 |
ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
health care institutions; licensing; complaints
Purpose
Requires the Department of Health Services (DHS) and the Arizona Health Care Cost Containment System (AHCCCS) to coordinate to review each agency's monitoring and compliance functions to identify areas of overlap related to health care institution licensing standards.
Background
DHS is the
agency responsible for licensing and oversight of all health care institutions
in Arizona, including enforcing statutes, rules and regulations governing
health care institutions. DHS may review and approve plans and specifications,
access books and records and conduct inspections and investigations to
determine compliance with licensing standards. DHS may also develop facility manuals
and guides to health care institutions and the general public (A.R.S.
§ 36-406).
AHCCCS serves as Arizona's Medicaid agency which offers qualifying Arizona residents access to healthcare programs. AHCCCS contracts with health professionals to provide medically necessary health and medical services to eligible members and may establish eligibility and enrollment processes and implement systems related to fraud prevention, quality assurance and contractor compliance (A.R.S. § 36-2903).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires DHS to license and monitor the operation of health care institutions to ensure compliance with applicable statutes.
2. Requires DHS and AHCCCS to coordinate to review each agency's monitoring and compliance functions to identify areas of overlap related to health care institution licensing standards.
3. Requires the review, at a minimum, to include:
a) licensing, certification and enrollment requirements;
b) on-site surveys, inspections, audits and other compliance activities;
c) data collection and reporting requirements; and
d) corrective action and enforcement processes relating to health care institutions.
4. Instructs DHS and AHCCCS to:
a) identify opportunities to eliminate or reduce duplicative, redundant or inconsistent requirements while maintaining patient safety and appropriate regulatory oversight; and
b) coordinate or align policies, procedures and operational practices to minimize administrative burdens on health care institutions.
5. Specifies that the review requirement does not require any action inconsistent with federal Medicaid conditions of participation, conditions of payment or other applicable federal requirements.
a) summarizes the findings of the review;
b) identifies areas of duplication or overlap; and
c) includes recommendations for statutory, regulatory or administrative changes.
7. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Requires DHS and AHCCCS to coordinate to review each agency's monitoring and compliance functions to identify areas of overlap related to health care institution licensing standards and outlines review requirements.
2. Requires DHS, by December 31, 2026, and October 31 every four years thereafter, to submit a written report to the Health and Humans Services Committees of the Senate and House of Representatives, or their successor committees, that:
a) summarizes the findings of the review;
b) identifies areas of duplication or overlap; and
c) includes recommendations for statutory, regulatory or administrative changes.
3. Removes DHS's ability to conduct an off-site preliminary review of a complaint to determine whether an on-site inspection is necessary.
4. Removes the requirement that DHS close a complaint without further investigation when:
a) the licensee has implemented systems reducing the likelihood of violations and provided sufficient evidence of compliance; or
b) the complaint is received more than 12 months after the incident that triggered the complaint.
Senate Action
HHS 2/4/26 DPA 6-0-1
Prepared by Senate Research
February 5, 2026
MM/hk