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ARIZONA STATE SENATE
Fifty-Fourth Legislature, First Regular Session
AHCCCS; dental services; native Americans
Purpose
Requires the Arizona Health Care Cost Containment System (AHCCCS) to seek federal authorization to reimburse the Indian health services (IHS) and tribal facilities to cover the cost of adult dental services.
Background
AHCCCS,
Arizona's Medicaid Program, contracts with health professionals to provide
medically-necessary health and medical services to eligible members. Currently,
AHCCCS contractors are required to provide: 1) inpatient hospital services; 2)
outpatient health services;
3) laboratory and X-ray services; 4) prescription medications; 5) medical
supplies, durable medical equipment, insulin pumps and prosthetic devices; 6)
treatment of medical conditions of the eye;
7) early and periodic heath screening and diagnostic services; 8) family
planning services;
9) podiatry services; 10) nonexperimental transplants; 11) up to $1,000
annually for emergency dental care and extractions per adult member; 12)
ambulance and nonambulance transportation; 13) hospice care; and 14) orthotics
(A.R.S.
§ 36-2907).
AHCCCS offers long-term care services for persons who are elderly or disabled through the Arizona Long-term Care System (ALTCS). The ALTCS program provides acute care services, behavioral health services, institutional services, home and community-based services and case management services. ALTCS program contractors are required to provide dental services in an annual amount up to $1,000 per ALTCS-eligible member (A.R.S. § 36-2939).
The Federal Medical Assistance Percentages (FMAPs) are published annually by the U.S. Secretary of Health and Human Services (U.S. Secretary of HHS) and used to determine the amount of federal matching funds for state expenditures for assistance payments for certain social services and state medical insurance expenditures. The U.S. Secretary of HHS additionally prescribes an FMAP specifically for IHS and tribal facilities. The U.S. Social Security Act specifies that services provided to Medicaid-eligible patients at IHS and tribal facilities can be reimbursed at 100 percent of the FMAP (42 U.S.C. § 1905).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires AHCCCS to seek federal authorization to reimburse the IHS and tribal facilities to cover the cost of adult dental services that are:
a) eligible for 100 percent FMAP;
b) in excess of the limits on covered services; and
c) received through the IHS and tribal facilities.
2. Becomes effective on the general effective date.
Prepared by Senate Research
February 18, 2019
CRS/AB/kja