 |
ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
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
2. Requires the current owner or new owner to provide written notice to AHCCCS at least 60 days before an anticipated change of ownership and respond to all provider enrollment requests within 10 business days.
3. Makes technical changes.
4. Becomes effective on the general effective date.
Amendments Adopted by the House of Representatives
1. Specifies that the change of ownership procedures apply to a licensed skilled nursing facility or an assisted living facility that is not in suspension, termination or payment hold and has an active provider enrollment with AHCCCS.
2. Clarifies that the continued payments in accordance with the change of ownership procedures are made under the previous owner's AHCCCS number, rather than certification number, until the new owner's system enrollment and contracting process is complete.
Senate Action House Action
RAGE 2/4/26 DP 6-0-1 HHS 3/16/26 DPA 11-0-0-1
3rd Read 3/3/26 24-6-0 3rd Read 4/16/26 50-0-10
Prepared by Senate Research
April 16, 2026
JT/ci