Results of AHCCCS Provider Rate Analysis

Results of AHCCCS Provider Rate Analysis

The Legislature enacted Laws 2015, Chapter 14 (SB 1475) on March 12, 2015, which authorized AHCCCS to reduce rates for providers up to 5% in aggregate for dates of service October 1, 2015 through September 30, 2016. In this process, the Legislature also authorized the agency to account for changes in utilization that were less than the amounts appropriated, as long as the fiscal impact of final decisions on provider rates did not exceed the amount appropriated for capitation rates for fiscal year 2015-2016.

On April 1, the agency opened up a public comment period seeking feedback on the impact a potential 5% rate reduction could have on providers. The agency reviewed comments submitted from 145 different providers and associations representing thousands of providers statewide. Based on the data and information provided through these public comments, along with lower than forecasted utilization and other available funding, AHCCCS has, working with the Governor’s Office, determined that no provider rate reductions are required at this time. The agency will continue to monitor access to care, as well as state budgetary issues and utilization trends. The agency appreciates the time and effort taken by the many providers and organizations that submitted comments. These comments were critical to informing the agency’s final decision.

http://www.azahcccs.gov/AHCCCSProviderRateAnalysis.aspx