Bill
Number: S.B. 1475
Biggs
Floor Amendment
Reference
to: printed bill
Amendment
drafted by: Leg Council
FLOOR
AMENDMENT EXPLANATION
Allows
political subdivisions of this state, tribal governments and any university
under the jurisdiction of the Arizona Board of Regents (ABOR), subject to the
approval of the Centers for Medicare and Medicaid Services(CMS), to provide to
Arizona Health Cost Containment System (AHCCCS) monies in addition to any state
General Fund (GF) monies appropriated for critical access hospitals in order to
qualify for additional federal monies, and stipulates that any amount of
federal monies received shall be distributed as supplemental payments to
critical access hospitals, and provides AHCCCS spending authority to distribute
those monies that are received for FY 2016.
Removes
the restriction stating that disproportionate share hospital payments
attributed to the Maricopa County Special Health Care District may not exceed
$105,945,500 for Fiscal Year 2015, and specifies that if the certification is
provided for an amount greater than $105,945,500, AHCCCS is required to
distribute a specified amount to the Maricopa County Special Health Care
District and a specified amount of the federal funds participation in the state
GF. Allows AHCCCS to make additional disproportionate share hospital payments
to the Maricopa County Special Health Care District.
Stipulates
after disproportionate share payments for FY 2015 and FY 2016 are made to the
Maricopa County Special Health Care District, the Arizona State Hospital and
private qualifying disproportionate share hospitals, the allocation of
disproportionate share hospital payments designated by a political subdivision,
tribal governments and universities must be made available first to qualifying
private hospitals located outside the Phoenix metropolitan statistical area and
the Tucson metropolitan statistical area before being made available to
qualifying hospitals within the Phoenix Metropolitan Statistical Area and the
Tucson Metropolitan Statistical Area.
Specifies
that if the certification relating to disproportionate share funds for FY 2015
and FY 2016 is provided for an amount greater than a specified amount, AHCCCS
is required to distribute a specified amount to the Maricopa County Special
Health Care District and a specified amount of the federal funds participation
in the state GF. Allows AHCCCS to make additional disproportionate share
hospital payments to the Maricopa County Special Health Care District.
Clarifies
that the AHCCCS provider rate cuts are an aggregate rate cut of five percent.
Stipulates the administration may reduce provider payments by less than five
percent if adjustments made to capitation rates for changes in utilization are
less than the amount appropriated in the general appropriations act to AHCCCS
only, instead of to AHCCCS and the Department of Health Services. Grants the
Department of Health Services similar authority as AHCCCS to reduce provider
rates up to an aggregate of five percent for all health care providers with
similar exceptions. Allows the Department of Health Services to reduce provider
payments by less than five percent if outlined conditions are met.
Removes
the provision stating that for FY 2015-2016 AHCCCS capitation rate increases
may not exceed three percent; and stipulates the Department of Health Services
capitation rate increases may not exceed one and one-half percent in FY
2016-2017 and FY 2017-2018.
Makes
technical and conforming changes.
Page 15, line 34, after the period strike remainder of line
Strike lines 35 through 44
Page 16, between lines 21 and 22, insert:
"U. Subject
to the approval of the centers for medicare and medicaid services, political
subdivisions of this state, tribal governments and any university under the
jurisdiction of the Arizona board of regents may provide to the Arizona health
care cost containment system administration monies in addition to any state
general fund monies appropriated for critical access hospitals in order to
qualify for additional federal monies. Any amount of federal monies received
by this state pursuant to this subsection shall be distributed as supplemental
payments to critical access hospitals."
Reletter to conform
Page 17, line 10, before "Disproportionate" insert
"A."
Line 37, after the period strike remainder of line
Strike lines 38 and 39, insert "If the certification provided is for an amount greater than
$105,945,500, the administration shall distribute $4,202,300 to the Maricopa
county special health care district and shall deposit $68,328,000 of the
federal funds participation in the state general fund. The administration may
make additional disproportionate share hospital payments to the Maricopa county
special health care district pursuant to section 36‑2903.01, subsection
P, Arizona Revised Statutes, and subsection B of this section."
Page 18, between lines 19 and
20, insert:
"B. After the distributions made pursuant to subsection A
of this section, the allocations of disproportionate share hospital payments
made pursuant to section 36‑2903.01, subsection P, Arizona Revised
Statutes, shall be made available first to qualifying private hospitals located
outside of the Phoenix metropolitan statistical area and the Tucson
metropolitan statistical area before being made available to qualifying
hospitals within the Phoenix metropolitan statistical area and the Tucson
metropolitan statistical area."
Page 20, line 31, before "Disproportionate" insert
"A."
Page 21, line 12, after the period strike remainder of line
Strike lines 13 and 14, insert "If the certification
provided is for an amount greater than $113,818,500, the administration shall
distribute $4,202,300 to the Maricopa county special health care district and
shall deposit $74,241,400 of the federal funds participation in the state
general fund. The administration may make additional disproportionate share
hospital payments to the Maricopa county special health care district pursuant
to section 36‑2903.01, subsection P, Arizona Revised Statutes, and
subsection B of this section."
Between lines 39 and 40, insert:
"B. After the distributions made pursuant to
subsection A of this section, the allocations of disproportionate share
hospital payments made pursuant to section 36‑2903.01, subsection P,
Arizona Revised Statutes,
shall be made available first to qualifying private hospitals located outside
of the Phoenix metropolitan statistical area and the Tucson metropolitan statistical
area before being made available to qualifying hospitals within the Phoenix
metropolitan statistical area and the Tucson metropolitan statistical area."
Page 24, line 38, after "to" insert "an
aggregate of"
Page 25, line 1, strike
"and the department of health services"
Between lines 6 and 7, insert:
"Sec. 17. Department of health services; health care provider rate
reduction
A. Notwithstanding any other law, for rates effective October
1, 2015 through September 30, 2016, the department of health services may
reduce payments up to an aggregate of five percent for all health care
providers, excluding nursing facility, developmental disability and home and
community based health care providers.
B. The department of health services may reduce provider
payments by less than the percentage specified under subsection A of this
section if adjustments to capitation rates for changes in utilization for the
period October 1, 2015 through September 30, 2016 are less than the amounts
appropriated in the general appropriation act to the department of health
services for a three percent capitation rate increase in fiscal year 2015‑2016.
The fiscal impact of reducing provider payments by less than the percentage
specified under subsection A of this section may not exceed the amount by which
the appropriation for capitation rates in fiscal year 2015‑2016 exceeds
utilization adjustments.
Sec. 18. AHCCCS; voluntary critical access hospital payments;
appropriation; fiscal year 2015‑2016; notification
Any monies received for critical access hospital payments from
political subdivisions of this state, tribal governments and any university
under the jurisdiction of the Arizona board of regents, and any federal monies
used to match those payments, that are received in fiscal year 2015‑2016
by the Arizona health care cost containment system administration are
appropriated to the administration in fiscal year 2015‑2016. Before the
expenditure of these monies, the administration shall notify the joint
legislative budget committee and the governor's office of strategic planning
and budgeting of the amount of monies that will be expended under this
section."
Renumber to conform
Page 27, line 5, after the second period insert "AHCCCS;"
Line 7, after "exceed" strike remainder of line
Line 8, strike "2015‑2016 and"
Between lines 9 and 10, insert:
"Sec. 27. Department of health services; capitation rate increases
The department of health services capitation rate increases may
not exceed one and one‑half percent in fiscal years 2016‑2017 and
2017‑2018."
Renumber to conform
Amend title to conform