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ARIZONA HOUSE OF REPRESENTATIVES57th Legislature, 2nd Regular Session |
Senate: HHS DP 4-2-1-0 | Third Read 16-11-3-0 |
SB 1171: AHCCCS; dual enrollment; notice
Sponsor: Senator Werner, LD 4
Committee on Health & Human Services
Overview
Requires the Arizona Health Care Cost Containment System (AHCCCS), subject to the availability of data and federal approval, to perform a monthly review to verify that individuals enrolled in a health plan offered through the Federally Facilitated Exchange (FFE) under the Patient Protection and Affordable Care Act (ACA) are not simultaneously enrolled in AHCCCS, and to notify any individuals identified as enrolled in both programs of the possible risks, consequences and liabilities of dual enrollment.
History
Established in 1981, AHCCCS is Arizona's Medicaid program that oversees contracted health plans for the delivery of health care to individuals and families who qualify for Medicaid and other medical assistance programs. Through contracted health plans across the state, AHCCCS delivers health care to qualifying individuals including low-income adults, their children or people with certain disabilities. Members must meet certain financial and nonfinancial requirements to be eligible for AHCCCS (A.R.S. § 36-2901).
The ACA, enacted as part of the Health Care and Education Reconciliation Act of 2010, created the FFE, which allows eligible individuals to purchase private health insurance with federal subsidies. To qualify, individuals must have household incomes between 100% and 400% of the federal poverty level (FPL). In states that chose to implement it, the ACA also expanded Medicaid eligibility to include adults with incomes up to 138% of the FPL (A.R.S. § 1-271; U.S. HHS).
The Public Assistance Reporting Information System (PARIS) is a federal–state partnership administered by the Administration for Children and Families within the U.S. Department of Health and Human Services. It operates as a data-matching system that compares public assistance records across states to determine whether individuals are receiving benefits in more than one state, helping to detect improper payments and reduce fraud and abuse (PARIS).
Provisions
1. Requires AHCCCS to conduct monthly reviews to ensure that persons who are enrolled in a health insurance plan that is sold on the FFE under the ACA are not also enrolled in AHCCCS. (Sec. 1)
2. Specifies that the monthly review is contingent on the availability of PARIS data and approval by the Centers for Medicare and Medicaid Services. (Sec. 1)
3. Requires AHCCCS to notify persons who are found to be enrolled in in both programs of information regarding the potential risks, consequences and liabilities associated with simultaneous enrollment in AHCCCS and a health insurance plan that is sold on the FFE under the ACA. (Sec. 1)
4. Defines Affordable Care Act. (Sec. 1)
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8. Initials AG/LK SB 1171
9. 3/3/2026 Page 0 Health & Human Services
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