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ARIZONA STATE SENATE
Fifty-Fifth Legislature, First Regular Session
AHCCCS; graduate medical education; reimbursement
Purpose
Directs the Arizona Health Care Cost Containment System (AHCCCS) to establish separate graduate medical education (GME) programs to reimburse qualified community health centers and rural health clinics. Specifies payment methodologies and reimbursement requirements.
Background
GME
is a program, including an approved fellowship, that prepares physicians for
the independent practice of medicine by providing clinical education in a
medical discipline to medical students who have completed a recognized
undergraduate medical education program. AHCCCS established the GME Program in
1997 to reimburse hospitals that have GME programs for operational costs, such
as compensation and benefits for residents and supervising faculty, as well as
administrative and facility management costs associated with GME programs
(A.R.S.
§§ 36-2901
and 36-2903.01).
The Rural Health Clinic Service Act of 1977 addressed an inadequate supply of physicians serving Medicare beneficiaries in rural areas. According to the U.S. Centers for Medicare and Medicaid Services (CMS), Medicare pays rural health clinics an all-inclusive rate for medically necessary, face-to-face primary health services and qualified preventive health services furnished by practitioners (CMS).
Qualifying community health centers are community-based primary care facilities that provide medical care in medically underserved areas or to medically underserved populations as designated by the U.S. Department of Health and Human Services (A.R.S. § 36-2907.06).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires AHCCCS, beginning March 1, 2022, and subject to CMS approval, to establish a separate GME program to reimburse qualifying community health centers and rural health clinics with approved primary care GME programs.
2. Requires AHCCCS to:
a) distribute any monies appropriated for GME to qualifying community health centers and rural health clinics for direct and indirect costs approved by AHCCCS; and
b) adopt rules specifying the formula by which the monies are distributed.
3. Requires each primary care GME program that receives monies to identify and report to AHCCCS the number of:
a) new residency positions created with appropriated monies, including positions in rural areas; and
b) funded residency positions that resulted in physicians locating their practices in Arizona.
4. Directs AHCCCS to coordinate with local, county and tribal governments and any university under Arizona Board of Regents jurisdiction that provide additional GME monies to qualify for additional federal matching monies for programs or positions in a specific locality.
5. Allows AHCCCS to:
a) limit payments to providers designated by the funding entity;
b) base payments on appropriate methodology; and
c) replace payments that might have otherwise been paid if monies had been available.
6. Specifies that GME programs, positions and payments must be approved by CMS.
7. Requires AHCCCS, by July 1 of each year, to report:
a) to the Joint Legislative Budget Committee (JLBC) on the number of new residency positions reported by each primary care GME program; and
b) to the President of the Senate, the Speaker of the House of Representatives and the JLBC Director on:
i. the amount of money contributed;
ii. the number of residency positions funded by local, county and tribal governments and universities; and
iii. the amount of federally matching monies used.
8. Makes a conforming change.
9. Becomes effective on the general effective date.
House Action
HHS 2/1/21 DPA 9-0-0-0
3rd Read 2/15/21 54-6-0
Prepared by Senate Research
March 1, 2021
CRS/JP/kja