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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AHCCCS; waivers; American Indians; services
Purpose
Requires the Director of the Arizona Health Care Cost Containment System
(AHCCCS) to annually apply for a federal waiver to authorize Medicaid payments
for certain services provided to American Indian and Alaska Native (AI/AN)
members through Indian Health Service (IHS) facilities or other facilities
operated by tribes or tribal organizations under the Indian
Self-Determination and Education Assistance Act (638 facilities) that were
eliminated or reduced during or after September 2010.
Background
AI/AN members enrolled in AHCCCS may choose to receive covered health care services from facilities operated by the Indian Health Service (IHS), tribal 638 facilities or other contracted AHCCCS providers. Under the Indian Self-Determination and Education Assistance Act, tribes and tribal organizations may operate federal programs, including health services, through contractual agreements with the federal government (Public Law 93-638).
Section 1115 of the federal Social Security Act authorizes the U.S. Secretary of Health and Human Services to approve experimental, pilot or demonstration projects that are deemed likely to promote the objectives of the Medicaid program. Section 1115 waivers provide states additional flexibility in designing and improving their Medicaid program by allowing states to test new approaches to better serve Medicaid populations that would otherwise not be permitted under federal law and require approval by the U.S. Centers for Medicare and Medicaid Services (CMS) (CMS).
The Joint Legislative Budget Committee estimates that H.B. 2177 would have no fiscal impact to the state General Fund (JLBC Fiscal Note).
Provisions
1. Requires the Director of AHCCCS, by March 30 of each year, to apply to CMS for waivers or amendments to the state's current Section 1115 waiver to authorize payments for covered services provided to AI/AN members through participating IHS or 638 facilities that were eliminated from, reduced or limited in the state plan during or after September 2010, including medically necessary diagnostic, therapeutic and preventative dental services.
2. Requires the Director of AHCCCS to only apply for waivers or amendments to the state's current Section 1115 waiver that have not been approved and are not in effect.
3. Requires AHCCCS, upon CMS approval, to make payments for covered services provided to AI/AN members through participating IHS or 638 facilities that were eliminated from, reduced or limited in the state plan during or after September 2010, including medically necessary diagnostic, therapeutic and preventative dental services.
4. Makes technical and conforming changes.
5. Becomes effective on the general effective date.
House Action
HHS 1/22/26 DPA 12-0-0-0
3rd Read 2/24/26 46-10-4
Prepared by Senate Research
March 5, 2026
AN/TR/ci