4,202,300 to the District and deposit $75,254,400 of the federal financial participation in the GF.
e. Permits AHCCCS to make additional DSH payments to the District pursuant to statute. (Sec. 11)
29. Sets the annual DSH Payment amount for ASH in FY 2019 in the amount of $28,474,900.
a. Requires ASH to provide a certified public expense form for the amount of qualifying DSH expenditures made on behalf of the state to AHCCCS by March 31, 2019.
b. Requires AHCCCS to assist ASH in determining the amount of qualifying DSH expenditures.
c. Requires AHCCCS to distribute the entire amount of federal financial participation to the GF.
d. Stipulates that if the certification is less than $28,474,900, AHCCCS must:
i. Notify the Governor and Legislature; and
ii. Distribute the entire amount of federal financial participation in the GF.
e. States that the certified public expense form must contain the total amount of qualifying DSH expenditures and the amount limited by federal law. (Sec. 11)
30. Sets the annual DSH Payment amount for private qualifying DSH hospitals in FY 2019 in the amount of $884,800.
a. Requires AHCCCS to make payments to hospitals consistent with the specified appropriation and the terms of the Section 1115 waiver.
b. Specifies that DSH payments are limited to:
i. Qualifying DSH hospitals as defined by federal law; and
ii. Hospitals which contain at least 300 beds and are in Yuma County. (Sec. 11)
31. States that after DSH distributions are made, allocations of DSH payments must be made first to qualifying private hospitals located outside of the Phoenix and Tucson statistical metropolitan areas and then to qualifying hospitals within those areas. (Sec. 11)
Miscellaneous
32. Permits Health Services Lottery Fund monies to be used for the purposes specified in the General Appropriations Act. (Sec. 21)
33. Makes technical and conforming changes. (Sec. 1, 5, 8)
Additional information
Laws 2017, Chapter 313 transferred ARRA's authority, powers, duties and responsibilities to ADHS.
Laws 2018, Chapter 234 conformed statute to reflect ARRA's consolidation within ADHS.
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Fifty-third Legislature HB 2659
Second Regular Session Version 2: Caucus & COW
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