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ARIZONA STATE SENATE

Fifty-Seventh Legislature, Second Regular Session

 

FACT SHEET FOR S.B. 1164

 

ALTCS; providers; change of ownership

Purpose

Outlines change of ownership procedures for licensed skilled nursing facilities and assisted living facilities to continue processing claims for services rendered to Arizona Long-Term Care System (ALTCS) members.

Background

ALTCS provides long-term care services to financially and medically eligible Arizona residents who have an age-related or physical disability, or both, and who require nursing facility level of care or have a developmental disability requiring skilled level of care. ALTCS manages and delivers hospitalization, medical care, institutional services and home and community-based services to eligible members, through the Arizona Health Care Cost Containment System (AHCCCS), program contractors and providers, together with federal participation under Title XIX of the Social Security Act. ALTCS services are provided through program contractors that receive capitation payments for each enrollee that they serve. ALTCS program contractors must provide certain services to ALTCS members who are determined to need institutional services, including: 1) nursing facility services, other than services in an institution for tuberculosis or mental disease; 2) behavioral health services that are not duplicative of prescribed long-term care services and that are authorized by the program contractor through the long-term care case management system; 3) hospice services; 4) case management services; 5) health and medical services covered by AHCCCS; and 6) dental services(A.R.S. §§ 36-2932 and 36-2939).

A claim for an authorized service submitted by a licensed skilled nursing facility, an assisted living ALTCS provider or a home and community-based ALTCS provider that renders care to ALTCS members must be adjudicated within 30 calendar days after receipt by the program contractor. Any clean claim for an authorized service provider to a member that is not paid within 30 calendar days after the claim is received accrues interest at the rate of one percent per month from the date the claim is submitted. The interest is prorated on a daily basis and must be paid by the program coordinator at the time the clean claim is submitted (A.R.S. § 36-2943).

There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

1.   Requires AHCCCS and its program contractors, when there is a change of ownership of a licensed skilled nursing facility or an assisted living facility, and upon the facility owner's request, to continue to process claims for services rendered to ALTCS members and make required payments under the previous owner's certification number and subcontractors until the owner's system enrollment and contracting process is completed.

2.   Makes technical changes.

3.   Becomes effective on the general effective date.

Prepared by Senate Research

February 2, 2026

JT/ci