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ARIZONA STATE SENATE
Fifty-Fourth Legislature, Second Regular Session
AHCCCS; dental services; Native Americans
Purpose
Adds, to the lists of services covered by the Arizona Health Care Cost Containment System (AHCCCS) and the Arizona Long Term Care System (ALTCS), adult dental services received at an Indian Health Service (IHS) facility or a tribal facility that meet outlined criteria.
Background
AHCCCS,
Arizona's Medicaid Program, contracts with health professionals to provide
medically necessary health and medical services to eligible members. Currently,
AHCCCS contractors are required to provide: 1) inpatient hospital services; 2)
outpatient health services;
3) laboratory and X-ray services; 4) prescription medications; 5) medical
supplies, durable medical equipment, insulin pumps and prosthetic devices; 6)
treatment of medical conditions of the eye;
7) early and periodic heath screening and diagnostic services; 8) family
planning services;
9) podiatry services; 10) nonexperimental transplants; 11) up to $1,000
annually for emergency dental care and extractions per adult member; 12)
ambulance and nonambulance transportation; 13) hospice care; and 14) orthotics
(A.R.S.
§ 36-2907).
AHCCCS offers long-term care services for persons who are elderly or disabled through ALTCS. ALTCS provides acute care services, behavioral health services, institutional services, home and community-based services and case management services. ALTCS contractors are required to provide dental services in an annual amount up to $1,000 per ALTCS-eligible member (A.R.S. § 36-2939).
The IHS is an agency
within the U.S. Department of Health and Human Services (U.S. HHS) that is
responsible for providing federal health services to American Indians and
Alaska Natives. The IHS is divided into 12 physical areas of the United States:
1) Alaska; 2) Albuquerque; 3) Bemidji; 4) Billings; 5) California; 6) Great
Plains; 7) Nashville; 8) Navajo; 9) Oklahoma;
10) Phoenix; 11) Portland; and 12) Tucson. Each area has a unique group of
Tribes that they work with on a day-to-day basis (IHS).
The Secretary of the U.S. HHS annually publishes the Federal Medical Assistance Percentages (FMAPs), which are used to determine the amount of federal matching funds for state expenditures for assistance payments for certain social services and state medical insurance expenditures. The Secretary of the U.S. HHS additionally prescribes an FMAP specifically for IHS facilities and tribal facilities. The U.S. Social Security Act specifies that services provided to Medicaid-eligible patients at IHS facilities and tribal facilities can be reimbursed at 100 percent of the FMAP (42 U.S.C. § 1905).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires, upon approval by the Centers of Medicare and Medicaid Services, AHCCCS contractors and ALTCS contractors to provide members with adult dental services, if the services are:
a) received at IHS facilities or tribal facilities;
b) eligible for 100 percent FMAP reimbursement; and
c) in excess of the annual $1,000 limit.
2. Directs AHCCCS to seek federal authorization to reimburse IHS facilities and tribal facilities to cover the costs of the adult dental services.
3. Makes technical changes.
4. Becomes effective on the general effective date.
House Action
HHS 1/23/20 DP 9-0-0-0
3rd Read 2/17/20 60-0-0
Prepared by Senate Research
March 3, 2020
CRS/AB/kja