ARIZONA HOUSE OF REPRESENTATIVES

57th Legislature, 2nd Regular Session

Majority Research Staff

Senate: HHS DP 6-1-0-0 | Third Read 27-1-2-0

SB 1399: prepaid capitated contractors; cost reports

Sponsor: Senator Shamp, LD 29

Committee on Health & Human Services

Overview

Requires the Arizona Health Care Cost Containment System (AHCCCS), by December 1 annually, to report aggregated data for all nongovernment entities with prepaid capitated AHCCCS contracts showing the percentage of funds spent in the previous contract year on provider payments for services and administrative expenses, by category, to specified state officials and legislative committees.

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. AHCCCS pays contractors a fixed per-member, per-month payment to provide covered services. Contractors are then responsible for managing the delivery and cost of care within those payments. 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; 36-2904; 36-2907).

Provisions

1. Requires AHCCCS, annually on December 1, to submit a report, aggregated for all nongovernment entities with prepaid capitated AHCCCS contracts, showing the percentage of monies spent in the previous contract year on direct payments to providers for services and on administrative costs, by category, to:

a. the Joint Legislative Budget Committee;

b. the Governor;

c. the President of the Senate;

d. the Speaker of the House of Representatives; and

e. the members of the Senate and House of Representatives Health and Human Services Committees, or their successor committees. (Sec. 1)

2. Specifies the report include the percentage of monies spent on administrative costs for each of the following:

a. health care quality improvement administrative activities;

b. program integrity, including fraud, waste and abuse prevention expenses;

c. taxes, licenses and regulatory fees;

d. community reinvestment; and

e. all other administrative activities. (Sec. 1)

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i. Initials AG SB 1399

j. 3/5/2026 Page 0 Health & Human Services

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